Make birth free – L’Atlantique


Immediately after the Supreme Court decision in Dobbs fell, anti-abortion groups began distributing press releases celebrating their victory and vowing to circumvent something the movement has politically neglected for decades: helping mothers afford children. For so many millions already distraught over the decision, the promises of help along the way were not so much a comfort as an insult. Despite the fact that American mothers and children have access to relatively few resources compared to the women and children of our peers, better welfare policy was not exactly what the majority of human rights activists abortion were demanding at the present time.

There was perhaps a time when the American pro-life movement, in its infancy, could have mobilized for broad political reforms in this direction. The broadly progressive politics of life devised by Catholic theologians and mainstream Protestants in the first half of the 20th century hoped to unite all sorts of separate issues – decent wages for workers, nuclear disarmament, the destruction of conscription, the eradication of capital punishment – under the principle that human life is good and deserves to be promoted, both in quantity and quality. Abortion was a concern in this framework, but not an all-encompassing concern, and not predictive of an entire policy or even a specific political commitment. Until the 1970s, pro-lifers maintained a variety of positions on what to do about abortion, including but not limited to the distribution of birth control and funds for mothers, the designation of a legal right to life and simply the prohibition of abortion and nothing. After.

But the modern American anti-abortion movement that emerged in the late 1980s was an ecumenical movement with an evangelical identity and a much narrower sense of what it meant to be “pro-life.” Instead of a broad societal vision, it had a very specific legal objective: to regulate the practice of abortion. Because deer and then Casey prevented states that would have outlawed abortion from doing so, reversing those rulings became a key part of the movement’s long-term strategy to regulate abortion. Organization, funding, and political activity were all centered around this singular effort. Everything else was noise.

So while American pro-life activists have had decades and plenty of encouragement to tackle the deprivations—poverty, poor housing options, and limited access to child care—that seem to precipitate many abortions, rather, their attention remained stubbornly focused on regulating the practice of abortion itself, through legislation codifying (among other things) time limits, specific clinical conditions and conditions for the burial of fetal remains. Anything done to overturn decisions, even something as seemingly bewildered as devout Catholics voting for Donald Trump, was ipso facto a higher political priority for the vanguard of “life” than anything which had to do with the living conditions of American mothers and babies. .

Nevertheless, the post-Dobbs the press releases had to say something, and most of them pointed to precisely the kind of legislation that the anti-abortion movement has flatly ignored for the past 50 years. Alliance Defending Freedom, the conservative legal organization that helped draft Mississippi’s gestational age law and helped the state defend it in the Supreme Court, hailed its own victory in Dobbs with a statement applauding that states could now “ensure women have better access to the support and resources they need and deserve…and that they receive the care and resources they need to flourish”. Susan B. Anthony List, a leading life advocacy organization, said in her post-Dobbs press release that the group was ready to “redouble its commitment to women and families – building on a pro-life safety net that includes 2,700 pregnancy centers nationwide and initiatives like Her PLAN of SBA Pro-Life America”, by which they meant charity, not politics. Meanwhile, Republican strategists who faked a “Marshall Plan” for American women and children recently in National exam were sober enough to readily admit that anti-abortion leaders “feel ideologically constrained from supporting a ‘safety net’ for women” and “perceive mission creep.” If you know you’re going to underdeliver, you can also underpromise.

A better approach: rather than launching an exhausting, decades-long legal battle over whether crisis pregnancy centers (the modern anti-abortion movement’s preferred delivery method for services, money and goods for women in the need) should receive public funds and under what conditions, accept that pregnancy, childbirth and postpartum care are free and demand that the federal government do so.

To answer the predictable objections: Yes, the costs of pregnancy, childbirth and postpartum care really mean the difference between life and death for dozens of American mothers and infants. Preventing premature births and protecting the health of babies in the first months of life would likely reduce the relatively high rates of infant mortality in the United States to levels closer to those of our peers, many of whom spend far more than we do on mothers and babies. Similarly, a 2020 report published by the Commonwealth Fund on maternal mortality in the United States observed that barriers to prenatal and postpartum care, namely non-insurance and poorly designed Medicaid policies that deprive new mothers of expanded postpartum coverage only 60 days after birth, contribute a lot to maternal death. In a country where health care can be prohibitively expensive, deaths from inadequate or inaccessible care might just as well be counted as deaths from poverty.

This is especially the case when it comes to pregnancy, childbirth and postnatal care, all of which range from manageable to exorbitantly expensive. For many, private insurance is hardly a comfort. Young mothers listed as adult dependents on their parents’ private health insurance plans may not discover that their benefits do not extend to maternity care until their bills of several thousand dollars for routine visits to the obstetrician arrive. The costs associated with the birth itself are even more heartbreaking. A recent study published by the American Academy of Pediatrics found that the average out-of-pocket cost of giving birth while privately insured exceeds $3,000. More than one out of six births covered by private insurance results in more than $5,000 in out-of-pocket expenses. While writing this story, I met mothers across the country who shared extraordinary medical bills after giving birth: A Texas hospital charged a couple north of $10,000 for labor and childbirth, with around $3,000 paid out of pocket over time. until the due date, and another $1,500 billed after the birth; in Indiana, a high-risk delivery this year totaled more than $24,000; In Colorado last year, a hospital billed a mother for $14,000 for her uncomplicated delivery without an epidural, $5,000 of which she was forced to pay out of pocket.

The federal government could, without much structural innovation, completely eliminate these costs and with them the deadly barriers to maternal and child care. Medicare already covers pregnancy and childbirth costs for those eligible for the program due to disability. This coverage could be extended to everyone, regardless of disability status, age, income, or work history – and such an extension should be feasible, at least administratively.

In July 1973, the first-ever Medicare expansion to extend coverage to people of all ages with a particular disease went into effect during the Nixon administration. Known as the Medicare End-Stage Renal Disease (ESRD) program, the policy covers the cost of dialysis and kidney transplants for anyone in need, including children and others who would not normally qualify. to Medicare benefits. Coverage for prenatal, delivery, and postpartum care would just have to follow the same lines, with a slightly broader scope: benefits would cover 100% of pregnancy costs for all Americans with no other eligibility condition.

And yet: where is the constituency to effect this kind of change? Pro-lifers form a powerful bloc within the Republican Party, but it’s still only a bloc, and they would need a new insurgency of allies to replace the business conservatives they would lose s ‘they sincerely demanded concrete policy relief for mothers and babies. (These fiscal conservatives have been openly hostile to generous mother and infant programs for years now, and I haven’t seen anything that makes me suspect they’ll change their minds now.) They’d be wise to woo the independents politically distant Americans. , many of whom favored Sen. Bernie Sanders’ presidential races with his landmark proposal, Medicare for All. Creating a Medicare pregnancy and childbirth program wouldn’t remotely accomplish what Sanders envisioned, but it would save lives, promote healthier mothers and babies, and save millions of parents from stressful financial burdens. and the threat of medical debt.

This would force pro-life veterans to take on a trifecta of onerous tasks: moving from a narrow fixation on regulating the practice of abortion itself; making welfare as worthy of political agitation as abortion; and overcoming a veritable addiction to liberal tears, unquestionably the highest goal of American politics today, and one that militates in any case against human flourishing. It is time for the pro-life movement to choose life.


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