Oliver Twist is coming to America

boy in poverty.jpg
Photo by Muhammad Muzamil on Unsplash

The Department of Health and Human Services has now passed rules[1] that will usher in a Dickensian era in America.  These rules promote the least effective forms of birth control and hide abortion as a dirty secret.

The methods promoted by these rules are abstinence and “fertility awareness-based methods.”  While abstinence is 100% effective,[2] many may feel that this is not a viable option.   According to HHS, fertility awareness-based methods depend on women identifying when they are ovulating and avoiding sex at that time or using condoms.[3]

But these methods are the least effective. Fertility awareness-based methods do not work 12%-24% of the time.[4]  Condoms don’t work 15% of the time.[5]  So if the women of this country use these methods, pregnancies will increase 12-24%.  That is a lot of unwanted babies.

Those who get pregnant under the new rules are less likely to have an abortion.  The rules treat abortion as a dirty secret.  Family planning clinics receiving federal funds must separate facilities that provide family planning from those that provide abortions or abortion referrals.[6]  And those clinics cannot refer patients to an abortion facility.[7]  If a pregnant woman decides to have an abortion and requests a referral, the clinic may provide a list of family planning facilities but may not indicate which of them provide abortions.[8]  The pregnant woman will have to take the time to figure that out, delaying an abortion — perhaps until it is too late.  The new rules, then, will result in fewer abortions, which in turn means that more babies will be born.

Some mothers may keep their babies, but others will be unwilling or unable to care for them.  Where will they go?  Orphanages no longer exist in this country.[9]  Instead, they have been replaced by foster homes.[10]  But the foster care system here has been strained beyond its limits by the opioid crisis.[11]  There are not enough foster homes now for children who need them.[12]

Where will all these children go?  No additional allowance has been made for their care.  Who will pay for their food, clothing, health care, and other needs?

The rules provide only that more women will get pregnant and more children will be born.  But after birth, they are on their own.  Those advocating pro-life look no further than the birth of the child and provide no relief for unwanted children after they are born.  As someone once pointed out to me, the more correct term for those people is pro-birth, not pro-life.

And the women most affected by these rule changes are likely to be poor.  After all, more poor women use federally funded facilities because the cost is lower than private facilities.  Saddling these women with more children will result in their remaining or sinking deeper into poverty.  What will happen to those children?

Visions of Oliver Twist spring to mind — ragamuffins living on the streets by any means possible – committing crimes or being victimized by the unscrupulous.  That’s the bright future that the new HHS rules promise.

The best prevention of abortions is the prevention of conception.  If fewer or no abortions is the goal, information about and access to effective contraception must be made available to women.  Otherwise, the additional children resulting from ineffective contraception must be provided for.  Paying for their care means higher debt or taxes.  If our country wants to force women to have more children, we must pay for their care. Abandoning them at birth is not an option.


[1] I discussed these rules before they were enacted in a post published October 2018.

[2] Planned Parenthood, “Abstinence and Outercourse.” 

[3] U.S. Department of Health and Human Services, “What is fertility awareness?

[4] American College of Obstetricians and Gynecologists, “Frequently Asked Questions:  Fertility Awareness-Based Methods of Family Planning.”

[5] Planned Parenthood, “How effective are condoms?

[6] Ariana Eunjung Cha, “Trump administration bars clinics that provide abortions or abortion referrals from federal funding,” The Washington Post, February 22, 2019.

[7] Id.

[8] Id.

[9] Virginia Spence, “Do Orphanages Still Exist in America?,” adoption.com, June 30, 2018.

[10] Id.

[11] Perry Stein and Lindsey Bever, “The opioid crisis is straining the nation’s foster-care system,” The Washington Post, July 1, 2017.

[12] Id.

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