Almost unnoticed in the wars over the federal budget has been a pitched battle over funding for Planned Parenthood, which provides contraception, medical services and abortions at 800 clinics around the country.

For the last several weeks, those on opposite sides of a sharp cultural divide have engaged in dueling rallies, virtual conferences, online petitions and phone banks as crucial congressional votes drew near. At stake is more than $75 million that Planned Parenthood receives to provide family planning to low-income women, money that its opponents say only frees up funds for abortions.

Now, in a surprise step that has set off deep alarm among advocates for women’s health, the newly conservative House of Representatives has proposed cutting the entire $317 million program of aid for family planning, known as Title X, in its 2011 budget resolution, which is expected to pass by the weekend. A proposed amendment to the budget bill would also bar Planned Parenthood from receiving any federal funds for any purpose.

The fight will shift to the Senate, where the Democrats retain a small majority. It is unlikely they will agree to cut all funding for Planned Parenthood, let alone the broader federal aid for contraception that serves 5 million low-income women, said Susan Cohen, director of governmental affairs for the Guttmacher Institute, a research organization. But more legislation in the House aimed at Planned Parenthood is in the offing, putting the organization in its most precarious political spot in decades.

Planned Parenthood’s role as a major abortion provider has long provoked fierce opposition, but this month its opponents broadened their attacks, seeking to discredit the organization by linking it to the sexual exploitation of minors. A group called Live Action, which has repeatedly taken aim at Planned Parenthood and receives support from conservative foundations, released undercover videotapes in which clinic employees are seen answering questions from a man posing as a sex trafficker. Planned Parenthood says the tapes are misleading, that an errant staff member was fired and that its affiliates reported the encounters to law enforcement.

Seizing on those videotapes, Rep. Mike Pence of Indiana, a Republican and longtime foe of abortion and the chief sponsor of a House bill to cut off funding for Planned Parenthood, said that the organization had "a pattern of apparent fraud and abuse" and that "the time has come to deny any federal funding to Planned Parenthood."

In an e-mailed Valentine’s Day appeal, Cecile Richards, president of Planned Parenthood, described the House budget and Pence’s proposals as "the most dangerous legislative assault on women’s health in Planned Parenthood’s 95-year history."

With a total budget of some $1.1 billion, more than a third of which comes from the federal, state and local governments, Planned Parenthood offers family planning, HIV counseling, treatment for sexually transmitted diseases, cancer screening and other services as well as abortions, mainly to low-income women. Congress has long barred the use of federal money for abortion, but it provides more than $75 million a year to Planned Parenthood affiliates to support family planning for low-income women. Millions more in federal dollars are provided for sex education and, indirectly, through Medicaid and other programs.

Planned Parenthood and its supporters are working to bolster defenses in the Senate. They hope that the Title X program — including a share for their group — will be restored as the two sides of Congress compromise on a spending bill. But supporters like Rep. Diana DeGette, D-Colo., and a leader of the abortion rights caucus, fear that protection of family planning could "get lost in the larger issue of the budget."

In the covert videos that were widely released on the Internet, clinic employees answer questions from a man, posing as a sex trafficker, about obtaining care for underage prostitutes. A coalition including the Family Research Council, the Susan B. Anthony List, Concerned Women for America and others created a website called "Expose Planned Parenthood" that has used Internet press conferences, appeals to sympathetic pastors, vigils and floods of phone calls to ratchet up the pressure on Congress.

Planned Parenthood has worked to respond in kind. In what Stuart Schear, vice president of the Planned Parenthood Federation of America, called "most intense short-term campaign we have ever run," the group has prompted tens of thousands of its supporters to call or e-mail Congress and organized petitions and rallies. One hundred members of Congress signed a letter attacking Pence’s proposals as harmful.

Planned Parenthood calls the videotapes "misleading" and "dirty tricks," taking advantage of its culture of confidentiality. Yet the organization said it would immediately retrain all employees on requirements for reporting any threats to minors.

"These charges make me so angry," said Judy Tabar, president of Planned Parenthood of Southern New England, which runs 19 clinics in Connecticut and Rhode Island, offering 70,000 patients birth control, cancer screening and other medical services and, for fewer than 10 percent of visits, abortions.

"What we do every day is prevent more unintended pregnancies than anyone else in the country," she said in an interview at her office in New Haven. "We have a huge impact on the lives of women and families."

Anti-abortion protesters have gathered outside the clinic a few times a week since the 1980s. A police raid on this clinic when it first opened in 1961, for violating a Connecticut law that barred distribution of contraceptives even to married couples, led to a landmark Supreme Court case declaring such laws an unconstitutional violation of privacy. Tabar said many critics mischaracterized Planned Parenthood’s activities, which overwhelmingly involve family planning and preventive medicine. While clinics must obey local laws and use common sense when they suspect the abuse of minors, she said, they try to preserve a nonjudgmental atmosphere. "People tend to come to us at a very vulnerable time," she said, in turmoil over new relationships, possible pregnancies or fears of disease.

Those opposed to Planned Parenthood and the broader family planning program, its supporters say, have not offered realistic alternatives for poor women.

For every dollar spent on contraception for low-income women, the government saves four dollars in medical costs within the next year by averting unwanted pregnancies, said Cohen of the Guttmacher Institute.

In an e-mailed response, Lila Rose, the president of Live Action, did not say how Planned Parenthood’s birth control services could be replaced but wrote: "The answer for poor women is not a corporation that is happy to help sex traffickers and that has enabled the sexual abuse and exploitation of countless girls and young women."

© 2011 The New York Times Company