1). “Adoption has a supply-and-demand problem. Amy Coney Barrett and her pals on the Supreme Court have the solution - Adoption means abortion just isn't necessary, SCOTUS claims: That's even worse than it sounds , May 3, 2022, Kathryn Joyce, Salon, at < https://www.salon.com/2022/05/
And
2). “Texas Republicans say if Roe falls, they’ll focus on adoptions and preventing women from seeking abortions elsewhere”, May 9, 2022, Zach Despart & James Barragán, Texas Tribune, at < https://www.texastribune.org/
And
3). “Texas isn’t ready to support more parents and kids in a post-Roe world, advocates warn”, May 9, 2022, Eleanor Klibanoff, Texas Tribune, at < https://www.texastribune.org/
~~ recommended by dmorista ~~
Introduction by dmorista:
While the general malignant control of the lives of American Women, that merely supplement the 75+ years of horrific wars waged against the Peasants and Workers of the Third World, is a major impetus for the ongoing attacks on Reproductive Rights in the U.S.; there are other motivations that are also very important. Prominent among these is providing a steady supply of healthy White babies for adoption by various American families who cannot produce children. The first article posted here, “Adoption has a supply-and-demand problem. Amy Coney Barrett and her pals on the Supreme Court have the solution” pointed this motivation out quite clearly. The role of providing adoptable white infants was starkly admitted by Samuel Alito in an argument about halfway through the 98 page Draft Opinion, The text there utilized an old anti-choice meme, in which Alito used the argument: “that 'modern developments,' including the availability of 'safe-haven' laws, which allow parents to anonymously relinquish babies without legal repercussions, have rendered abortion unnecessary. The opinion noted that 'a woman who puts her newborn up for adoption today has little reason to fear that the baby will not find a suitable home.' ”
The Salon article also points out that: “Tucked into a footnote for that statement was a telling citation from a 2008 CDC report that found 'nearly 1 million women were seeking to adopt children in 2002 (i.e., they were in demand for a child), whereas the domestic supply of infants relinquished at birth or within the first month of life and available to be adopted had become virtually nonexistent.' ” (Emphasis added)
The article then notes that Politico, had previously pointed out that Alito's draft included in his text: “... that passage strongly resembled the argument Justice Amy Coney Barrett made last December, ... During oral arguments, Barrett, (opined that) … safe-haven laws and adoption in general … protects women from 'forced motherhood.' Rather, she continued, 'the choice, more focused, would be between, say, the ability to get an abortion at 23 weeks, or the state requiring the woman to go 15, 16 weeks more and then terminate parental rights at the conclusion.' ”
The Adoption Business (and don't forget that like most social functions in the U.S. Adoption is most certainly a business that provides fortunes for certain well positioned people) faced an increasing problem once Roe v. Wade became the law. The article points out that: “After Roe v. Wade, the number of children relinquished for adoption began to drop precipitously. In 1972, close to 20 percent of unmarried pregnant white women relinquished their babies for adoption, but by the late 1990s, the rate had dropped to around 1 percent. (Infant relinquishment rates among never-married Black women have been statistically zero for decades.)” {Emphasis added}
The article also points out that as the “Adoption Marketplace” changed and became less favorable to the Adoption Industry: “In response, in the mid-2000s, some anti-abortion crisis pregnancy centers (CPCs, dm) began trying to deploy market research to determine what 'subconscious emotional motivators' might make adoption more appealing. Two reports that emerged from that research — one bluntly titled 'Birthmother, Good Mother: Her Story of Heroic Redemption' — counseled CPCs to use a common message: that single women who opted to parent their children were being selfish and immature, while choosing adoption was more mature and loving and even, in some cases, a chance for a woman to 'prove her character by relinquishing her child.' ” (Emphasis added)
The response in Texas, that led the way with its Bounty Hunter / Vigilante enforced 6-week Fetal Hearbeat law, was predictably harsh. The second article, “Texas Republicans say if Roe falls, they’ll focus on adoptions and preventing women from seeking abortions elsewhere”, notes just part of the response of Texas State “Rep. Briscoe Cain, R-Deer Park, a member of the far-right Freedom Caucus. ... said he has a particular interest in going after abortion funds, which seek contributions from donors to help defray the cost of out-of-state trips for pregnant Texans to receive the procedure, citing a state law that prohibits 'furnishing the means for procuring an abortion.'
