Last September, several months after Alabama lawmakers attemped to ban almost all abortions in the state, C. Melodi Stone-Spies received an urgent plea for help. A friend who is a doula was at a Birmingham hospital supporting a black mother through her birth. The patient had mentioned while a nurse was in the room that she didn’t have hot water at home. Then the hospital called in the state child welfare agency, and it seemed like the woman’s newborn might be taken away.
“There are people who are considering abortion who would actually like to continue their pregnancy and become parents, but they have a very accurate understanding of the lack of support that is available to families."
For Stone-Spies, a doula and reproductive justice activist, it was a familiar pattern. The state, which despite its efforts to eliminate abortion, provides little support for parents in poverty, and will often take custody of children because of the consequences of that poverty. This is especially true for black women; the percentage of black children in Alabama’s foster care system exceeds the percentage of the state’s child population that is black.
So Stone-Spies, who uses the pronoun they, moved fast. They called Home Depot to ask how much a hot water heater cost. After some quick math to factor in installation and other costs, Stone-Spies headed to the bank, withdrew a stack of bills that had been raised by the reproductive justice group the Yellowhammer Fund, and headed to the hospital.
“I walked into that room and I was like, ‘Ma’am, if you had a case for neglect before . . . you don’t have one now, because I have $6,000 in my hand to fix this person’s hot water heater,’ ” Stone-Spies says. The social worker left and the case was dropped.
Stone-Spies is part of a network of grassroots activists committed to reproductive justice, a term coined by black women in 1994. It supports the human right to have and raise children as well as the right to abortion. It helps people in states hit with wave after wave of laws restricting access by extending support to those who choose to raise children—or who are forced to do so because of these anti-abortion laws.
C. Melodi Stone-Spies, a doula and reproductive justice activist.
“The same person can have an abortion and have a miscarriage and then give birth the next year,” Stone-Spies notes. By supporting families across a full spectrum of pregnancy experiences, Stone-Spies and others have drawn attention to gaping holes in the social safety net, and a glaring contradiction in the Republican agenda.
States that have passed the most abortion restrictions consistently have among the fewest policies to support families, and among the worst health and well-being outcomes for women and children. The coronavirus has laid bare the deadly implications of this absent safety net.
Alabama, for example, has declined to expand Medicaid, leaving hundreds of thousands of people without health insurance. The state has also not raised the minimum wage beyond the federal floor of $7.25 an hour. Its monthly cash assistance payments, just $215 for a single-parent family of three, amount to only over a quarter the cost of fair-market rent in the state.
And Alabama is far from alone. Louisiana, where legislators passed a law currently under consideration by the Supreme Court that could leave the state with just one abortion doctor at a single clinic, ranks last in the nation when it comes to the economic well-being of children.
Internationally, the United States is the only wealthy nation that lacks paid family leave and lags far behind on spending for child care. In recent years, the Trump Administration has waged unprecedented assaults on the parenting ability of poorer people—by cutting funding to Planned Parenthood, for example, and seeking to slash safety-net programs like Medicaid and SNAP (food stamps).
All of this has deprived many people facing unintended pregnancies of the ability to make decisions free from the coercive influence of austerity. Indeed, one of the most common reasons for seeking an abortion is a lack of money. In one survey, 73 percent of women said they had an abortion because they “can’t afford a baby now.”
The majority of people who have abortions are already parents. This puts groups that support reproductive rights in a difficult position—trying to support people making decisions about their pregnancies while acknowledging that there are few resources available if they choose to parent.
“There are people who are considering abortion who would actually like to continue their pregnancy and become parents, but they have a very accurate understanding of the lack of support that is available to families,” says Parker Dockray, executive director of All-Options, which runs a pregnancy resource center in Indiana. Her organization provides funding for abortions as well as free diapers and help with Medicaid enrollment. Indiana has not raised its monthly cash assistance payments since the 1980s.
This legislative session, Indiana state lawmakers failed to advance a bill that would have expanded such assistance, even as they proposed another measure to consider abortion murder. “The hypocrisy of the anti-abortion groups is so painful,” Dockray says, “because there are people who would like to not have an abortion, but they’re making a pragmatic decision based on what’s available to them.”
Over the past few decades, low-income families have suffered from two overlapping trends: the erosion of the social safety net and the rising difficulty of accessing an abortion. People who are denied access to abortion suffer a range of negative economic outcomes; one major study found that being forced to carry an unwanted pregnancy to term quadrupled the chances that a new parent and child would live below the poverty line. The odds of this happening will likely increase as workers lose wages due to the COVID-19 pandemic.
Since the 1990s, state legislatures have passed hundreds of anti-abortion laws, many in states that have diverted money from basic assistance programs. In many states, these programs have also become increasingly difficult to access.
In 1997, the year after President Clinton signed legislation converting welfare into state-issued block grants known as Temporary Assistance for Needy Families, states nationwide spent 71 percent of such funding on basic assistance for families. By 2018, that number had fallen to 21 percent.
“What we’ve seen over time is that that share has significantly reduced, and mainly because caseloads have declined,” says Ife Floyd, senior policy analyst at the Center on Budget and Policy Priorities. States have added cumbersome strings to such assistance. Consequently, in sixteen states including Alabama and Indiana, ten or fewer families received cash assistance for every 100 families with children in poverty in the state.
