In the past few years, long-acting reversible contraceptives have been promoted as a tool for fighting poverty in America. The premise is that if there are less unplanned pregnancies, the poverty rate will also fall.
An op-ed published by the New York Times took issue with the conversation surrounding intrauterine devices, or IUDS, and the reduction of poverty. The authors of the op-ed, reproductive researchers who work with the Person-Centered Reproductive Health Program, cautioned that the promotion of contraceptives to reduce poverty is reminiscent of a shameful history where women were sterilized for the benefit of society.
Unwanted Sterilization at the Private and Public Level
The authors cited evidence that about 20,000 people were sterilized in the state of California over a 70-year period in the 20th century. A 2014 report recalled a case in which low-income Latinas were sterilized before, during, or immediately after giving birth at the Los Angeles County-USC Medical Center in the 1970s. Some of the women reported not understanding that the procedure was a permanent sterilization, while others had no idea that they had the procedure done. This story of unwanted sterilization happened to other women of color in the same time period as well, and was actually funded at the federal level as part of President Lyndon Johnson’s War on Poverty.
IUDs are effective, long-lasting contraceptives and do not result in sterilization. However, the promotion of them as a way to combat poverty is highly problematic. The authors of the Times op-ed emphasize that unplanned births are not an underlying cause of poverty. “This idea distracts from the structural factors — like the availability of social services and racial discrimination — that determine economic opportunities,” they wrote. In contrast, proponents of contraception as a poverty-reduction initiative have argued that the war on poverty cannot be won through social services alone and that the growth of single-parent families far outpaces the country’s ability to offer them financial assistance.
Based on recent research covering the disparity in family planning services, unplanned birth rates are higher in low-income groups than among high-earning women. The most affluent women, who happened to be the most sexually active, reported the highest usage of contraception as well as the highest rates of abortion, which would suggest that they have better access to and the ability to afford healthcare. These findings in fact implicate poverty as the cause of unplanned births, and not the other way around.
Racial Disparity in Contraceptive Counseling
However, studies have already provided evidence that the promotion of IUDs has been directed at women of color, suggesting that poverty-reduction through contraception can have a eugenic effect on communities. The Times op-ed cited a handful of reports that expressed a disparity in contraceptive health for black and Latina women. One found that healthcare providers were more likely to recommend IUDs to low-income black and Latina women than to low-income white women, while another reflected the pressure that black and Latina women felt to get IUDs over other family planning options based on their interactions with their providers.
Ultimately, contraceptive access is crucial to the well-being of low-income women, but using contraceptives to address poverty is ultimately a backwards and demonstrably racist solution to the issue.