Paying addicts to get long-term birth control

This was the first I’d heard of such a project. Called Project Prevention, it pays women (and men) who are drug addicts to get some long-term birth control — tubal ligation (or vasectomy), Norplant, an IUD or something similar — something they don’t have to use every time (like a condom) or every day (like birth control pills).

If you’ve read this blog for any length of time, you know my objections to forms of birth control that may allow ovulation but prevent implantation of the embryo, because if life starts at conception (which is not even in dispute, medically, gentically, or biologically speaking), then that allows a new life to be created but prevents it from being lived. Since “abortion” and “abortifacient” are defined to refer to actions that take place after implantation, the action of preventing implantation is not technically abortifacient (although ACOG changed the definition in the 70s, so prior to that, it was considered abortifacient), but it is still bothersome for people like me. I wouldn’t take them; and for this and other reasons, I advocate against them; but I’m not going to look down on you if you do it.

But long-term birth control for drug addicts is different. This may be inconsistent at first glance, but I believe it to be actually of a more consistently pro-life stance. I’ve not done too much research into babies born to drug-addicted mothers, but I know enough to know it’s not pretty. There is a higher incidence of miscarriage, preterm birth (which also increases infant mortality by itself, even without drug abuse), stillbirth, and infant mortality among drug addicts; not to mention increased risk of pregnancy complications which further hurt the baby (which may also harm or kill the mother) such as placental abruption, IUGR, low birthweight, etc.; not to mention the neonatal and long-term complications of being a “crack baby” or having been exposed to other drugs before birth. Plus, we have to add in the dangerous and risky behavior of some addicts (such as selling her body for sex) which may increase the likelihood that these women will repeatedly get pregnant and give birth to compromised babies who will be taken from them and put into foster care (assuming they survive at all). The woman who started this program adopted four children from a drug addict (who had eight altogether), so she knows first-hand the complications they face through life, as well as the other sad statistics of pregnancy and birth. This addict had eight children. Eight.  And she couldn’t care for them, because she was a slave to drugs. Other addicts have even more children, with even more pregnancies lost to miscarriage, and more babies being stillborn or dying in the first year of life, due to the maternal drug use.

I don’t know the percentage of pregnancies that are prevented by these long-term methods of birth control, but I suspect that most are prevented due to suppression of ovulation or inhibiting the sperm from reaching the egg. At least, I hope that most women using these forms of birth control “don’t get pregnant” due to preventing an embryo from implanting. I assume (and hope) that the number of babies that die after conception and before implantation due to the hormonal interference of these forms of birth control is less than the number of babies who would die after implantation (an “established pregnancy”), due to maternal drug use — from miscarriage, stillbirth, and infant mortality. Not to mention the greater problems the babies that survive face due to maternal drug use.

There have been some attempts (all unsuccessful, as far as I know) to require long-term birth control or sterilization under certain circumstances (perhaps after the birth of one drug-addicted baby, perhaps after other criteria), but I would assume it would be difficult to pass such legislation, and even if it were passed, that it would somehow be declared unconstitutional. But this is different, because it’s not mandatory; and assuming women are not being coerced into it, they are choosing it of their own free will. Which is one step of responsibility, even if they find themselves unable to kick the habit — and at least, they won’t have any babies born addicted to drugs. And it’s not a “Mississippi Appendectomy” but is her conscious choice. Nor is this racist nor eugenicist (“1,478 clients have been Caucasian, 845 African-American, 385 Hispanic,and 321 of other ethnic backgrounds”), but is strictly based on their actions (taking drugs).

So, what do you think?


13 Responses

  1. I urge you to read the research done by Dr. Ira Chasnoff, who is the guru on infant’s exposed to drugs in utero. There are many wrong assumptions in paying mom’s for sterilzation or long term birth control.
    To me, the end does not justify the means. We are going to pay desperate women to go on birth control? She is desperate for money and will do anything for it. Shouldn’t we be paying for free drug treatment, housing, counseling etc?
    There is a higher incidence of pregnancy complications for drug abusers. Just like their is a higher incidence of complications for mom’s who are obese, have diabetes, are over the age of 35, have infertility issues, have chronic illnesses, etc. Should we also be paying them to go on birth control?
    One misconception is that infant’s exposed to drugs will have more long term developmental issues than those of the general population. This is just not true. They have a rocky coarse during withdrawal, this is for sure. Yet long term, you would never know what kids where exposed to drugs in utero and what kids were not in the classroom. There is no such epidemic as “crack babies.” The one exception is fetal alcohol syndrome. Alcohol happens to be the worst drug a mom can take during pregnancy, and it is legal!
    Don’t get me wrong. I would love mom’s (and dad’s) who are addicted to drugs to go on some sort of long term birth control. I just do not believe paying them to do so is ethical. It is ironic in the state where I work, that mom’s on public aid (the majority of drug addicted moms) who request a tubal ligation, have to wait 30 days from the time of consent for the procedure to be done. I have yet to see an addicted mom come back to the hospital 30 days later for her tubal.
    (sorry for the long comment 😦 )

    • I just read this new article and thought of this post. Basically, it says what you said: that so-called “crack babies” are not nearly as bad as adults like they were predicted to be, with most being normal, and some even excelling. I am very glad to hear it.

