The Trump team is quietly eliminating U.S. support for birth control abroad

Prossy Muyingo spent a dozen years as a health worker in central Uganda. She's been at the forefront of providing information and services for reproductive, maternal and child health. U.S. aid cuts eliminated her salary. Edward Echwalu for NPR hide caption toggle caption Edward Echwalu for NPR "I'm on your veranda." That's the text Prossy Muyingo would get each night for years, sent by a 28-year-old standing outside her home in central Uganda. Immediately, Muyingo would pour a glass of water and, from the sideboard in her living room, fetch a birth control pill and bring it outside. As a community health worker, Prossy Muyingo kept birth control pills as well as HIV medication inside a box in her living room in the central Ugandan town of Mityana. Edward Echwalu for NPR hide caption toggle caption Edward Echwalu for NPR "She was swallowing [the pill] from my house," explains Muyingo, who served as a community health worker in Mityana District for 12 years. The woman had told Muyingo that she feared her husband would beat her if he knew about the birth control. "The man is ever asking for a child," the woman said to Muyingo. She already had three children and didn't want another one, at least not right now. So she used Muyingo's home as a place to store and take her pills. Muyingo has similar arrangements with many neighbors. Now all of that has changed. In September 2025, Muyingo lost her job. Her stipend had been paid for by U.S. foreign aid. Now, she says, instead of providing contraception, she's informally counseling neighbors through unintended pregnancies. A historic disruption Muyingo's story is part of what reproductive health experts are describing as the largest disruption ever to international family planning efforts. The second Trump administration has moved to eliminate programs for contraception and other family planning work abroad. Congress actually appropriated funds for this work, but the administration has not spent it. And it has shut down programs aimed at helping people choose when to have children, such as efforts to improve access to birth control and provide resources for treating sexually transmitted diseases. The issue here is not abortion. For more than 50 years, it's been illegal for foreign aid to fund abortions. Asked at a Congressional hearing about appropriations for family planning in May 2025, Secretary of State Marco Rubio said: "There's no plan to spend that money. We're not going to be in that business globally. We're not going to do it." Besides this public statement, the change has happened without much fanfare. But the new approach becomes clear by looking at the Trump administration's budget documents and memos that show family planning has repeatedly been targeted for cuts. "Very disruptive, very significant" For well over a decade, the United States has been the top contributor to international family planning and reproductive health efforts, responsible for over 40% of donor funding worldwide to the tune of over $500 million. Indeed, family planning had been a priority since the U.S. Agency for International Development was first established in 1961. The U.S. support has changed millions of lives. The Guttmacher Institute — a nonprofit research organization that supports access to family planning — estimates U.S. funds gave over 47 million women and couples access to modern contraceptive care each year. That, in turn, prevented 17.1 million unintended pregnancies annually and saved 34,000 lives because women and girls did not die from complications during pregnancy or childbirth. It's been a bipartisan undertaking, supported during Republican and Democratic administrations. Now, with the sudden loss of programs, family planning work abroad is in jeopardy. The Women's Refugee Commission, a non-governmental organization, found that almost 95% of U.S. foreign aid for sexual reproductive health and family planning was cut in 2025. Another report, from late 202