I think one crucial way to defend the child without laying a burden on the most vulnerable mothers is to train doctors, nurses, etc. to not see poor women's children as a burden! So much medical care for pregnant women below a certain income/education level presumes that the child is unwanted, unplanned, or will face difficulties that mean they should never come into existence at all. While obviously there are real material difficulties that women need help overcoming, and I don't want to diminish those, I also wonder what would happen if the unborn child of a poor woman was treated with the same anticipation and joy by medical professionals as the unborn child of a woman who can afford to get treated in the fancy clinics. I'm expecting my first child and all my care providers thus far have assumed that this child was loved, wanted and planned because I am a well-educated, well-dressed young white woman with a steady income. (The joke's kind of on them: while this child is very loved and wanted, it was also very much not planned - but no one assumes that if you look and talk a certain way.) Nobody's tried to talk me out of having this baby or suggested that I should get on birth control when I tell them I'm not using contraception. This is very much not the experience of many women being treated in free clinics. But just because you might experience a financial burden because of your child doesn't necessarily mean you aren't just as excited to have that baby! Imagine if we assumed that all women experience a similar mix of joy, trepidation and excitement when they conceive a child, and celebrated with them as much as we say "that must be tough for you". While we work to lift the economic and social burdens that exist for vulnerable women, we also need to work to change our attitude towards children conceived in these situations, otherwise we send mixed messages about the value of their lives.
The Jeremiah Program: they work closely with single teen moms and their children to break the cycle of poverty using a 2-Gen approach. https://jeremiahprogram.org/
I'm a big fan of in home parent education as an early intervention. Here's one group that implements that well for teen moms - https://myhealthmn.org/becoming-program/
I'm also a big fan of the holistic policies in Scandinavian states, like the Finnish baby box, free healthcare and a strong social safety net including childcare and leave policies. The Finnish Baby Box is a particularly great story: https://www.bbc.com/news/magazine-22751415
One thing to keep in mind when looking at the disproportionate impact of pro-life laws on marginalized women is their implementation - and that they don't ban abortion, they ban legal abortion. One study on the impact of implementation of pro-life laws was done in Ethiopia, where they repealed some abortion restrictions in an attempt to decrease maternal mortality: https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-019-0396-4
One thing I love about the Finnish baby box is that it emphasizes that babies really only need a few basics! While there are some helpful baby/mom gadgets out there, there's also a huge push to buy a ton of baby stuff that isn't necessary which makes the perceived cost of having a baby seem higher than it has to be. Women facing an unexpected pregnancy and also living in an area with a higher abortion rate may be less likely to know people who will drop off bags of gently used baby things, which makes the work of crisis pregnancy centers all the more important.
Agreed! And I also love that *all* parents get it so there's no stigma associated with getting the box. It builds community and says simply 'we welcome babies!'. I'm also all for the community stepping up until we get family friendly policies. I'm part of a wonderful thriving facebook group for parents here in MN that is 2/3 kids clothing and baby gear swap and 1/3 food pantry. The idea is that everyone can pass along what they can and everyone asks for what they need (mutual aid - not charity).
I like several of the examples you've raised, although I would caution against over-applying the Ethiopian example. In most developing countries, abortion complications are the lowest percentage cause of maternal death, and they overlap with the largest causes (sepsis and hemorrhage)--which those countries already struggle to handle.
I like the Baby Box a lot. I was interested to hear from a group of women from Scandinavia at a conference, though, share that they felt the generous leave policies came with an edge--you get a lot of time off, but then you *must* go back to work, and the child is essentially in state care from toddlerhood. So I would like to make sure that any recommendations we come up with respect and enable families to decide whether they want both parents working or one, support wage policies that make that possible, and help women (or stay at home dads) re-enter the workforce whenever they want to.
Agreed on the recommendations! I wonder how much social pressure played into that perception that the Scandinavian parents must go back to work? Guaranteed housing & healthcare plus free college go a long way in making budgets on one income work. For Ethiopia, check out this great comprehensive study - abortion came in as the consistent #2 reason for maternal mortality: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4071-8
It's hard to say, but it was interesting. They also have some very strongly anti home schooling policies, so it may be less directly coercive, but with a perception of coercion based on some of those troubling cases.
