Is free childbirth the next step for the pro-life movement?

Denver, Colo., Jan 19, 2023 / 11:37 am

Childbirth in America should be free, say two prominent pro-life leaders on both sides of the political divide. Federal funding of all baby deliveries and related costs would help American women, their babies, and their families while reducing abortion rates, they say, and they hope to convince lawmakers from both sides of the aisle to join their cause.

“Making birth free to American mothers can and should be a national unifier in a particularly divided time,” Catherine Glenn Foster, president and CEO of Americans United for Life, and Kristen Day, executive director of Democrats for Life of America, said in their policy proposal paper “Make Birth Free.”

It’s no accident that their paper was published on Jan. 18, days before the 50th anniversary of the Supreme Court decision Roe v. Wade, which had legalized abortion nationwide. In a post-Roe world, they say, it is time for some new thinking about what it means to be pro-life.

Foster and Day told CNA their proposal is an opportunity and a challenge for both parties.

“It’s a challenge to Democrats who proclaim their concern for women but focus obsessively on abortion and contraception rather than real choice, and it’s a challenge to Republicans who imagine that a radically free market will always support a mother’s choice for life,” Foster said. 

“With Roe gone, we believe it’s time to think bigger and escape the false binaries of partisanship. Are we pro-life first and foremost? Or more concerned with other conservative or progressive commitments?” she asked.

“Our proposal can gain traction with both Democrats and Republicans, no matter where they stand on the legality of abortion,” Day said. 

“With Republicans, who tend to be pro-life, we will emphasize that women and parents in underserved communities often lack the resources and support to carry, birth, and raise children. If we want to see the abortion rate drop, we must provide them,” Day said.

“Democrats, even those who are pro-choice, can pass a ‘Make Birth Free’ proposal to ensure that women who feel like they have no other option other than abortion due to the high cost of birth have a real choice.”

Writing in their paper together, Foster and Day say that Americans can “rise above the rancor of partisanship” and address “the disproportionate financial burdens imposed on mothers and families.”

“‘Make Birth Free’ enables mothers to make the choice for life,” Foster and Day write.

In their view, pregnant women in America “often lack real and effective choice when making decisions about birth.” Observations in other countries indicate that removing financial barriers to childbirth can reduce abortion rates.

American women self-report that they have fewer children than they would prefer, with financial burdens a significant barrier. The current state of health care costs for pregnant women is “unworkable and untenable” and prevents families from starting families and having children.

The average cost of childbirth in the U.S. is close to $19,000, while those with private insurance will pay $3,000 just for the delivery of a baby. Families whose babies require neonatal intensive care pay even higher costs: almost 10% of these families pay more than $10,000 out of pocket for childbirth. Some families are surprised to find that contraceptives and even abortion are covered under their health plan, but not childbirth.

“Maternity care in the United States is uniquely expensive,” Foster and Day write. Ireland guarantees free maternity care at public hospitals, while in Finland childbirth costs are almost free.

Foster and Day’s proposal calculates the financial impact. There are about 3.6 million births each year and paying for each of these births costs on average $5,000, resulting in a total estimate of about $68 billion. They note that 42% of births are already paid for through Medicaid, leaving $39.5 billion unpaid.

“If an additional $60 billion were allocated to assist with perinatal care, baby supplies, and expanded paid leave under the federal Family Medical Leave Act program, the total additional cost to Make Birth Free in America would still be less than $100 billion per year,” their white paper says.

This represents a “mere fraction of the federal budget.” The country has sent $100 billion to Ukraine in the last year, while federal spending for education is $250 billion. The federal health care spending is about $1.6 trillion.

“America’s mothers and infants are worth the marginal spending increase it would take to Make Birth Free,” Foster and Day argue. “There is no better investment than healthy mothers and a thriving next generation.”

Comprehensive funding for free childbirth would reduce pregnancy and childbirth costs overall, they continue, attributing high financial costs to “misaligned financial incentives” in health care. Cesarean section births are performed in the U.S. two to three times more often than medically necessary, even though they are more expensive and riskier than vaginal birth.

Foster and Day also propose to incentivize using midwives or doulas for pregnancies without complications. Home births and birthing centers would lead to more savings, they say.

The two pro-life leaders defend the idea that childbirth should be free rather than subsidized or provided based on proven need. Administrative burdens and scrutiny of personal finances impose “significant barriers” to many pregnant women in need who would otherwise participate.

Further, high costs deter women from seeking prenatal or postpartum care, which increases the risk that needed medical interventions could be delayed. Reported maternal and infant mortality rates in the U.S. are also much higher than in comparable countries.

Several states of very different political leanings already provide pregnancy support funding. Day noted initiatives in Texas, Minnesota, and Arkansas.

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The Texas Legislature expanded Medicaid support for eligible pregnant women from 60 days to six months after giving birth. To promote alternatives to abortion, the legislature more than doubled funding to support pregnant women and pregnancy centers, allocating up to $100 million in its latest two-year budget. Minnesota expanded Medicaid support for eligible pregnant women from 60 days to 12 months after giving birth. Democrats for Life endorsed Arkansas’ Every Mom Matters Act, which passed in 2021 with bipartisan support. The bill funds a telephone hotline to connect pregnant women with public and private resources to support them and their unborn babies.

“We have worked and are working with state and national leaders from both parties on pregnancy and parenting support, including Sen. Mitt Romney and Sen. Marco Rubio,” Day said.

Foster told CNA that federal precedent for such funding includes a Nixon-era program for people suffering from kidney failure, as well as HIV/AIDS prevention efforts.

“Congress is changing. There’s lots of new energy and there are some bold members in both the Senate and the House,” Foster said. “We see a future where making birth free is picked up by a few brave members as a commonsense policy that deserves to ultimately be enshrined as law.”