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The other side of “reproductive choice” — the working poor

The other side of “reproductive choice” — the working poor

Last updated on: January 30, 2016 at 9:17 am by Jane the Actuary

The other side of “reproductive choice” — the working poor 2016-01-30T09:17:35-06:00 Jane the Actuary

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Getting tired of discussing abortion, so:

Earlier today, in reaction to a Chris Christie statement about Planned Parenthood funding at yesterday’s debate, Nick Kristof, the New York Times columnist, tweeted,

Attn: Chris Christie. One Planned Parenthood IUD costs $500. One Medicaid childbirth costs $14,000. You’re not saving government money.

Which reminded me of a post I had written back in April, which I’m going to revisit now. What follows is this old post, but with edits throughout to try to clean and tighten this up a bit, though I’m not going to edit every last reference to times and dates.

Everyone talks about contraception as a money-saver, as Kristof did above: cheaper than government-funded childbirth, cheaper than WIC, cheaper than food stamps and welfare and so on. But is this right? — and by “right” I mean (conveniently making use of its dual meaning) both “is this correct?” and “is this just?”

Consider this:

Here’s a quote from Our Kids by Robert Putnam which I offer to you, from page 205, describing a girl (contrary to stereotype, a white girl) who became ensnared in substance abuse, until pregnancy (and the attention shown her via a special high school intended to help mothers graduate) turned her to the straight-and-narrow, a straight A student headed for college.

“Pregnancy changed my life,” she says. “I wouldn’t even be going to college if it wasn’t for my son.”

And IUDs for teens and young women are again in the news, this time in The Economist. Back in October, there was another spate of stories, which I wrote about and linked to here — the bottom line being that a new generation of social planners were keen to aggressively push teens onto IUDs and implants, with the rationale that any potential side effects were better than pregnancy.

Also a week or so ago, an article called “When a Pregnancy is Planned but Not Planned” was making the rounds, describing the fact that, for many pregnant teens and young adults, there was an in-betweenness to the pregnancy, in which middle-class concepts of planned pregnancies or contraceptive failures just didn’t exist; there was much more of an indifference, and an acceptance of life happening.

One last link: my post from last summer on the official rationale for requiring insurers to cover all contraceptives. The stated objective of the mandate is to move women onto IUDs and other long-acting no-user-action-required contraceptives. And their further objective is to eliminate “unplanned pregnancy” as an unhealthy condition (that is, they’re careful to say that pregnancy itself is not a disease), because women who get pregnant without having first formed the intention to conceive first are less likely to get early prenatal care, more likely to continue smoking or drinking in the early months, more likely to give birth prematurely or to a low-birthweight baby, etc. — thought the studies they cite for these impacts didn’t necessarily seem to control for the fact that there are other, correlating factors which may be just as likely to explain the identified issues.

So this is what I’m thinking:

The whole issue of contraception and morality is one I don’t address terribly often. Aside from Catholic moral teaching, there’s the issue of consequences of making a daily dose of chemicals into a necessary part of women’s healthcare. And, even without addressing these issues, I am uncomfortable, to say the least, with the progressive social planners’ objective of making IUDs and similar contraceptives universal, given that it always seems to be accompanied by the approach that women and even teens (with no identified lower age limit that I could tell in my prior reading of articles and comments) should feel free to have as much sex as they want, whenever and with whom they want, as long as it’s consensual.

But let’s set these issues aside for the purpose of thinking about this. What if? What if the progressive social planners implement their vision?

What would happen — to the birth rate, to our society, to the women themselves — if teens and twenty-something women, and even older women who aren’t financially stable, are persuaded to use an IUD indefinitely?

In the ideal case, the girls and women, freed from the risk of pregnancy (or, in some cases, the near-certainty of it), would finish high school, go to college, and live the sort of perfectly middle-class life that the social planners themselves live, maybe choosing to get pregnant in their 30s, say. After all, they argue, they’re not trying to practice eugenics by reducing the number of births poor (black, Hispanic, or white) women have; they just want these women to wait until they’re established financially.

But I don’t think the young woman in Putnam’s story is all that unusual. From a distance, we see unplanned pregnancy and teen pregnancy as destroying a bright future, but “in the trenches” (from what I’ve read), poor teen and young mothers don’t always experience this. Instead, being a mother motivates many teen moms who, prior to getting pregnant, simply weren’t going anywhere anyway.

So what happens to the girls in these IUD-promoting studies? Do they in fact, freed from the need to care for an infant, meet the social planners’ expectations for them, go to college or learn a skilled trade? Or are they just as impoverished, just as stuck in low-wage jobs or trapped in substance abuse? (I googled IUD + longitudinal study, but no luck.) I don’t know, but consider this: poor men, even though they are generally not trapped by the need to care for a baby, are not doing particularly well either. The mere lack of a baby doesn’t guarantee you success in life. It is, after all, young black men in Chicago, not young black women, who have a 47% NEET-ism rate.

All of this is really in the manner of preliminary thoughts, because the the question I really want to get into is this: when are these women “allowed” to get their implants removed? No, I’m not envisioning a hypothetical when they are state-mandated, simply suggesting that in such a future, there would be situations in which it would and wouldn’t be socially acceptable. So let me rephrase this: when is the right time, if at all, for a poor woman to get her implant removed and have a child, or two, or however many she chooses? Social conservatives, of course, would much prefer that (even again, taking as a given the overall context, above) they find a husband first; progressives will say that poor men are generally unmarriageable anyway so you might as well be a single mom.

But are we confident that, freed from the burden of too-soon parenting, every young man and woman can indeed be expected to prepare themselves for, and land, and succeed at, the sort of job that does indeed support a family, or perhaps make their way there by means of promotions over time, from, say, line cook to shift manager? Remember, poor young men are already freed from direct childcare burdens and aren’t doing so hot.

But in that case, who will work the minimum wage/unskilled jobs? Oh, sure, eventually they’ll be replaced by robots, you say. But, even if so, what about now, not the future? Are the day-shift McDonald’s workers, and the personal aides for the elderly, and similar low-paid workers simply to be consigned to lifetime childlessness?

By the way, the answer is not: “we’ll import migrant workers.” Do they not deserve to have families?

Some on the left have an easy solution: raise the minimum wage to whatever is necessary to “support a family.” And, in whatever I’ve read, “support a family” is never defined, but always seems to be in the context of a single parent, though with some unspecified number of children. And if you look at living wage calculators that determine that such a parent needs an hourly wage in the high teens in order to truly be able to support herself and her family without welfare, you know that it’s simply impossible for us to fix a minimum wage at this level without tremendous levels of unemployment, just making the whole thing worse.

And in such a case, are we willing to say that, even without the excuse of an unplanned pregnancy, but instead as a general case, parents working at low-paying, even minimum wage jobs, should, as a routine matter, be given the necessary subsidies to fill in the gap between their earnings and their family’s financial needs? In that case, then, the IUDs may indeed help such women to space their children better, but don’t actually save money, not on healthcare spending, nor on general government welfare spending.

Or, in the end, is it indeed acceptable for poor women to have families, but do we believe, in the end, that those families are, as they stand, too large, and these women ought to have smaller families, that one kid is enough for them to have love and companionship, but that’s about enough? Hence, the “savings” comes about from smaller families, and lower, middle-class-level, fertility rates for the poor.

Thus, the other side of “reproductive choice” — is it right, moral, ethical, for poor/low-skilled people to choose to have families? And, if so, how should we structure our economy and our social welfare system as a response – without being so generous as to create dependency?

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