“In a March letter to one such group, the Lilith Fund, Cain threatened to file a bill in the coming legislative session that would empower district attorneys to prosecute abortion-related crimes across the state even when local authorities refuse to do so.”
One of the massively outnumbered Democrats, in the highly gerrymandered Texas State Legislature: “Austin state Rep. Donna Howard spoke of expanding the safety net in terms of pregnant Texans who still will be seeking abortions.
“How do we provide enough health care to those who we are going to be forcing to have pregnancies and carry them to term?”
This is a significant issue as Texas is one of the 10 states that still has not taken the Federal Monies to expand Medicaid and only recently expanded Medicaid funded pre-natal care for poor women from 60 days to 6 months. Actually the pertinent Federal Legislation automatically extends pre-natal care for poor women to 1 year, and applying for a waiver to reduce that to 6 months is a much more involved and difficult process. But the ever busy Rethugs, who are determined to make life as difficult as possible for poor women, decided it was worthwhile to apply for the waiver that reduced the recommended 1 year Medicaid prenatal program to 6 months; even though it would have been primarily funded by the Federal Government.
Meanwhile, among other Republican luminaries in the state preened and postured about providing some help to the Breeding Stocks of poor women, who they want to see producing adoptable children. The article notes that among them: “Lt. Gov. Dan Patrick, a staunchly conservative Republican, said in a statement Tuesday that the Legislature would continue to strengthen adoption programs in the state.
“ 'Texas has led the way to protect innocent life in the womb, and we will continue to do so moving forward in the Texas Senate,' Patrick said.”
Of course Texas has a big problem in this heavily promoted adoption issue, the percentage of white women who get abortions is only 40% nationwide and is undoubtedly even lower in Texas. So the majority of the children that women will be forced to produce as breeding stock in Texas will be primarily non-whites (the great majority Hispanic). We would therefore expect that the main response will be to increase the number of police who push students around at junior high schools and high schools in the state, more heavily armed police to patrol their neighborhoods and shoot them down for minor infractions, more guns so they shoot each other, and yet another prison building boom to house these unwanted and uncared for non-white children. A group that was saved from the evils of abortion only to be abandoned to the lives of poor deprived children in Texas' huge constellation of low-quality rental neighborhoods and failing schools.
The third article, “Texas isn’t ready to support more parents and kids in a post-Roe world, advocates warn”, points out that:
“More than a quarter of women of childbearing age are uninsured in Texas, the highest rate in the nation, and the state has chosen to cap Medicaid benefits for new moms earlier than other states. …
“ 'When you say “social safety net” in Texas’ , it sounds like a joke', said D’Andra Willis of the Afiya Center, a North Texas reproductive justice group. 'Everything they could have set up or increased to protect people if they really cared, they’re not doing it here.'
“Pregnant women in Texas are more likely to be uninsured and less likely to seek early prenatal care than the rest of the country. They’ll give birth in one of the worst states for maternal mortality and morbidity. And low-income new parents will be kicked off of Medicaid sooner than in many other states.”
One final item that is worth noting is that there have been a series of entirely peaceful and extremely polite demonstrations at the homes of some of the right-wing hack Supreme Court Justices; and somebody wrote a pro-choice message with chalk outside the home of Maine Senator Susan Collins. In response the senate, within a couple of days of the first demonstration at a Supreme Court Justice's home, voted 100 to 0 to provide Secret Service protection for them. And some greater protection was provided to Susan Collins too. This contrasts sharply with the response when, in particular, the Governor of Michigan saw the capitol building invaded by large numbers of heavily armed extremist paramilitaries. They actually stood just outside her office door while holding their assault rifles. Then they began posting themselves outside of her home, and the homes of the Michigan Secretary of State, and the Michigan Attorney General. Again there were a large number of these thugs and they were heavily armed with assault rifles and all other manner of firearms and who knows what else. They hung around outside of these 3 Michigan Elected officials for many nights menacing their families. This is in very stark contrast to the totally benign presence of well-behaved and polite protesters who stood, on public property, near the homes of the unelected reactionaries who are now the majority of the Supreme Court. 5 of these reactionary Supreme Court Justices were appointed by Rethug Presidents (Bush the Younger and Trump) who lost the popular vote; but won the Slavocrat anti-democratic Electoral College Vote. To even call the U.S. a democracy in jest, is the height of absurdity.
