The federal government is fundamentally changing how it funds teen pregnancy prevention, pivoting from evidence-based programs that have dramatically reduced teen births to an approach focused on fertility awareness and reproductive goals counseling. Beginning this summer, the administration will steer millions of dollars toward organizations emphasizing anatomy, fertility tracking, hormonal production, and abstinence from sex, marking a significant departure from decades of bipartisan support for comprehensive sex education.

What Is Restorative Reproductive Medicine and Why Does It Matter?

The new funding approach aligns with an ideology called restorative reproductive medicine (RRM), which has gained traction among conservative groups and Make America Healthy Again initiatives. RRM discourages all forms of contraception and instead focuses on fertility awareness methods, typically in the context of couples trying to conceive without medical intervention like in vitro fertilization.

Under this approach, people track indicators such as cervical mucus, body temperature, and other physical symptoms to monitor the menstrual cycle rather than using birth control. The new grant requirements mandate that female modules include instruction about the menstrual cycle and recognize ovulation as the "central event and primary indicator of hormonal health and fertility." They must also compare the advantages and disadvantages of "ovarian suppression" (a term referring to how many birth control methods work by temporarily suppressing ovulation) compared to approaches that address "root causes".

How Does This Compare to What Actually Works?

The contrast between the new approach and proven results is stark. Congress created the Teen Pregnancy Prevention Program in 2010, and it has been renewed on a bipartisan basis for 16 years, including in the 2026 budget bill. During that time, teen birth rates declined by approximately 72%, according to federal Centers for Disease Control and Prevention data. Much of the overall national birth rate decline stems from this sharp drop in teen births.

Experts attribute this success to more comprehensive sex education, better access to contraception for girls, and general behavioral trends around sex. However, academic studies have repeatedly shown that abstinence-only approaches result in higher rates of teen pregnancy and births, even after adjusting for other socioeconomic factors.

The new funding opportunity requires applicants to pass an "alignment review" with agency priorities conducted by political appointees, a new process the U.S. Office of Management and Budget is implementing across federal financial assistance. Most of the grants that were canceled this year were programs implementing methods proven effective in reducing teen pregnancy, while others were research-based programs testing and refining additional strategies in states such as Louisiana, Texas, and Washington.

What Are Experts Saying About Body Literacy and Reproductive Health?

Reproductive health professionals are divided on the implications of the new language. While some support teaching young people about their bodies, concerns center on how that information is interpreted and applied.

"I genuinely don't know what body literacy means to the folks who wrote these proposals, other than based on everything else we know, there is an assumption that if people knew more about their bodies, they would choose not to use, for example, hormonal birth control," said Joely Pritzker, senior director of healthcare for Power to Decide.

Joely Pritzker, Senior Director of Healthcare, Power to Decide

Pritzker, a family nurse practitioner with more than 20 years of experience, emphasized that this assumption is false. Not wanting to use hormonal birth control is different from discouraging its use entirely, she noted.

The American College of Obstetricians and Gynecologists has issued a warning against relying on restorative reproductive medicine in fertility discussions, saying it can be "ineffective and redundant" and unnecessarily delay patients from seeking medical treatment when presented as the sole or best approach.

How Should Young People Learn About Reproductive Health?

Experts agree that comprehensive reproductive health education should include multiple perspectives and options:

• Full Options Awareness: Patients should understand all available reproductive health options, including fertility awareness methods, contraception, and medical treatments, along with the advantages and disadvantages of each.
• Evidence-Based Programming: Funding should prioritize programs that have been rigorously evaluated and shown to reduce teen pregnancy, rather than approaches with limited evidence of effectiveness.
• Body Literacy with Context: Teaching young people about anatomy and reproductive health is valuable, but should not be framed in ways that discourage access to proven contraceptive methods.
• Medical Professional Input: Healthcare providers trained in comprehensive reproductive medicine should guide discussions about fertility, contraception, and reproductive goals based on individual circumstances and preferences.

Amy Friedrich-Karnik, director of federal policy at the Guttmacher Institute, a reproductive rights-focused organization, acknowledged that fertility awareness-based methods should be explained to patients and that people should understand these options. However, she stressed that patients also need to be aware of all available options and the pros and cons of each.

The shift in federal funding represents a significant departure from the Teen Pregnancy Prevention Program's original intent, which was to fund "medically accurate and age-appropriate programs that reduce teen pregnancy" and continue programs shown to be most effective through rigorous academic evaluation. As these changes take effect, reproductive health advocates and medical professionals will be watching closely to see whether the new approach maintains the dramatic progress in reducing teen pregnancy that the nation has achieved over the past 16 years.