Statistics from the Guttmacher Institute indicate that only 19.6 pregnancies per thousand in the United States end in induced abortion procedures, a number that has declined from 29.3 per thousand in 1981. Of these some 88% occur in the first 12 weeks.
If 88% of all induced pregnancy terminations take place within the first 12 weeks, why would states enact ultrasound testing? Further, why would a state enact a statute forbidding physicians from imparting information about potential pregnancy complications or about the results of pre-natal tests which show the likelihood of fetal abnormality?
What if the test showed evidence of anencephaly, a neural tube defect which usually happens in the first four weeks of a pregnancy? Approximately 1 out of every 4,859 babies born in the U.S. are anencephalic, and will not survive very long after their birth. [CDC] What if the ultrasound, demanded now by the state of Virginia, indicated that a fetus was thus fatally flawed, and would not survive for much longer than 24 hours? The irony may be that in the case of the Virginia statute, the parents may well receive information which might cause them to seek termination of a pregnancy rather than “scaring” the woman into not seeking the termination.
What if the pre-natal testing indicated congenital, chromosomal, or genetic defects? What if the parents were financially incapable of supporting a child with such severe defects? One can demand that a fetus not be aborted for financial reasons, however such a demand requires a commitment on the other side of the equation, i.e. the community and state must provide services needed which the parents cannot afford. Are the state legislatures willing to appropriate funding for a range of special services from institutional care facilities to home based medical providers to special education program funding?
The response in some instances, such as Arizona, is to put the government “between a woman and her doctor” and restrict what the physician can tell the family. This is not a rational solution.
Frankly, Kansas, which is considering draconian anti-abortion and contraception measures, enacted a state budget which proposed the exact opposite:
“Lawrence schools have about 11,000 students and 1,600 employees, with a monthly payroll of $4.5 million. The district trimmed its spending by laying off paraprofessionals who worked with special-education students, reducing the number of days teachers work and increasing the student-teacher ratio by one student, a move that may seem small but saved more than $1 million in one year.” (emphasis added)
“The House Health and Human Services Committee is scheduled to hold hearings next week on a bill that would exempt long-term care services for the developmentally disabled from the managed care provisions in KanCare, Gov. Sam Brownback’s Medicaid reform plan.” [KHI]
The Democratic Party supported bill may not get much support in a Republican controlled legislature. The situation in Virginia isn’t much different, the state legislature cut approximately $700 million from its budget for K-12 education, meaning that special education services will also feel the squeeze. [CBPP] The 2012 Virginia budget cut $400 million from Medicaid funding. [ABC7] Those proposing the enaction of stringent restriction on abortion procedures, appear not to have thought ahead as to what state services will be required if all pregnancies — including those in which there is a strong chance of fetal abnormality — must be carried to full term.
Not to put to fine a point to it, but I am awaiting the day when the same people who rally for “Pro-Life” statutes attend hearings on Medicaid, state health services, and education with the same level of enthusiasm.
If the prevalence of abortion procedures has declined in the last three decades, as the chart clearly indicates, what is the role of contraceptive services in precluding abortions? The science is clear:
Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant. The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly. [Guttmacher]
Meaning: In developed nations with relatively stable fertility levels, such as the United States, the availability of contraception resulted in fewer abortions.
What of the pregnancies which are not prevented or terminated? We’ve still not developed a nationwide consensus on how to support infants with health issues.
The latest figures from the CDC indicate there are about 6,408,000 pregnancies in the United States every year. [CDCpdf] The CDC also reports that 8.2% of live births are complicated by Low Birth Weight, and another 12.2% of live births are Pre-Term. [CDC] That means there are 338,715 low birth weight babies born each year, and another 503,941 infants born pre-term.
We know that smoking, age, genetics, and nutrition play a significant role in the low birth weight statistics. From a Stanford University study we can add some additional information:
“Different ethnic groups show varying degrees of prenatal care utilization, with 76 percent of all women seeking prenatal care within the first trimester, and only 61 percent black and Hispanic women seeking prenatal care during the same time period. Underutilization of prenatal care is often attributed to poor socioeconomic statuses like inability to pay for prenatal care, a lack of knowledge in the importance of prenatal care, and inadequate location and availability of prenatal care providers.” (emphasis added)
Medicaid covers 51% of all babies delivered in Florida hospitals, but the state is looking at proposed program cuts ranging from $376 million to $720 million: “Dr. Peter Dayton, who provides prenatal, obstetric and gynecological services for Medicaid patients through the Physicians to Women program, told the editorial board hundreds of pregnant women would be put at risk if Medicaid funds are slashed.”Five hundred women will be showing up in emergency rooms with no prenatal care if this program is not sustained,” Dayton said.” [TCPalm]
A 2011 editorial in Texas summed up the problem:
“Texas already runs one of the leanest Medicaid reimbursement programs – one so lean that it doesn’t cover the actual cost of treating Medicaid patients. Doctors already lose money on those patients; many simply can’t afford to accept them. And further cuts could mean that far more would have to stop accepting Medicaid.
The upshot? If pregnant women can’t find a doctor who’ll see them, they’re likely to skip prenatal care — and thus, more likely to suffer serious problems with their pregnancies or give birth to a premature baby. Those intensive-care outcomes aren’t just tragic; they’re far more expensive than prevention. And we taxpayers will end up paying for them.”
And so it goes. Those demanding severe anti-abortion statutes, and those demanding restrictions on the availability of contraception, are all too often supporting politicians who also favor the restriction of public health services, and the parsimonious funding of education and family assistance programs. IF we truly are a compassionate nation, in which we care deeply about healthy families, then we must also be a country in which we recognize that there is no such thing as a “Free Pregnancy.”