Penalizing poor women: welfare policies in the United States penalize larger families while denying the means to plan for smaller ones.

IN 1996, WELFARE, AS THE TERM is commonly understood, ceased to exist. Poor families, primarily mothers and children, had to start earning their keep. Promoted by Democratic President Bill Clinton and eagerly passed by the Republican Congress, this "reform" was the most dramatic change in welfare policy since its establishment in the Social Security Act of 1935. What people do know about that legislation is generally confined to the five-year time limit on the receipt of cash assistance and the fact that mothers must now work for their checks. Less well known is the fact that almost half (24) of the states penalize poor women if they have a child.

The child exclusion ("family-cap") policy stipulates that if a woman receiving cash assistance gives birth to a child, the amount of her cash grant will not increase in recognition of her larger family size (as was done in the past in line with the formula for determining poverty, which includes household income and size). As such, when a poor woman receiving welfare, now called Temporary Assistance to Needy Families (TANF), has a child there is less income per capita in her household precisely at a time when more, not less, assistance may be needed. But there's another issue to be considered here. When did the American people decide that poor women should be penalized for having children?

While rhetoric concerning the propensity of the poor to have more children than they can afford is ever-present, that is very different from establishing social policies to influence their family formation. Yet, the reforms that began in the early 1990s have continued with unprecedented vigor, with conservative "values-driven" policies and programs such as abstinence-only until marriage, marriage promotion and cuts in publicly funded family planning. At once, poor women are being told not to have children, to be abstinent, to consider marriage, to forego contraception and to most certainly reject abortion as an option. Quite a tall order, to say the least.

The overarching contradiction appears to be the actions by conservative, family-values supporting policymakers in three related areas: first, they discourage poor women from having families; second, they deny poor and low-income women the means to limit their family size; and, third, they intentionally make life materially harder on women (not to mention their children) if they choose to give birth. The following describes each of these policies and the dilemma each presents for poor women.

MARRIAGE PROMOTION

The preamble to the 1996 legislation made it very clear that policymakers considered the traditional two-parent family a norm to be promoted to poor women. Specifically, it stated that marriage is the foundation of a successful society, an essential institution that promotes the interests of children and that promotion of responsible fatherhood and motherhood is integral to successful child rearing. The legislation had four aims:

* provide assistance to needy families so that children could be cared for in their own homes;

* end dependence of needy parents on government by promoting job preparation, work and marriage;

* prevent and reduce out-of-wedlock pregnancies and establish numerical goals toward this objective; and

* encourage formation and maintenance of two-parent families.

This landmark poverty legislation began by making explicit assumptions about social norms regarding family formation that are open to debate in light of demographic trends over the past half-century in this and other western industrialized countries, including the decline and postponement of marriage and increased out-of-wedlock child bearing. Furthermore, nowhere in the legislation is there an explicit goal to reduce poverty--a not unreasonable objective in such legislation.

In 1996, although TANF funds were not specifically dedicated to marriage promotion programs, states could use TANF funds to support these activities. In 2003, the Senate Finance bill allocated $500 million over five years; the House bill provided $600 million for "healthy marriage" promotion. Most recent Senate and House proposals seek to allocate $100 million annually through 2008. Some point out that research conducted to date has failed to show evidence of the effectiveness of these programs. That aside, a focus on program effectiveness of "marriage promotion" may miss important other considerations.

First, most would agree that the decision to get married is a very private one, influenced by many factors, not the least of which is a profound feeling of affection for another person. Scholars have documented associations between declines in job opportunities for low-income, often minority, men (e.g., in conjunction with the decline in manufacturing industries) and their marriageability. Thus, it is likely that, like their middle-class counterparts, poor women and men take factors such as income and employment into account as they consider whether or not to marry. Another consideration is the reality that a substantial proportion of poor women are or have been victims of intimate partner violence. The proposition that they be encouraged to consider marriage to the father of their child or children, who may have perpetrated violence against them, is unfathomable. What these women and men probably need is more educational and employment assistance, and the ability to form more stable, happy families will likely follow.

