Your Answers on Regressive Abortion Policy
Your Answers on Regressive Abortion Policy
How do you navigate laws that defend the vulnerable, but affect rich and poor differently?
I felt nervous sending out the first Hard Questions email last week, especially as a missive early in this newsletter’s life, before I’ve gotten to know more of you and you’ve gotten to know me.
I asked you about how you think about abortion restrictions that are, in practice, restrictions only for poor women, and you responded thoughtfully, including when you disagreed strongly with me.
Your answers also helped inform my comments when I was part of a discussion on the future of the pro-life movement hosted by the Pelican newsletter.
I’ve assembled a selection of your responses below, and you’re always welcome to email me nominations for future Hard Questions.
Kathryn suggested one pro-life endeavor that would particularly support poorer women: education for doctors. I’m excerpting her comment below:
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.)
I’m reminded of the Maryland IUD push, where doctors asked women if they were planning to get pregnant in the next five years, and, if they said no, the doctor recommended an IUD.
Not planning to get pregnant isn’t the same as urgently avoiding pregnancy (cycle tracking apps are full of people “trying to whatever” rather than to avoid or conceive). But these doctors took sterility as the default state, whereas children needed to be actively sought.
MG highlighted the 2Gen approach, where “you work closely with parents and children together—not only one or the other.” She offered several examples of groups taking this approach—none of which identify their work as pro-life, but all of which refuse to see people as isolated individuals.
Several of you brought up the Finnish baby boxes—all parents receive a baby box full of supplies, and the box itself doubles as an early bassinet. I like this approach, which pledges help to parents from the beginning, and, by being offered to everybody, treats all babies with equal dignity.
A number of you pushed back against some of my assumptions. Several people pointed out accurately that all laws meant to discourage a certain action fall more heavily upon the poor. It’s much easier for richer people to travel, move, or hire someone to find them an exception to the rules.
And Alex pointed out on twitter that there’s something specifically strange about being worried about disproportionately preventing the poor from accessing something bad. Does it really count as burdening someone to hold them back from an evil? We had a fruitful exchange that I’ve excerpted below:
Alex: It just feels very hard to start with the idea that abortion restrictions are good, and conclude that (for example) they would be more good if they bound less tightly on marginalized women.
Leah: Part of what puts me off is that poor folks are often treated with contempt, even when a nudge is intended well. I’m against tight restrictions on what food stamps can buy. The stakes for abortion are much higher than buying soda, but the idea that a legal bar exists only for people without work flexibility or a car, feels like it conveys that contempt, as well as the care for babies.
Alex: It's an interesting and difficult question. My feeling (after admittedly only some thought) is that the strategy "pair restrictions with more financial support" is the only satisfactory answer you can come to. Which is unfortunate because that strategy has credibility problems.
Credibility problems seems to go to the heart of it. Readers recommended several organizations that are passionately pro-life, and connect that work to other work for the vulnerable. Your suggestions included:
American Solidarity Party (I am on the board of advisors for the ASP)
I’d love to profile some of these organizations or their leaders in future issues, and I’d always appreciate your recommendations. Thank you for all of your responses.
Sincerely,
Leah
Maryland, my (current) state! Maryland's IUD/LARC push (assuming we are referring to the same thing) is particularly troubling because of the way it was carried out - but is also a good cautionary tale. Maryland's LARC push was part of an HHS grant program that funds home visitors to low income/vulnerable women during the prenatal and postpartum period. TL;DR lengthening interbirth intervals was one of the grants' goals and states had to choose their own metric. Maryland was the only state to choose LARC usage as their metric - some states measured the use of contraception generally, others measured whether or not women gave birth within a certain interval after their previous birth (usually ~12 months), and some states (such as Connecticut) chose to measure whether women were provided information about the risks of short interbirth interval. Personally, that last one is my preferred approach. What particularly concerned me about MD's program was that 1) it was targeted towards low income women, often on Medicaid 2) LARCs generally require medical assistance to discontinue 3) home visitors were advocating for these devices in mothers' homes - a particularly vulnerable area. (end tl;dr) I've done some data deep dives on this grant program more broadly and it's quite interesting - for example, HHS wants programs to be evidence-based, and privileges grant money going towards interventions that have been studied, but the most effective programs tend to be ones where the home visitor is a nurse Paraprofessional home visitors were no more effective than the control group in many studies, but many states turn to them because they are more cost effective. I imagine there are all sorts of difficulties with doing reliable studies in this area, but that facet stood out to me. I have links and articles buried on my hard drive if anyone wants to know about their state program and chosen metrics.