  2. Don’t apologize for the length of comments — you, particularly, have more experience with this (at least on the neonatal side) than most people. The website I linked to discussed things like drug treatment, and pointed out that there are already billions of dollars being spent on such things, so the money they have available would be a drop in the bucket. While I don’t know how much money they pay the women — and this includes alcoholics, as well as drug addicts, btw — I daresay that it is less money than what rehab costs, and is more permanent (or at least lasts longer) so it might be argued that it has a better cost-benefit ratio. [I don’t know if this is true, but I can see arguments being made for that — it’s a one-time cost, as opposed to ongoing costs like housing and rehab.]

    I didn’t look at everything on the website, but it appears that this is part of a program and not just an event — that women do have to go through some sort of process. In the FAQs, it talks about referring the “clients” to drug treatment programs, and one client says something about having “graduated” from the program. Plus the program’s founder writes countless cards to the clients with encouragement for them to stay clean, etc. So, it’s more personal than the typical government program, I daresay.

    You do bring up a valid point, in that it might be unethical to pay a cash-strapped woman desperate for drugs to get her tubes tied. But it seems like a starting point. Yes, I have qualms with this, on many levels; but I also have qualms with habitual users and abusers having 18 kids that are born strung out on crack. It really bothers me to think about these poor babies who did nothing to deserve such prenatal treatment, and are suffering for their mother’s actions. I will have to do further research into this topic — most of what I’ve read has had to do with the neonatal period, and not the long-term consequences (or lack thereof) for babies born addicted to drugs.

    Lots of food for thought, which is why I posted it here — to get other people’s opinions on the matter, to help settle the qualms one way or the other.

  3. I think it is a good idea. I don’t see how it is unethical. If someone chooses to have their tubes tied because the government will give them some cash. They are choosing to do it. They can choose not to.

    I think for it to be fair, it should probably be availible to anyone below a certain tax bracket. That way hard working folks who are not drug addicts and have had to work hard could also get a monetary benefit for being responsible and they should be able to get a free tubal also and a stipend.

    I think it is more about being rewarded for being responsible. Perhaps it should only go into effect after the person has had 2 children? I like the idea.

  4. RR — I also forgot to add, in regards to the higher complications of people who have various health problems (like obesity, etc.) — one difference I see is that the above women mentioned are not necessarily engaging in socially risky situations more than the average population (i.e., selling sex for drugs or money) whereas cash-strapped addicts would be more likely to do so. Therefore, they are more likely to get pregnant in the first place (assuming the drugs don’t mess with their fertility, or at least not more so than the other risk profiles), and to get pregnant accidentally and not to want the baby after they discover they’re pregnant. I would hope and assume that most of the other high-risk pregnant women would seek medical care when they find out they’re pregnant which would serve to reduce the risk (hopefully, anyway) of these problems. Whereas drug addicts seem less likely to seek medical care while pregnant because they don’t care enough about anything but their drugs, even including themselves and their babies.

  5. I’m torn on the issue. It does sound good, but I am always incredibly wary of any program that judges certain demographic groups as “undesirable for reproducing” or etc. It can so easily slide over into other areas – like certain races, certain religions, certain genetic carriers, certain intelligence-levels, etc….. So… I don’t know!! But it’s an interesting question, and we certainly don’t want more poor babies born with drug addictions. A difficult questions!!

  6. Wow, I’m all for this program. I don’t think it’s unethical at all. The first comment mentioned that the effects of drug babies is short term. I strongly disagree. I worked in treatment for years. Up to %50 of our clientèle were adopted and usually came from mothers who were using. These kids were pretty dang messed up even though they were raised in a loving home. It could also be genetics, but there is no way to know. I would support this program 110%.