CUTS IN PUBLICLY FUNDED FAMILY PLANNING

Despite policies that discourage child bearing among the poor, the federal government has sought to reduce funding for public family planning programs over the last two decades. Inflation-adjusted funding for Title X programs (which are specifically dedicated to family planning) has decreased by two-thirds since 1980. Although overall Medicaid funding for family planning programs has increased during that same period, most of that increase is due to family planning expansion programs in a few states, since funding levels declined in 29 states. Recently, the Bush administration and members of Congress have proposed to cut tens of billions of dollars from the Medicaid program, as well as to eliminate the requirement that states include family planning services in the benefits package. The potential combination of fewer funds and states' ability to opt out of covering family planning services threatens to amount to a double blow against poor women's ability to control their fertility--a primary objective of the reproductive-related welfare policies.

Medicaid, Title X and other sources of family planning services provide critical funds for reproductive health services for low-income and poor women and men. Reduced funding levels will affect access to contraception as well as other important services, such as screening for and treatment of sexually transmitted infections, and preventive health services such as Pap smears and mammograms. One wonders if, in the zeal to limit poor women's fertility, that these other aspects of their health have been considered or deemed to be of minimal importance. The sentiment that poor women should not reproduce was made clear in a 2001 news report in the Seattle Times. The article announced that the birthrate among welfare recipients in Washington state had dropped by almost one third between 1994 and 2000, with clear reference to the state's goal of reducing the number of births to those on

FAMILY CAP

Evaluations of the family-cap policy have repeatedly shown that the policy does not appear to have an impact on poor women's fertility. Essentially, births among poor women in family-cap states do not differ from women in states without a family cap. In a pilot study in New Jersey, none of the 32 women we interviewed (who either currently or previously received welfare) knew about the policy. Once they were made aware of it, the majority of women said the policy would not affect their contraceptive decisions. Moreover, all women said that if they were pregnant at that time, the policy would not influence their decision regarding the pregnancy; all women said they would carry it to term despite their economic circumstances.

While this pilot study cannot be generalized to all poor women, its exploratory nature provides some understanding of poor women's childbearing decisions. Specifically, one of the reasons women stated for having the baby was that it would be the "responsible" thing to do; they also stated that they should not take the "easy way out" (i.e., in not having the baby). This theme was recently reported by sociologist Kathryn Edin in a more extensive study of childbearing and marriage among poor women. At once these findings challenge policymakers' rhetoric about "irresponsible" poor women who have children and their apparent disregard for family values, when in fact it may be a shared sense of value for children, families and marriage that influences poor women's family formation decisions in the context of their impoverished circumstances.

WHO'S RESPONSIBLE?

So what if research findings are indeed true; that poor women may choose children precisely for the same reasons that the affluent suggest they shouldn't--to be "responsible"? What we are left with is a quandary for both poor women and policymakers. The women may want to plan their families and delay childbearing but have less access to affordable family planning and reproductive health services. Irrespective of their plans or wishes for marriage, federal and state funds are being funneled into "marriage promotion" programs, the appropriateness of which is debatable and the effectiveness of which has not been proved. And if they have the misfortune of living in one of the 24 family-cap states, less funding for family planning could result in an unplanned birth, for which there is now less public social assistance.

Conversely, many policymakers decry the "loss" of family values among the poor. They envision the solution in the form of punitive measures (such as the family cap) as a way to counter deviant behaviors, such as out-of-wedlock childbearing, without recognizing this as a complex decades-long trend. Furthermore, such punitive measures are not applied to non-poor single mothers. Policymakers also fail to recognize the contradiction in investing hundreds of millions of dollars to promote marriage among the poor (via programs with questionable effectiveness) while proposing cuts to publicly funded family planning programs which have been associated with declines in unplanned pregnancy and abortion. Poor women are essentially asked to forgo childbearing and denied the means to do so.

The way in which the issues of poverty and reproductive health have been brought together by policymakers deliberating over our welfare system is troubling. Legislation that is supposed to deal with poverty in this country does not even contain an explicit goal of reducing it. The causal connections that policymakers have drawn--both explicitly and implicitly--between childbearing and poverty are questionable. This has led to a conservative rhetoric demeaning the moral makeup of those living near or in poverty, instead of a focus on the fundamental causes of poverty, such as inequitable economic and educational institutions. Add to that a disregard for universal human and reproductive rights, which assure the individual's right to found a family, and it is clear that there is much room for improvement in American welfare policy.

DIANA ROMERO, PHD is the Project Director for the Finding Common Ground project and Assistant Professor at the Heilbrunn Department of Population and Family Health at Columbia University. Finding Common Ground, a collaborative research project involving Columbia University and Boston Medical Center, investigates the potential impact of welfare reform policies on the health of poor women and children.