Some states have even used funding intended for low-income families to advance an explicitly anti-abortion agenda. Indiana is among more than half a dozen states that have diverted funds away from basic assistance and into anti-choice crisis pregnancy centers that use misinformation to deter people from seeking abortions. These centers provide baby supplies to parents, but often only if they complete classes or worksheets that have an anti-choice, religious message. Echoing the logic used by Republican lawmakers, these programs compel people to “earn” benefits in order to combat the “entitlement mentality.”
Yet in states with sparse alternatives, some low-income parents must rely on such programs.
Samantha Starks, a twenty-seven-year-old resident of Bloomington, Indiana, who is raising her sister’s child and three of her own with her husband, says she has earned baby supplies by completing lessons at crisis pregnancy centers.
While her family receives some state assistance, including Medicaid, Starks says the requirements for these programs are at times prohibitively cumbersome. Her family’s food stamps were shut off for two months because her husband’s bank sent the state a bank statement in the wrong format, she says. The family survived on meals Starks brought home from her job at a Japanese restaurant.
Samantha Starks and two of her children.
With three kids currently in diapers, Starks is enrolled in the diapers program offered by the pro-choice group All-Options, where she feels more comfortable than at the crisis pregnancy centers. “All-Options, it just really stuck out to me because of the name, there were always all the options,” Starks says. “They’re not going to judge you in any way.”
All-Options launched its Indiana center for this very reason—to create a pro-choice counterpoint to the coercive tactics of crisis pregnancy centers. But unlike the anti-abortion centers, it hasn’t received federal or state support, and it can be hard to raise money for child care from donors who are focused on the mounting crisis in abortion access.
“It’s so much easier to raise money for our abortion fund than for our diaper program,” Dockray says.
Foundations that support abortion access may also balk at extending support to parents. As a result, All-Options has had to stop accepting new diaper clients, with about 100 people on the waiting list. The state’s failure to implement policies supportive of families has created too large of a demand. “Nonprofits cannot fill the gap,” Dockray says. “It’s not possible.”
Nationwide, many reproductive justice groups applaud the kind of holistic work All-Options and the Yellowhammer Fund are doing, but say they lack the capacity to do it. Stone-Spies in Alabama, who no longer works with Yellowhammer, sees that as a cop-out.
“When we tell a community, we’re only going to pay for your abortion, but we’re not going to help you stay in your house, that’s just eugenics,” Stone-Spies says. They add that the movement needs to generate grassroots solutions that don’t rely on the state. “We are looking beyond what the state can do, because the state has never offered comfort to black families.”
Even small contributions can make the difference between whether someone remains in their home or keeps custody of a child, Stone-Spies says. Yellowhammer’s work has been bolstered by an influx of millions of dollars in donations last year, after Alabama’s attempt to ban almost all abortions rocketed the issue of access in the state into the national spotlight.
But most abortion funds struggle to provide for patients seeking abortion care in a landscape where more and more people have to travel across state lines to obtain abortions—a dilemma that will likely worsen due to the coronavirus pandemic. The roughly seventy groups that make up the National Network of Abortion Funds can, on average, help only one-fifth of all callers who need help paying for an abortion.
“I don’t know any abortion fund that ever feels [it’s in] a stable place in terms of funding coming in versus need,” says Caitlin Lejarzar-Gaffin, co-director of Holler Health Justice in West Virginia. The group helps people afford abortions and the related costs of child care, gas, and lodging in a state with one clinic and one of the highest poverty rates in the nation. They’re proud of having so far been able to help every caller secure funding and get to their appointment.
The vast majority of Holler Health Justice’s clients are rural residents who may travel hours from mountain communities to access abortion. While the group has branched out by supporting harm reduction efforts in a state at the center of the opioid crisis, it would like to do more comprehensive work supporting parents, Lejarzar-Gaffin says.
But not all activists think it should be their job to compensate for the failures of the state. Hunter Starks, a board member of Holler Health Justice who is a single parent, survives on an income of $12,000 a year, in part because income requirements for Medicaid, food stamps, and day care subsidies are so low that Starks could lose benefits by earning more.
“Each time I look at getting a new job, I do the math and see if it makes sense, kind of like a cost-benefit analysis, and it really never does,” Starks says. “The need is so great and access is so limited in West Virginia that reproductive justice and reproductive health organizations should be focusing on abortion. I think that’s the job of the state, to provide that safety net.”
Still, other activists say it’s a “false dichotomy” to force groups to choose between supporting abortion or supporting parents. Laurie Bertram Roberts, executive director of Mississippi Reproductive Freedom Fund, said her group accepts that it can’t fund every abortion, especially since Mississippi is one of a majority of states where Medicaid doesn’t cover the procedure. But she still chooses to provide diapers, food, cribs, and other support to parents.
“The bottom line, for me, is I don’t ever want someone to choose to have an abortion they do not want simply because no one was there to support the decision they actually wanted to have,” she says. “Just like I never want someone to have to carry to term because they didn’t have anyone who could help them.”