Here's a source on abortion as a proportion of maternal mortality. Now, this study, more recent than the previous one I'd seen has abortion as second lowest named cause in sub-Saharan Africa, but I note that they are defining abortion as induced abortion, miscarriage, and ectopic pregnancy (which I consider a bit shifty). I also haven't seen embolism listed as a major cause in WHO fact sheets. https://www.thelancet.com/action/showPdf?pii=S2214-109X%2814%2970227-X
Apart from making sure women aren't criminalized, which will help them not be afraid of getting help if they do suffer complications, I'm not sold that legalization is necessary for reducing maternal deaths or deaths due to abortion. The main abortion complications are sepsis and hemorrhage--which are also major MM causes. If a healthcare system can't handle that with childbirth, legalizing abortion won't make it safe. But strengthening a healthcare system to manage those complications improves all women's likelihood of surviving (whether childbirth, miscarriage, or abortion)--and something developed countries all did before legalizing abortion. The political commitment to invest in key interventions makes a huge difference, and that should definitely also be a priority.
It sounds like you support a pretty extensive social protection system. I want all those things (healthcare, education, etc.), to be accessible to people, but I'm not convinced government-based provisions are the best answer. So that's probably an area of significant divergence in method, despite a common goal.
Definitely all for strengthening the healthcare system, and starting from common goals of universal healthcare and education goes a long way! Honestly, while I am in favor of single payer etc., I see the issue as being so urgent that compromise in order to get coverage to everyone as quickly as possible is, I think, a moral necessity. Same (but of course, different) when it comes to quality education. I wish we had more forums to have policy debates actually about what is the best tactic to get something done, rather than 'should we try to make this happen at all'!
On abortion, I think the main case for legalization is threefold: 1) women will always get abortions, legal or not, 2) creating an illegal abortion market is dangerous for women's health and for women's safety, 3) when healthcare workers have to be law-interpreters it interferes with their ability to provide care to their client (the first Ethiopia study I posted included this burden in their qualitative analysis).
I don't know if anyone has mentioned the organization New Wave Feminists, but its lead organizer, Destiny Herndon works for the elimination of the need for abortion. Laws and support systems that make it possible for women to have their children. They are a small organization but they have touched a nerve and garnered a lot of support.
I both agree with and diverge from the points about narrowing access for poor women. My divergence is the criticism of the undue burden laws and cases. I get the idea, but we're throttled to a certain extent by the jurisprudence. Georgia and Alabama knew the laws would get knocked down immediately (so one could also ask, why not go for broke?). Texas and Louisiana didn't; once their laws were challenged, they defended on the applicable legal standard. And I think we shouldn't hide that obviously a lot of pro-lifers hoped the laws would reduce abortion, but there is a genuine concern for women's wellbeing, too, because have been enough cases to raise concern that the politicized nature of it makes it hard to hold bad practitioners accountable (see, e.g., Will Saletan's interesting series in Slate from a decade ago). (I also should admit to a grudging respect for one TX abortion clinic which proactively updated their facilities to meet ASC standards to be able to continue providing abortions. I wish they were committed to something else, but it's clearly a commitment to provide something they think is important for women.)
Where I agree is that the wealthy are always going to have more options, and the poor are always going to have more difficulty dealing with the same challenge.. so we should very much focus on supporting the marginalized and lessening that gap. A related but somewhat separate example I see with the PP clinics vs. federally qualified health centers. It's very easy to say, "There are more FQHCs and they treat more people and provide more services!" but that doesn't mean they can just absorb all of PP's clients (they're also often stretched thin), and it certainly doesn't resolve things like how underserved certain rural and urban areas and populations are in terms of medical care. I think we should be working on that gap--and that also can help connect poor women who find themselves in an unexpected and challenging pregnancy with additional resources and support (public and private).
One answer I think is beyond the abortion issue altogether. How might we encourage poor women to work towards more effective family formation so that they don't have to become single pregnant women more likely to seek abortions?
I think this question is sort of a red herring, honestly. Indiana's law also lays a "disproportionate burdern" on poorer mothers, because richer mothers can more easily travel to Illinois or Ohio or wherever to get eugenic abortions. Closing clinics isn't any different in that respect; it just prevents more abortions (right?) and therefore "burdens" more women. (Being dishonest in order to close clinics is wicked, and it may be bad politics, but that's a separate question.)