Adoption means abortion just isn't necessary, SCOTUS claims: That's even worse than it sounds
Adoption has a supply-and-demand problem. Amy Coney Barrett and her pals on the Supreme Court have the solution
"Less abortion, more adoption. Why is that controversial?"
That was the response of Rep. Dan Crenshaw, R-Texas, to Politico's bombshell revelation Monday night: a leaked Supreme Court majority opinion suggesting that we face the imminent reversal of Roe v. Wade.
About halfway through the 98-page opinion, which was authored by conservative Justice Samuel Alito — and which Chief Justice John Roberts acknowledged on Tuesday as genuine — came a familiar argument: that "modern developments," including the availability of "safe-haven" laws, which allow parents to anonymously relinquish babies without legal repercussions, have rendered abortion unnecessary. The opinion noted that "a woman who puts her newborn up for adoption today has little reason to fear that the baby will not find a suitable home."
Tucked into a footnote for that statement was a telling citation from a 2008 CDC report that found "nearly 1 million women were seeking to adopt children in 2002 (i.e., they were in demand for a child), whereas the domestic supply of infants relinquished at birth or within the first month of life and available to be adopted had become virtually nonexistent."
As Politico noted, that passage strongly resembled the argument Justice Amy Coney Barrett made last December, when the case in question, Dobbs v. Jackson Women's Health Organization, concerning Mississippi's 15-week abortion ban, came before the court. During oral arguments, Barrett, who is herself an adoptive mother, suggested that the existence of safe-haven laws and adoption in general rendered moot the pro-choice argument that abortion access protects women from "forced motherhood." Rather, she continued, "the choice, more focused, would be between, say, the ability to get an abortion at 23 weeks, or the state requiring the woman to go 15, 16 weeks more and then terminate parental rights at the conclusion."
Critics quickly pointed out that safe-haven laws are so rarely used that in many states the number of infants relinquished through them each year can be counted in single digits. But the larger problem is more basic: the suggestion that adoption entails nothing more than several months of inconvenience before women can wash their hands of the entire ordeal profoundly fails to understand how relinquishment affects parents. After reporting on adoption issues for more than a decade, it's clear to me that anyone who argues that adoption is a tidy solution to the abortion debate has never spoken with — or actually listened to — the people most affected by that decision.
If you want to understand what using adoption as the solution to unplanned pregnancies looks like, you don't need to look far. But you do need to look. There's a long and ugly history in the U.S. of coercive and even forced adoption. From roughly 1945 to 1972 — the year before the Supreme Court's original Roe v. Wade decision — somewhere between 1.5 million and 6 million women relinquished infants for adoption, often after being "sent away" to homes for unwed mothers, where many women faced brutal coercion, were prohibited from contact with outsiders, went through labor and gave birth in segregated sections of hospitals, and were urged to relinquish their newborns while recovering from anesthesia. Close to 80 percent of residents ended up being separated from the babies they delivered. But the fact that estimates of how many women were affected vary so widely testifies to how secretive these places were: liminal spaces where women were often forbidden from using their real names, in order to facilitate their return to society as though nothing had ever happened. Many of the women were told they would forget about the babies and go on to live fuller lives, says Ann Fessler, author of the groundbreaking oral history, "The Girls Who Went Away." Instead, many experienced lifelong guilt, worry, trauma and the sort of unresolved grief that family members of missing persons endure. One 1999 medical review found that women who had relinquished children for adoption had "more grief symptoms than women who have lost a child to death."
After Roe v. Wade, the number of children relinquished for adoption began to drop precipitously. In 1972, close to 20 percent of unmarried pregnant white women relinquished their babies for adoption, but by the late 1990s, the rate had dropped to around 1 percent. (Infant relinquishment rates among never-married Black women have been statistically zero for decades.)
