Throughout our lives, we rely on different clues and impressions to help us determine what is right, and what is wrong.
These clues may be large or small, and take many forms; in select cases, they can even appear as financial figures. For while it may be impossible to put a price on human health and happiness, the cost of neglecting those things is becoming all too clear.
In the case of Americans’ reproductive health, such numbers clearly show that denying women contraceptives and wanted abortions has a substantial toll on their lives and livelihoods, their children and families, and society as a whole.
Evidence in favor of giving women full access to family planning is extensive and varied, with many pragmatic aspects, from the costs of Medicaid-paid births to combating environmental threats. However, according to those who have dedicated themselves to tracking the effects of reproductive policy, the most compelling data of all — gathered from patients and families across the country — suggest that if we truly mean to value human life, we must allow people to choose when to create it.
Dr. Diana Green Foster, Director of Research at UCSF’s Advancing New Standards In Reproductive Health program (ANSIRH), said in a phone interview that the financial and social costs of restricting abortion and contraceptive access may be objective, but are nevertheless “a controversial topic” in the current political climate.
At the same time, Foster said, “People who don’t think about reproductive health as a rights issue might understand that it’s also an economic issue.”
Over the past several years, Foster and her team have researched a range of economic and social outcomes relating to abortion, as well as other methods of family planning. During that time, Foster has also penned a number of op-eds addressing common misconceptions in these areas, and spoken to Congress about legislators’ need to recognize the effects of restrictive abortion laws on women’s health and well-being “as determined by sound empirical research.”
Pro-choice activists, politicians and supporters of Planned Parenthood gather for a news conference and demonstration at City Hall against the Trump administrations Title X rule change on February 25, 2019 in New York City. The proposed final rule for the Title X Family Planning Program, called the “Gag Rule,” would force a medical provider receiving federal assistance to refuse to promote, refer for, perform or support abortion as a method of family planning. (Credit: Spencer Platt/Getty Images)Getty
Among other things, Foster and her colleagues found that of the one third of US women who have an abortion in their lifetimes, half of them already have children, and are often concerned about the impact that raising another child would have for extant ones.
According to research conducted by Foster, those mothers’ worries aren’t misplaced; her review of women who wanted abortions, were turned away, and who carried those pregnancies to term found that their other children subsequently had lower developmental scores. Such families were more likely to rely on federal assistance, too, while not receiving enough of it to avoid poverty.
Mothers who carried unwanted pregnancies to term also showed lower levels of bonding with infants, and were noticeably more financially insecure following such births. Among women polled who wanted an abortion, the top reasons given were not being able to afford a(nother) child, and not being ready for one.
Women who wanted abortions and got turned away for waiting a few weeks or days too long under local laws — typically because they had to spend significant time and money, or because pregnancy symptoms aren’t always clear, especially to younger or recently pregnant women — also had lower incomes than those who received abortions.
After being turned away, regardless of whether they later obtained an abortion, women further reported having lower levels of self-esteem, and more anxiety. On the other hand, women who received wanted abortions were more likely to have a wanted pregnancy in the next five years.
“We also found that when women are able to access an abortion, they are able to continue on a path of working or going to school,” Foster said. “When they are denied an abortion, we see an immediate drop in employment and an increase in public assistance, but not enough to keep women and their children from being poor.” And over the past ten years, legal conditions for women’s reproductive health in this country have been getting worse.
See also: The Trump Administration Just Axed $213M From Teen Pregnancy Prevention, All By Itself
Many states have repeatedly sought to restrict the window when women can legally have abortions, to minimize the number of clinics that provide or make referrals for abortions, to pile on waiting periods and extra consults, and to end or re-appropriate funding for these services at various levels. Federal lawmakers have floated similar ideas, while President Trump has personally moved to restrict federal funds for abortion providers, referrers, and the other forms of contraception they dispense on multiple occasions.
“If the focus were really on trying to make abortions happen as early as possible, then every state would pay for them,” Foster said. “Trying to raise the money is a major cause of delay. And by time you’ve raised that money, it’s [become] a different procedure, and it costs more.”
Regarding the president and others’ attempts to limit funding for contraceptives like birth control (both with and without ties to abortion facilities), she added, “Contraceptives prevent unintended pregnancies, and lots of studies show that the easier you make accessing contraception, the fewer abortions are needed. Making birth control harder to get will absolutely increase the number of unwanted pregnancies and abortions.”
According to advocates for women’s rights and health, such legislation makes clear that improving the lives of women and children is not the goal. Yamani Hernandez, Executive Director for the National Network of Abortion Funds (NNAF), commented by phone that laws preventing Medicaid funds from being used for abortions, for example, are a way of “coercing people into continuing pregnancies they don’t want to have.” Like Foster, she also believes that people “are being pushed into later abortions because they can’t afford it earlier.”
At NNAF, Hernandez oversees employees and volunteers working in 41 states to disperse financial support from over 70 funds to US women, particularly those seeking second-term abortions, which cost $2100 on average just for the procedure. “There are so many other costs that are not talked about more widely,” she said. “There’s transportation and traveling within a state or across state lines, medically unnecessary waiting periods, having to miss work, finding childcare, and having somewhere to stay.”
“About 90% of US counties don’t have an abortion clinic, and it shouldn’t be a privilege to live somewhere that has one.”
See also: How Pain Inspired A Mom’s Quest For Cannabis Emojis
Hernandez also pointed out that even unsuccessful legislation can have a significant negative impact on women’s health and well-being. “There is already a public perception and stigma issue when the president gets on TV and talks about executing babies,” she said, referring to a recent Republican bill that effectively proposed to force doctors into treating non-viable, late-term fetuses rather than let mothers — often in great physical and emotional distress themselves — hold them quietly before they pass, for example.
“It confuses the public,” she continued. “Many people aren’t sure if abortion is legal right now. They call us and have to ask, which is really disturbing, because this a constitutional right.”
“The fact that there’s such a venomous debate about it completely stigmatizes the issue, and makes people confused about whether they even could or should access the care they need.” Much of the work her group does, Hernandez says, is helping people “navigate the complexities” of that care, from process to payment.
In some ways, perhaps it isn’t surprising that the national conversation around women’s reproductive health is both low on facts and extremely contentious in this country. As journalist Amy Westervelt reflected for The Guardian last year, “The reality is, for all its pro-family rhetoric, the US is a remarkably harsh place for families, and particularly for mothers.”
Quite frankly, medical science is still struggling to make up the research gap on women and people of color, including in the reproductive realm, too. The state of research on women’s reproductive health and well-being is improving, however, and it is vital to acknowledge and move forward with what we do know.
After all, presumably all of us want to see future generations thrive, and to be good and thoughtful stewards, on this planet we must share.
And the time has never been better to honor that future by making thoughtful choices, and allowing others to do the same.