  7. i know this is an old post but just found it. First off Kathy, neither norplant nor IUD prevents conception, just live birth. And for some good information on Norplant go to (no www) and type it into their search engine.
    I’m a chronic pain sufferer and need daily pain management through medication (currently oral morphine). So I did a great deal of study about short term/long term drug effects on baby. Some drugs, like heroine, have been proven to make permanent changes in the pleasure centers of the brain. The average person is in a happy mood, has a good meal, loving touch etc, and the brain releases endorphines and we feel good. Heroine addicts do not have that feedback loop anymore, their brains have adapted and only the drug will make them feel good. Cocaine does this on a temporary basis, but the brain can recover (according to my research). Some other drugs (morphine among them) have shown no longterm effects, (and in clinical doses, no increase in things like preterm labor, low birth weight, birth defects etc) and just a miserable withdraw if the baby is born while mom is still on the drugs. Withdraw can be managed painlessly in the hospital (my pain management doctor said most of her pregnant women would remain on their meds and check baby into a planned hospital stay, usually a 3 day stay, for a safe detox. I chose to wean myself off the drug safely during late pregnancy so baby would be born drug free, so no need for detox).
    You are right that drug addicts mix high risk behavior that will also have an effect on the baby (not to mention there is a huge difference between a ‘street drug’ cut with who knows what and a prescription drug! Who knows what a mother strung out on morphine she got on the street is actually putting into their bodies). Now my research was limited to opioids (because its the only thing I would even be on) so I can’t speak to long term/short term effects of other types of drugs (I can imagine that meth could be particularly devastating to a developing baby given what it does to the adult).
    That being said, while having children, and as many as you want, is a basic human right I think it, like some other basic human rights (think freedom) can be lost through egregious actions. Everyone has a right to ‘liberty’, but we take away that right when someone commits a crime by sending them to prision. We even take away someones right to life if they commit a bad enough crime. So I think if a woman (or man) has shown to be egregiously criminal in the treatment of their born or unborn children the right to have those children should be taken away. We as a society are willing to take away a child after abuse has occured but we are unwilling to say she can’t have any more. (yet we are willing to give a life sentence to other criminals that are likely to reoffend) I do not understand why it is acceptable to take a child away from a parent who abuses them, and then let them have another (I’m talking about children that are either repeatedly or permanently removed from a home and/or multiple children abused). But I think this should be something that should be handled through criminal proceedings. Paying women/men to be on long term birth control, or permanently sterilized, leads, I think, to both an imediately situation we don’t want to reinforce (giving a drug addict money of any sort is just going to encourage drug use and it may cause drug addicts who may not be habitual or who may be turned around by a pregnancy to do this just to get the money), but also a long term situation that is a start down a ‘slippery slope’. If one charity (government or not) can pay a certian group of people another charity can pay another group of people. How many poor minority woman would be tempted to submit to sterilization for money, even if they knew the money was coming from some wealthy racist? (and, for your information sterilization campaigns for compensation are done in other countries and a great many women are desperate enough to accept sterilization against their wishes or beliefs just to get the money.)
    To conclude what I know is a very long post: I don’t think women/men who habitually abuse children should be allowed to continue to procreate. I don’t think sterilization should EVERY be offered for compensation.
    (on a personal note I knew a woman who had had her first child die under questionable circumstance, SIDS was the offical diagnosis but the child was well over a year old, her second child was in the custody of her parents, her third/forth child *fathered by current husband when I knew her* were removed from her care for abuse. When her husband had a vasectomy to keep them from having any more children she divorced him, stating she would find someone else to have more children with. Why we don’t have societal recourse to keep people like this from further child bearing is beyong me.)

    • Yes, a sticky situation. “What a tangled web we weave…” Sigh…

    • I don’t understand that woman! Why would she divorce her husband after getting a vasectomy, I think a guy who would do that for the sake of his family is a real man.

      Take for instance my husband, he has had a vasectomy before when our financial situation was not going very well. He had it and we didn’t regret it. In fact, it made me love him more. We worked hard and soon our finances improved. When that time came, we just had his vasectomy reversed. If you’re wondering how well the reversal went, it really went okay. We used Dr. Wilson, who only charged us for $1700. You can check out his site at Anyway, our baby is the proof that the vasectomy and the reversal both worked for the ultimate benefit of our family.

      So I don’t understand women who despise men who had a vasectomy. They just don’t know the sacrifice that a man has to go through.

  8. I am happy and in love with my husband. My life is full without children . I never thought things could be this good.. You will be THRILLED with how wonderful your life can be without kids. It’s OK. The world has enuf! Have one if you have to, or even better adopt or volunteer. I have always wondered why organizationse, Republican Party, Catholic Church, etc. force women to have, yet another that they really do not want or can not afford. And also, the norplant is NOT sterilization. You can have babies later. I would like this idea to go also to welfare mothers. First one on us, second one maybe?? Third one…if you want the public dollars, Norplant. Again, not sterilization, just very needed birth control.

    • Hi …I liked your comment and it irritated me that the news media predictively equated norplant with sterilization. It’s just birth control, that’s all. And frankly, it wouldn’t bother me if after the 2nd welfare baby, you need birth control as well. why not? I really don’t see why not. It’s all on our dime. It’s NOT sterilization. You want another. OK. But if you want PUBLIC MONEY then you are on forced birth control. I am a democrate, but I think the republicans could run on this one.

  9. No issue is more important to me than birth control.I just came back from 4 months in India. It makes me laugh when people talk about saving the clearly changing world by, oh, changing a lite bulb or planting a tree. The only thing that will change the world is to admit that only wanted, planned for, supported, and of coursed, loved beyond description children were brought into this world. I had an abortion when I was 17and it saved my life. But I am noone. A small person. where are all the big stars and famous ones that had an abortion 20 years ago as well?? They all are in hiding. The foes have done a great job of making us all afraid. Except I’m not. Only birth control will save this planet.

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