For some people, that steep decline in the number of American children available for adoption was a problem. The stats Alito cited in his opinion — contrasting an overly abundant "demand" for adoptable children with a "virtually nonexistent" "supply" — reveals a little-recognized truth. First, adoption is an industry driven by supply and demand, as unpalatable as those terms may sound when we're talking about human children. Second, the reflexive liberal retort to anti-abortion rhetoric — well, those right-wingers had better be ready to adopt all those extra babies! — badly misunderstands how this particular industry works.
Even in the heyday of maternity homes, there were concerns that growing demand was outstripping the supply of the sort of babies prospective parents wanted most. In 1961, one sociologist even warned, "If the demand for adoptable babies continues to exceed the supply … then it is quite possible that, in the near future, unwed mothers will be 'punished' by having their children taken from them right after birth." By the 2000s, conservative publications were publishing fretful pieces about the "Last Days of Adoption."
In response, in the mid-2000s, some anti-abortion crisis pregnancy centers began trying to deploy market research to determine what "subconscious emotional motivators" might make adoption more appealing. Two reports that emerged from that research — one bluntly titled "Birthmother, Good Mother: Her Story of Heroic Redemption" — counseled CPCs to use a common message: that single women who opted to parent their children were being selfish and immature, while choosing adoption was more mature and loving and even, in some cases, a chance for a woman to "prove her character by relinquishing her child."
That sort of rhetoric had real effects. One mother I met was sent to a modern maternity home in Washington state when she got pregnant at 19. There she was told that choosing adoption would both please God and prove that she loved her child more than if she kept him. Isolated from her friends, family and boyfriend, she was instead encouraged to spend time with the couple who wanted to adopt her child. She came to feel like a surrogate rather than a "real" mother, and when she expressed doubts about going through with the plan, she was chastised severely. When she fell into a deep depression after relinquishing her child, the family closed what was originally intended to be an open adoption, and she wasn't allowed to see her son again.
Another woman in North Carolina responded to an ad in the Yellow Pages offering help for unplanned pregnancies, and was quickly placed with a "shepherding family" in another state. When she went into labor, in a town hundreds of miles from her family, no one was there for her except the prospective adoptive parents, the shepherding family and an adoption agency staffer. When she said she didn't think she could go through with the adoption, the shepherding family told her she would be on her own.
"I was never an 'expectant mother,' a 'mom-to-be,' or even 'Carol,'" the woman told me. "I was simply one of the agency's 'birthmothers,' although I hadn't signed a thing. I felt like a breeding dog . . . a walking uterus for the agency."
There are a lot of stories like this, but they're often rendered invisible in a culture where adoption is seen as a unilateral good or a "win-win-win"; where Democrats have long sought to triangulate the abortion morass by offering, somehow, to "make adoption more available"; and where media depictions of birthmothers are often limited to seedy reality-show storylines. In a dynamic where adoptive parents are almost universally wealthier and more powerful than birthparents, even the language we use privileges one side of the story, leaving almost no neutral way to discuss the issue.
These narratives have also played out against the backdrop of a much larger phenomenon, as international adoption rates have plummeted from their peak of around 23,000 in 2004 to just over 1,600 in 2020 (the most recent year for which there is data). This has caused such a constriction in the adoption field — a market contraction, to return to the business metaphor — that numerous agencies and even a large-scale lobbying organization have been forced to close shop.
"The underlying consideration of adoption in the leaked opinion reflects the view that the decline of American infants available for adoption is inherently an adverse trend," says sociologist Gretchen Sisson, author of the forthcoming book "Relinquished: The American Mothers Behind Infant Adoption." Rather, she continues, "this trend reflects that more women are parenting the children to whom they give birth — which would have been the preferences of many 'baby scoop' era birth mothers as well."
In researching more than 600 mothers who relinquished children from adoption, Sisson found that most had done so in the context of extreme poverty or instability. Most reported income of less than $5,000 per year, most were unemployed, and a fifth were homeless at the time they relinquished. Statistics like those cast relinquishment not as a selfless choice, or one parents can easily forget, but rather, as Sisson says, "a reflection of an American failure to not just allow people the dignity of making their own choices about their bodies and lives, but to invest in families at the most basic level."
