Gender

How Right-Wing Attacks on Reproductive Health Care Force Poor Women Into More Unwanted Pregnancies

A new study finds that right-wing attacks on family planning services are landing squarely on poor women and their families.

In denying undeniable human nature – that people will have sex, regardless of how much moralizing they're exposed to or whether or not they receive abstinence-only education or wear “chastity rings” – the Christian right, which claims that abortion is “murder,” is doing its part to bring the long decline in the number of abortions in this country to a halt. In fact, they've succeeded. After a quarter-century-long decline in abortions -- from 29.3 per 1,000 women in 1981 to under 20 per 1,000 in 2005 -- the rate began to tick up again in the latter years of the Bush administration.

A number of factors impact those numbers. One of them is the belief that by limiting women's access to contraceptives, they'll be less likely to have sex outside of marriage. Give a high-school girl access to a condom, and get a reckless slut; deny her that access and she'll be as chaste as Doris Day until her wedding night. It's self-evident nonsense that only leads to more unintended pregnancies.

A new study (PDF) by Lawrence Finer and Mia Zolna of the Guttmacher Institute tells the tale. It found that the rate of unintended pregnancies in the United States has remained relatively stable over the years – about 5 percent of women will have one each year. But those overall numbers obscure a dramatic story of racial and class division; while unintended pregnancies among women aged 15-44 whose incomes were at least double the poverty line declined by 29 percent between 1994 and 2006, among women struggling to get by beneath the poverty line they rose by 50 percent.

The sharp rise in unplanned pregnancies among low-income women – disproportionately women of color – leads to a higher rate of abortions; according to Guttmacher, 43 percent of unintended pregnancies are terminated. And with a threadbare social safety net providing scant support and the least-flexible workplaces on the planet, those who choose to bring a pregnancy to term often end up trapped in a grueling cycle of poverty. That's because of a sad truth in this country: women are punished economically for giving birth. And significantly so -- Jane Waldfogel of Columbia University found that a first child lowers a woman's earnings by 7.5 percent and a second child lowers her income by another 8 percent.

According to Guttmacher, “In contrast to the high rates among certain groups, some women in the United States are having considerable success timing and spacing their pregnancies.”

Higher-income women, white women, college graduates and married women have relatively low unintended pregnancy rates (as low as 17 per 1,000 among higher-income white women—one-third the national rate of 52 per 1,000), suggesting that women who have better access to reproductive health services, have achieved their educational goals or are in relationships that support a desired pregnancy are more likely than other women to achieve planned pregnancies and avoid those they do not want.

It also suggests that women who rely on publicly funded family planning services have seen a surge in unintended pregnancies while those more likely to have the means to buy contraceptives – or a high-quality health plan that pays for them – have had a different experience.

The study speaks to this point, noting that “family planning programs are under unprecedented attack.”

Some of these attacks appear purely ideological. For example, the House of Representatives earlier this year moved to strike all funding for Title X for the remainder of the current fiscal year... Although the Senate blocked that move, funds for the program were eventually cut by $17 million. Such cuts were disproportionately higher than those made to other programs, ultimately leaving Title X at 64% below what the program had been funded at in 1980, when inflation is taken into account...

Moreover, both in Congress and in the states, opponents of family planning are taking aim at the network of family planning providers. The funding bill approved initially by the House would have denied federal funding to Planned Parenthood affiliates, a move that ultimately was... blocked. Nonetheless, opponents of family planning have tried to emulate this approach on the state level, with efforts (some of which currently are being litigated) in five states...to either limit or deny funding to Planned Parenthood affiliates specifically or specialized family planning providers more generally.

Social conservatives have also championed “conscience clauses” allowing fundamentalist health-care providers to pick and choose which drugs and services they find sufficiently moral, and fight laws compelling insurers that cover other prescription drugs to pay for FDA-approved contraceptive drugs and devices. Again, more than four in 10 unintended pregnancies end in abortion, so whether or not they know it, the religious right is driving an increase in what they call “baby-killing.” It is simply an inescapable truth that denying women access to contraception doesn't make them forego sex. (Obviously, men share the responsibility for avoiding unplanned pregnancies. I refer to women here because the study, like most research into family planning issues, focuses on women.)

The assault on publicly funded family planning services may be part of the right's larger “war on women,” but it is often justified as a matter of mere fiscal austerity. This, too, is profoundly misguided. While 43 percent of unintended pregnancies result in abortions, 57 percent do not. Guttmacher found that of those births – 1.6 million per year -- “64% were paid for by Medicaid—and, to a much smaller extent, the Children’s Health Insurance Program (CHIP)—at an average cost of $11,700 per birth.” That adds up to about $11 billion per year on the public tab. In addition to driving up the abortion rate, one dollar spent on publicly funded family planning services saves four dollars in the cost of publicly subsidized births.

So if the religious right has its way in continuing to gut these safety net programs – and defund Planned Parenthood – it will drive up both the abortion rate and the costs of publicly funded health-care. Just as cutting spending in the midst of a recession increases the deficit, it's a policy that has the opposite effect than its proponents intended. It also provides yet more evidence that the anti-choice movement is less about “saving babies” from abortion than controlling women's sexuality.