I think one crucial way to defend the child without laying a burden on the most vulnerable mothers is to train doctors, nurses, etc. to not see poor women's children as a burden! So much medical care for pregnant women below a certain income/education level presumes that the child is unwanted, unplanned, or will face difficulties that mean they should never come into existence at all. While obviously there are real material difficulties that women need help overcoming, and I don't want to diminish those, I also wonder what would happen if the unborn child of a poor woman was treated with the same anticipation and joy by medical professionals as the unborn child of a woman who can afford to get treated in the fancy clinics. I'm expecting my first child and all my care providers thus far have assumed that this child was loved, wanted and planned because I am a well-educated, well-dressed young white woman with a steady income. (The joke's kind of on them: while this child is very loved and wanted, it was also very much not planned - but no one assumes that if you look and talk a certain way.) Nobody's tried to talk me out of having this baby or suggested that I should get on birth control when I tell them I'm not using contraception. This is very much not the experience of many women being treated in free clinics. But just because you might experience a financial burden because of your child doesn't necessarily mean you aren't just as excited to have that baby! Imagine if we assumed that all women experience a similar mix of joy, trepidation and excitement when they conceive a child, and celebrated with them as much as we say "that must be tough for you". While we work to lift the economic and social burdens that exist for vulnerable women, we also need to work to change our attitude towards children conceived in these situations, otherwise we send mixed messages about the value of their lives.
I love this question: "How do we defend the child without laying a disproportionate burden on the most vulnerable mothers?"
I think the answer is in work that surrounds every mother with supportive care, material/financial resources and community support.
Here are some awesome policies and orgs that advocate for all families, although none identify as pro-life:
The Two Gen approach: The idea is that you work closely with parents and children together - not only one or the other. https://www.nga.org/center/issues/two-generation-approaches-to-serving-low-income-families/ (here's MN: https://mn.gov/dhs/2-generation/)
The Jeremiah Program: they work closely with single teen moms and their children to break the cycle of poverty using a 2-Gen approach. https://jeremiahprogram.org/
I'm a big fan of in home parent education as an early intervention. Here's one group that implements that well for teen moms - https://myhealthmn.org/becoming-program/
I'm also a big fan of the holistic policies in Scandinavian states, like the Finnish baby box, free healthcare and a strong social safety net including childcare and leave policies. The Finnish Baby Box is a particularly great story: https://www.bbc.com/news/magazine-22751415
One thing to keep in mind when looking at the disproportionate impact of pro-life laws on marginalized women is their implementation - and that they don't ban abortion, they ban legal abortion. One study on the impact of implementation of pro-life laws was done in Ethiopia, where they repealed some abortion restrictions in an attempt to decrease maternal mortality: https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-019-0396-4
One thing I love about the Finnish baby box is that it emphasizes that babies really only need a few basics! While there are some helpful baby/mom gadgets out there, there's also a huge push to buy a ton of baby stuff that isn't necessary which makes the perceived cost of having a baby seem higher than it has to be. Women facing an unexpected pregnancy and also living in an area with a higher abortion rate may be less likely to know people who will drop off bags of gently used baby things, which makes the work of crisis pregnancy centers all the more important.
Agreed! And I also love that *all* parents get it so there's no stigma associated with getting the box. It builds community and says simply 'we welcome babies!'. I'm also all for the community stepping up until we get family friendly policies. I'm part of a wonderful thriving facebook group for parents here in MN that is 2/3 kids clothing and baby gear swap and 1/3 food pantry. The idea is that everyone can pass along what they can and everyone asks for what they need (mutual aid - not charity).
I like several of the examples you've raised, although I would caution against over-applying the Ethiopian example. In most developing countries, abortion complications are the lowest percentage cause of maternal death, and they overlap with the largest causes (sepsis and hemorrhage)--which those countries already struggle to handle.
I like the Baby Box a lot. I was interested to hear from a group of women from Scandinavia at a conference, though, share that they felt the generous leave policies came with an edge--you get a lot of time off, but then you *must* go back to work, and the child is essentially in state care from toddlerhood. So I would like to make sure that any recommendations we come up with respect and enable families to decide whether they want both parents working or one, support wage policies that make that possible, and help women (or stay at home dads) re-enter the workforce whenever they want to.
Agreed on the recommendations! I wonder how much social pressure played into that perception that the Scandinavian parents must go back to work? Guaranteed housing & healthcare plus free college go a long way in making budgets on one income work. For Ethiopia, check out this great comprehensive study - abortion came in as the consistent #2 reason for maternal mortality: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4071-8
It's hard to say, but it was interesting. They also have some very strongly anti home schooling policies, so it may be less directly coercive, but with a perception of coercion based on some of those troubling cases.