The reality is, Sisson says, that in general "women are not particularly interested in adoption," but may feel forced to consider it when they cannot access abortion services or when they feel "wholly unsupported" in parenting. "This was true for 'baby scoop' mothers, and it is true of relinquishing mothers today."
This is all necessary context when we hear right-wing Supreme Court justices arguing that adoption — and falling adoption rates — are part of the justification for re-criminalizing abortion. It's also key to understanding, and rebutting, the various responses to Alito's opinion that weaponize adoption to make a point: whether from pro-choicers trying to shame their opponents or anti-abortion advocates hopeful that adoption waitlists may get a little shorter. Neither is reckoning with what it is they're actually calling for.
Texas Republicans say if Roe falls, they’ll focus on adoptions and preventing women from seeking abortions elsewhere
BY ZACH DESPART AND JAMES BARRAGÁNDuring their 20 years in control of the Texas Legislature, Republican lawmakers have steadfastly worked to chip away at abortion access.
Bound by the limits of Roe v. Wade, which stopped them from enacting an outright ban on the procedure, lawmakers got creative. They required abortion clinics to have wide hallways and deputized private citizens to sue providers in an effort to shut down facilities that offer the procedure.
Future lawmaking on the topic will likely not require such ingenuity. A leaked draft of a U.S. Supreme Court opinion, published last week by Politico, suggests the court will reverse the landmark abortion ruling in the coming weeks, allowing states to regulate abortion as they see fit. Texas has a “trigger law” that would make performing an abortion a felony, which would go into effect 30 days after the Supreme Court overturns Roe.Their decadeslong goal achieved, Republican lawmakers said there’s still work to be done. Texas GOP leaders and members of the Legislature said it is now time to turn their attention to strengthening the social safety net for women and children and investing in foster care and adoption services.
“It only makes sense,” said Rep. Steve Toth, R-The Woodlands. “The dog’s caught the car now.”
At least some of the more conservative members of the House said they also want to ensure strict enforcement of the abortion ban and to prevent pregnant Texans from seeking legal abortions in other states.
“I think I can speak for myself and other colleagues that align with my policy beliefs — we’ll continue to do our best to make abortion not just outlawed, but unthinkable,” said Rep. Briscoe Cain, R-Deer Park, a member of the far-right Freedom Caucus.Texas already has an arsenal of statutes to punish virtually anyone involved in the procurement of an abortion, said University of Texas at Austin law professor Liz Sepper. These include last year’s Senate Bill 8, which empowers private citizens to sue anyone who “abets” an abortion after six weeks of gestational age, as well as unenforced pre-Roe abortion statutes criminalizing a person who gets the procedure, which the Legislature never repealed — some dating to the 1850s.
“If Roe is overturned, there’s already a criminal ban, there’s already an aiding and abetting ban, there’s already a ban on mailing medication abortion,” Sepper said. “In terms of law’s ability to change behavior, they’ve almost filled all the gaps — with the exception of criminalizing the pregnant person involved in an abortion.”
Cain said he has a particular interest in going after abortion funds, which seek contributions from donors to help defray the cost of out-of-state trips for pregnant Texans to receive the procedure, citing a state law that prohibits “furnishing the means for procuring an abortion.”
In a March letter to one such group, the Lilith Fund, Cain threatened to file a bill in the coming legislative session that would empower district attorneys to prosecute abortion-related crimes across the state even when local authorities refuse to do so.
Attempts to prohibit individuals from contributing to abortion funds would likely violate the First Amendment’s protections on free speech, said South Texas College of Law Professor Charles “Rocky” Rhodes.
“Helping people go get abortions is going to be one of these difficult questions that’s going to arise in a post-Roe world if a legislature tries to criminalize the ability of a pregnant person to get an abortion someplace where it’s legal,” Rhodes said.
Cain said he is in discussions with fellow Republicans about other abortion-related legislative priorities but that it is premature to discuss them. The next legislative session is scheduled to begin in January.
