Fruit of the wombs in Alabama

My head was flooded with confusion when I read the following phrase from a plan the governor is supporting: “[the state will] make available immediate postpartum long acting reversible contraceptive insertion in hospital settings before discharge.” Roughly translated: the state of Alabama is will buy and insert IUDs or hormonal implants for women who have just given birth. There are other components of the new initiative, but this is the one that shocked me.

The contraception is part of the “State of Champions” campaign designed to reduce Alabama’s infant death rate. In case you haven’t heard, the state’s infant mortality rate has increased since 2011. Then it was 8.1 deaths per 1,000 live births. The 2012 rate was 8.9. Alabama has traditionally held one of the higher rates in the nation. (The national average is 6 in 1,000 deaths.) Even with this high number, the state has made some progress. In 2010, the rate was 10 for every 1,000 births.

The new campaign is designed to reduce the number of unintended pregnancies in Alabama, because “unintended babies have a higher rate of death.” An Associated Press article I read stated that unintended births account for almost 50 percent of the births in the state. I don’t know if that assertion about higher death rates came from the meeting where the governor talked with health care professionals about the new campaign or from almost any reproductive rights brochure printed over the past 100 years.

On one hand, I’m pleased to learn that the governor supports the use of artificial birth control for family planning. I wasn’t really sure. What’s more, he’s even encouraging the state to be involved with it. I find that an interesting twist for a man who is steadfast in refusing expanding the role of Medicaid in the state. That refusal makes the governor’s support for the new “State of Champions” campaign even more fascinating, since one of the components includes alleviating “barriers for Medicaid women to obtain replacement LARCs [long term reversible contraceptives].”

It will be interesting to see where the governor’s state party will stand on this government-endorsed birth control, since the position is close to reeking of “nanny state” interference. And there’s that pesky little fact that so many of those who call themselves “pro-life” believe that the way IUDs work is tantamount to abortions. Many of these people have been telling girls that using birth control will cause them to get cancer and die. The governor’s party and the governor himself are unquestionably “pro-life.”

The other hand is spelled out in black and white, at least to me. Recall those numbers for the infant mortality rates? If not, go back and read them again. Now let’s break that down to the most relevant factor with anything involving money and children in Alabama: race. According to the Associated Press, the infant death rate for white children is 6.6, which is just slightly above the national average; for black children it is 14.4. The black Alabama babies’ death rate is at least twice that of white Alabama babies.

I don’t know about you, but when a “pro-life,” limited-government governor starts supporting IUDs for “Medicaid mothers,” the first thing I think of is the history of eugenics in this country. First, I am cognizant that in these parts “Medicaid mothers” are presumed to be black. Second, the plan endorses something that so many politicians in this state adamantly oppose. Don’t forget that fellow members of the governor’s political party regularly become apoplectic at any hint of government funding for birth control of any type. Hell, most of them are opposed to readily accessible birth control even if government funding isn’t involved. The governor’s party has political dominance in the state, and he is up for re-election, so I can’t imagine him stepping outside its platform.

Bear with me while I build a scenario that flashed before my eyes. Alabama is blessed with an army of Christians who visit folks in the hospital as part of their mission work. According to polls, a majority of church people in Alabama identify themselves as “pro-life.” It is easy to imagine a kindly visitor telling a “Medicaid mother” that her doctor is about to put her on a path to Hell by offering her a free IUD. (I’m assuming that since the young woman has been told by many well-meaning people that birth control causes cancer, she’s not going to want the hormonal implant.) The visitor will share with the new mother her belief that IUDs are the same as having an abortion and she should refuse it. Then the church visitor will share with the tired and frightened young woman how she understands worrying about money to feed her child, and if there are other children, having the time to be a good mother. “And, bless your heart, we wouldn’t want you to go through that, so let’s pray together for the Lord to provide another option.” Then, low and behold the doctor comes in with an offer to perform a tubal ligation or partial hysterectomy. No doubt it would be recorded as “medically necessary” in order to save the life of the mother.

I whole-heartedly support reducing the infant mortality rate in Alabama. 
Such efforts are unquestionably necessary and the “State of Champions” campaign has several noteworthy components. I also readily support government funding of IUDs and other forms of birth control for “Medicaid mothers” of all ethnicities. Sadly I don’t have confidence that the attitudes that led to the eugenics movement in the South last century have faded much. I hope I’m wrong.