Here's a source on abortion as a proportion of maternal mortality. Now, this study, more recent than the previous one I'd seen has abortion as second lowest named cause in sub-Saharan Africa, but I note that they are defining abortion as induced abortion, miscarriage, and ectopic pregnancy (which I consider a bit shifty). I also haven't seen embolism listed as a major cause in WHO fact sheets. https://www.thelancet.com/action/showPdf?pii=S2214-109X%2814%2970227-X
Apart from making sure women aren't criminalized, which will help them not be afraid of getting help if they do suffer complications, I'm not sold that legalization is necessary for reducing maternal deaths or deaths due to abortion. The main abortion complications are sepsis and hemorrhage--which are also major MM causes. If a healthcare system can't handle that with childbirth, legalizing abortion won't make it safe. But strengthening a healthcare system to manage those complications improves all women's likelihood of surviving (whether childbirth, miscarriage, or abortion)--and something developed countries all did before legalizing abortion. The political commitment to invest in key interventions makes a huge difference, and that should definitely also be a priority.
It sounds like you support a pretty extensive social protection system. I want all those things (healthcare, education, etc.), to be accessible to people, but I'm not convinced government-based provisions are the best answer. So that's probably an area of significant divergence in method, despite a common goal.
Definitely all for strengthening the healthcare system, and starting from common goals of universal healthcare and education goes a long way! Honestly, while I am in favor of single payer etc., I see the issue as being so urgent that compromise in order to get coverage to everyone as quickly as possible is, I think, a moral necessity. Same (but of course, different) when it comes to quality education. I wish we had more forums to have policy debates actually about what is the best tactic to get something done, rather than 'should we try to make this happen at all'!
On abortion, I think the main case for legalization is threefold: 1) women will always get abortions, legal or not, 2) creating an illegal abortion market is dangerous for women's health and for women's safety, 3) when healthcare workers have to be law-interpreters it interferes with their ability to provide care to their client (the first Ethiopia study I posted included this burden in their qualitative analysis).
I don't know if anyone has mentioned the organization New Wave Feminists, but its lead organizer, Destiny Herndon works for the elimination of the need for abortion. Laws and support systems that make it possible for women to have their children. They are a small organization but they have touched a nerve and garnered a lot of support.
Huge fan of NWF!
I both agree with and diverge from the points about narrowing access for poor women. My divergence is the criticism of the undue burden laws and cases. I get the idea, but we're throttled to a certain extent by the jurisprudence. Georgia and Alabama knew the laws would get knocked down immediately (so one could also ask, why not go for broke?). Texas and Louisiana didn't; once their laws were challenged, they defended on the applicable legal standard. And I think we shouldn't hide that obviously a lot of pro-lifers hoped the laws would reduce abortion, but there is a genuine concern for women's wellbeing, too, because have been enough cases to raise concern that the politicized nature of it makes it hard to hold bad practitioners accountable (see, e.g., Will Saletan's interesting series in Slate from a decade ago). (I also should admit to a grudging respect for one TX abortion clinic which proactively updated their facilities to meet ASC standards to be able to continue providing abortions. I wish they were committed to something else, but it's clearly a commitment to provide something they think is important for women.)
Where I agree is that the wealthy are always going to have more options, and the poor are always going to have more difficulty dealing with the same challenge.. so we should very much focus on supporting the marginalized and lessening that gap. A related but somewhat separate example I see with the PP clinics vs. federally qualified health centers. It's very easy to say, "There are more FQHCs and they treat more people and provide more services!" but that doesn't mean they can just absorb all of PP's clients (they're also often stretched thin), and it certainly doesn't resolve things like how underserved certain rural and urban areas and populations are in terms of medical care. I think we should be working on that gap--and that also can help connect poor women who find themselves in an unexpected and challenging pregnancy with additional resources and support (public and private).
One answer I think is beyond the abortion issue altogether. How might we encourage poor women to work towards more effective family formation so that they don't have to become single pregnant women more likely to seek abortions?
I think this question is sort of a red herring, honestly. Indiana's law also lays a "disproportionate burdern" on poorer mothers, because richer mothers can more easily travel to Illinois or Ohio or wherever to get eugenic abortions. Closing clinics isn't any different in that respect; it just prevents more abortions (right?) and therefore "burdens" more women. (Being dishonest in order to close clinics is wicked, and it may be bad politics, but that's a separate question.)