Texas Democrats, who are vastly outnumbered at the Legislature, characterized the leaked opinion as “bleak” but said they would not stop fighting for access to abortion.“This will only power our fight to codify the right to abortion at the federal level,” Hannah Roe Beck, the Texas Democratic Party’s co-executive director, said in a news release. “It’s more important than ever that we elect leaders who are ready to put everything on the line to get this through Congress. We cannot tolerate anything less.”
An effort in Congress to do this, however, failed to pass the Senate in February. Another vote scheduled for this week is also expected to fail.
Austin state Rep. Donna Howard spoke of expanding the safety net in terms of pregnant Texans who still will be seeking abortions.
“How do we provide enough health care to those who we are going to be forcing to have pregnancies and carry them to term?” Howard said. “It’s more going to be a focus, I think, on that now, if there’s a way to look at how people can access medication abortion that is a way to get around the law.”Lt. Gov. Dan Patrick, a staunchly conservative Republican, said in a statement Tuesday that the Legislature would continue to strengthen adoption programs in the state.
"Texas has led the way to protect innocent life in the womb, and we will continue to do so moving forward in the Texas Senate,” Patrick said.
Gov. Greg Abbott did not respond to questions from The Texas Tribune about abortion-related legislative priorities for the coming session in January. House Speaker Dade Phelan said in a statement that he was confident the Legislature would “rise to the occasion and redouble our commitment to maternal health care in our state.”
State Sen. Bryan Hughes, R-Mineola, the author of SB 8, did not respond. He posted on Twitter on Thursday that Texas would “lead the way in a post-Roe world.”Republicans have good reason to avoid discussing enforcing Texas’ pre-Roe laws, said Renée Cross of the Hobby School of Public Affairs at the University of Houston: A full abortion ban is broadly unpopular with voters.
Just 15% of respondents in a University of Texas at Austin poll released this week said they support prohibiting all abortions. More troubling for Abbott’s reelection bid this year, Cross said, is the fact that a majority of independents said they believe abortion should be available in most circumstances.
“The Republican Party has been able to rely often on independent voters, but not on this issue,” Cross said. “We saw some Republican voters, particularly suburban women, not vote for President Trump in 2020. A lot of those women will probably think twice about voting for Gov. Abbott.”
Other Republican lawmakers spoke about pitching nonpunitive measures in the upcoming legislative session. Toth said if abortion is outlawed in the state, Republicans in the statehouse will focus on expanding social programs to help pregnant women and their children.
“Now more than ever, the pro-life community and legislators need to step up and make sure we help out women in a crisis pregnancy,” he said. “It means prenatal care, helping them stay in school. It means making sure that we help women once the baby is born, it means adoption services.”
Toth said the expansion of safety net programs would be a “moral response” to the outlawing of abortion in the state. Such an expansion would require an increase in state funding for adoption services, foster care and welfare programs, which Republicans have been hesitant to support in the past. But Toth, a member of the staunchly conservative House Freedom Caucus, said he believes GOP lawmakers would now support the increased funding.
Joe Pojman, executive director of the anti-abortion group Texas Alliance for Life, said he would also support an increase in funding for the Alternative to Abortions program, which the Legislature funded with $100 million this two-year budget cycle. The program pays a far-flung network of nonprofits — many of them ardently anti-abortion — for counseling, classes on prenatal nutrition and newborn care, and the provision of baby items.
But Pojman says lawmakers need to better promote the program so more pregnant people have access to it.
“For a lot of women who find themselves pregnant, they don’t even know that those exist,” he said.
State Rep. Giovanni Capriglione, R-Southlake, who is a member of the budget-writing House Appropriations Committee, said he would support an increase in funding for social safety net programs for pregnant women and young children.
He said he’d push for an increase in Medicaid coverage for low-income new mothers. That coverage was increased last year from 60 days to six months, but experts had recommended extending it by a whole year.
House lawmakers agreed to extend it by a year, but the Senate brought the coverage back down to six months during final negotiations in the 2021 legislative session.
“We have to now work really hard to help these new moms and these new babies,” Capriglione said. “I’m going to be pushing for it.”
But Republicans are also preparing for a protracted fight with Democrats in Congress who will be reenergized to push for access to abortion at the federal level.
“This is not going to go away,” Toth said. “Nothing really changes.”
Rhodes, the South Texas law professor, said the potential overturning of Roe could also weaken federal protections ensuring access to contraceptives. He said states could consider reclassifying emergency contraception such as Plan B, the pill that prevents pregnancy by the delaying the release of an egg from the ovary, as forms of abortion.
Texas isn’t ready to support more parents and kids in a post-Roe world, advocates warn
With a near-total abortion ban looming in Texas, advocates and experts say the state’s support systems for low-income mothers and children are already insufficient — and won’t easily bear an increase in need.
“When you say ‘social safety net’ in Texas, it sounds like a joke,” said D’Andra Willis of the Afiya Center, a North Texas reproductive justice group. “Everything they could have set up or increased to protect people if they really cared, they’re not doing it here.”
Pregnant women in Texas are more likely to be uninsured and less likely to seek early prenatal care than the rest of the country. They’ll give birth in one of the worst states for maternal mortality and morbidity. And low-income new parents will be kicked off of Medicaid sooner than in many other states.
This would make many Texans want to avoid pregnancy altogether. But learning about, let alone accessing, contraception can be a challenge in a state that does not require sex education and has narrowed family planning options in recent years.
Republican lawmakers, many of whom have focused on restricting abortion access in recent years, have said strengthening the state’s social safety net will now become a top priority. But advocates who have been working on these issues for years say any help will likely be too little, too late.
“People fail to realize that this is bigger than abortion access,” Willis said. “We’re going to be setting people up for generational poverty.”
Maternal mortality in Texas
Texas consistently ranks in the 10 worst states for maternal mortality, in a country that already ranks worse than its peers in that category.Maternal mortality and morbidity — death or serious illness or injury — disproportionately impact Black women. The state’s Maternal Mortality and Morbidity Review Committee found that Black women made up 31% of pregnancy-related deaths, but only 11% of live births.
The rate of severe maternal morbidity for Black women in Texas is nearly double that of white women, according to a study from the University of Texas.
“This is the worst place and the most dangerous place to have a baby,” said Willis. “It’s safer to get an abortion in Texas than it is to have a baby in Texas.”
Willis also worries about a potential increase in pregnancy-related deaths and injuries as desperate people turn to self-managed abortion care.One of the causes of Texas’ maternal mortality numbers, according to experts and advocates, is the state’s staggering rate of uninsured residents. Texas is one of just 12 states that has not expanded Medicaid and has one of the lowest eligibility standards in the country: A single parent with three children would have to earn less than $400 a month to qualify for Medicaid.
As a result, in 2019, nearly 1 in 5 Texans had no health insurance, double the national average. And the stats are worse for women of childbearing age — in 2017, more than a quarter had no health insurance, the highest rate in the nation.
Texas also has the lowest rate of women accessing prenatal care in the first trimester, according to an investigation from ProPublica and Vox. Babies are five times more likely to die if their mothers did not access prenatal care, according to the U.S. Office on Women’s Health.
Pregnant Texans can qualify for Medicaid at a much higher income level — up to $4,579 a month for a single parent of three. As a result, half of all births in the state are financed by Medicaid, among the highest rates in the nation.For years, that program covered women through pregnancy and two months postpartum. But last year, as part of the American Rescue Plan, the federal government allowed states to easily expand coverage through the first 12 months postpartum.
On the recommendation of the state’s maternal mortality task force, Texas House lawmakers approved a bill that expanded coverage to 12 months after birth.
“It was the first time that there was that much bipartisan support for the issue,” said Diana Forester, director of health policy for advocacy group Texans Care for Children. “It was amazing. We were so excited.”
But then the state Senate rolled it back to six months postpartum. While the feds automatically approved states that extended coverage to 12 months, the new six-month plan will require Texas to go through the lengthy and cumbersome waiver process.Texas has not yet submitted the waiver application, according to Texas Medicaid Director Stephanie Stephens at a hearing last Thursday. While the state hopes to begin offering six months of postpartum Medicaid coverage in October, it will depend on when their waiver is approved.
She said the federal government has at least 120 days to review the waiver “but we’ve seen waivers that they have not acted on for much longer than that.”
Right now, due to the federal public health emergency, no one is being moved off of Medicaid when their eligibility expires. That declaration is set to end in July, though it could be extended, as it has several times already.
The choice to approve only six months of postpartum Medicaid expansion was a huge disappointment for maternal health advocates.
“If you want healthy babies, you’ve got to have healthy mommies,” Forester said. “How do you have healthy mommies? You provide them coverage.”
Access to contraception, sex education
Uninsured and low-income Texans who would prefer to not become pregnant also face challenges in accessing contraception and reproductive health care.
Starting in 2011, Texas began a yearslong effort to “defund” Planned Parenthood, in part by slashing the budget for women’s health care and family planning.
By 2014, more than a quarter of family planning clinics in Texas had closed, most of which were not affiliated with Planned Parenthood. While some have reopened, access to contraception, cancer screenings, STI testing and other sexual health care remains much more sparse than it was before.
The remaining clinics that receive family planning funding from the state struggle to keep up with the demand for services.
“This program has never left money on the table,” said Erika Ramirez, policy and advocacy director for the Texas Women’s Healthcare Coalition. “We really want to ensure that lawmakers know that our women’s health programs are … not currently meeting that need, and that need is only going to increase.”
The state’s reproductive health care programs are additionally stretched, Ramirez said, because Texas is one of just two states that don’t cover contraception on its Children’s Health Insurance Program. Teens on this program who want to access contraception have to go through the state-funded Family Planning Program clinics.
“That’s an easy fix,” said Ramirez. “There’s actually evidence that this would produce cost savings for the state, and presumably if CHIP covers comprehensive care, to be able to access something as essential as contraception should be considered comprehensive care.”
Texas has among the highest rates of teen pregnancy in the country, and the highest rate of repeat teen births — teens having multiple children before their 18th birthday. Texas does not require high school students to take sex education to graduate.
“We can’t get birth control. We can’t get adequate health care. We’re not given comprehensive sex education, so we’re not being educated on birth control or naturally preventing pregnancy, and now you can’t get an abortion,” said Willis. “You take away all of this … and you don’t have any plan in place.”
Lawmakers and abortion opponents have argued that the plan, as it were, rests on the Alternatives to Abortion program, which the state has invested over $100 million into in recent years. The program funds a network of nonprofits intended to support people in continuing their pregnancies, often with little government oversight.
But even some of these programs say they’re unprepared to support the influx of need.Vincent DiCaro, chief outreach officer of Care Net, told the Texas Tribune last week that the group’s 82 Texas crisis pregnancy centers have not been able to keep up with demand since the state banned abortions after about six weeks of pregnancy.
“We think crisis pregnancy centers are awesome, of course,” he said. “But if that’s the only solution, we’re not going to have enough manpower to help all of the people who are going to need help if Roe v. Wade gets overturned.”
Other barriers for new parents
These centers typically only offer material support, counseling or parenting classes through the early months of a baby’s life. But an unplanned pregnancy can have lifelong consequences for mother and child.
And many of the most significant changes that advocates are pushing for will have to come through future legislative action.Texas does not require employers to offer paid time off of any kind, though federal regulations mandate that qualified employees be given 12 weeks of unpaid job protection offered under the federal Family and Medical Leave Act.
Unlike neighboring New Mexico, which just debuted a program that offers a free year of child care to most families, Texas offers a limited child care scholarship program for children of low-income parents who are working or pursuing education.
And if the state decides that a parent can’t adequately care for the baby they had as a result of an unplanned pregnancy, the foster care system intervenes. The state is in the midst of a decadelong lawsuit over its inability to adequately care for children in the foster system, often with troubling consequences.
Willis, with the Afiya Center, said children often end up in the foster care system because of circumstances far beyond their control — or the control of their parents. And whether those children are in foster care or at home with parents, many of those factors are only going to get worse.“You have young women who do not have control of their bodies to even access birth control,” she said. “And then these same women are living in areas that are food deserts, that are heavily impacted by air quality and environmental issues, that are dealing with poor school systems.”
When she thinks about the systems in place to support low-income Texans who will have to carry their pregnancies to term as a result of the forthcoming abortion bans, she said she feels hopeless.
“Black women in Texas have never had hope that any of this would come through,” she said. “And now it feels like we’re almost all the way back to square one.”
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