Detroit abortion rate underscores rising poverty, declining access to contraception

By Debra Watson
30 May 2014

Nearly one in three pregnancies in the city of Detroit ends in abortion, a figure that has been rising steadily since 2001. In 2012, the most recent year for which data is available, of an estimated 18,360 pregnancies among Detroit residents, 5,693 ended in abortion, or 31 percent.

These figures are based on mandatory health statistics compiled by the Michigan Department of Community Health (MDCH). Reporting on the study, the Detroit News cites public health experts who attribute the sharp rise in abortion in the state’s largest urban center to rising poverty and dwindling access to affordable contraception.

The rate of abortions among all Detroit women of childbearing age aged 15 to 44 years old, including women who were not pregnant that year, was 37.9 per 1,000 women. This figure marks an increase from 27.5 per 1,000 in 2001, and almost equals the peak of the abortion rate recorded at the onset of the recession in 2008. While rates in Detroit rose dramatically, the rate of abortion declined statewide, from 12.6 to 11 per 1,000 women of childbearing age. Rates nationwide are also on the decline.

Earlier this year widespread poverty was similarly cited as the underlying cause of high infant mortality in the city (see: “Detroit infant mortality rate worst among large US cities”). Detroit’s infant mortality rate is the worst among large US cities, three times the national average, and worse than in some developing countries.

The liberal Guttmacher Institute estimates that one in three women will have an abortion in her lifetime. When compared to contraceptives that prevent pregnancy in the first place, however, it is not the most desirable form of birth control. The cost of the procedure, which can be as much as $400 to $800, is also prohibitive for very low-income women.

According to the MDCH, 95.4 percent of abortions in Michigan are paid for out of pocket. Reactionary political forces have prevented the use of Medicaid for abortions, while the Obama administration has retreated from strengthening access to contraception coverage under the Affordable Care Act. (See: “New attacks on contraceptive access follow Obama cave-in on issue)

As state funding for family planning and contraceptives was slashed from more than $5 million in 2006 to $692,300 in 2013, Detroit’s abortion rate exploded. For Detroit and other poverty-stricken areas of Michigan, the number of clients receiving free family-planning assistance decreased by about 80,000 between 2006 and 2013.

More recent figures from the MDCH web site show that of 162,936 pregnancies among all Michigan women in 2013, a total of 25,412 ended in abortion. Wayne County as a whole, which includes Detroit and the formerly heavily industrialized suburbs to the west and south of the city, accounted for 10,000 of that state total.

Macomb and Oakland counties in suburban Detroit, which contain pockets of low-income families, also have rates per thousand somewhat higher than the state average for women of childbearing age. So does Genesee county, home to the city of Flint, which was also devastated by the loss of auto jobs over decades and hit hard in the aftermath of the 2008 recession.

Real choice in reproduction means providing women with free or low-cost access to the best reproductive health care. Women must also have the economic means to support the children they desire to have. Detroit women are being forced to make reproductive decisions under severe economic stress, including scarce jobs, falling wages and drastic cuts in social programs.

Economic distress is faulted for the precipitous decline in the US birth rate, which dipped in 2011 to the lowest ever recorded. The US birth rate, which is the annual number of births per 1,000 women in the prime childbearing ages of 15 to 44, declined 8 percent from 2007 to 2010. The 63.2 per 1,000 birth rate in 2010 was the lowest since reliable statistics were first gathered in 1920.

According to research by Rachel Jones and others reported in the Journal of Family Planning and Reproductive Health Care in 2013, “Abortion has become increasingly concentrated among poor women.” More than half (57 percent) of the women obtaining abortions experienced a potentially disruptive event within the last year, most commonly unemployment (20 percent.)

Detroit, once the American city with the largest percentage of home ownership, is now characterized by large concentrations of low and very low-income families. Forty-two percent of women in the city have incomes below the poverty line, compared with 17.3 percent statewide.

In Michigan, actions by Democrats and Republicans have led to unprecedented and devastating cuts in welfare benefits that once helped low-income families deal with the unreliability of weekly income endemic to low-wage work and precarious social circumstances. Because of state government policy under both Democrats and Republicans, large numbers of families with children lost welfare benefits even as long-term unemployment reached record highs due to the recession.

The number of poor Michigan families with children receiving any cash assistance through the Family Independence Program (FIP) dropped from 80,000 in September 2011 to less than half that, 36,810 cases, last month. Tens of thousands of Detroiters have been cut off benefits. In 2011 and 2012, the state began to strictly enforced lifetime limits codified in 1996 federal welfare reform under the Clinton administration. Temporary Assistance for Needy Families (TANF) in Michigan was gutted, abruptly throwing families off support and starting a downward spiral in help for families.

Republican Governor Rick Snyder has proposed even deeper cuts in the FIP budget for next year. This includes a 29 percent reduction in funding, dropping from the current level of $214.3 million to $152 million in fiscal year 2013. Caseloads are expected to fall to 33,200 in 2015.

In addition, food stamp cuts implemented late last year have hit families already under financial stress. The cuts implemented by President Obama and Congress wiped out more food assistance in dollar amounts than is currently provided by private food banks in many states, including Michigan.

The growth of extreme poverty in the US has left family incomes so low that private charities like food banks have had to take on a new crisis in recent years—providing diapers to mothers with babies and young children. It is estimated that disposable diapers can cost up to $100 a month for one baby, a need not covered by programs like Women’s Infants and Children (WIC) designed to help low-income mothers. Nevertheless, food banks report they can only hand out a dozen or so at a time, a totally inadequate amount.

The abortion statistic for Detroit, like the infant mortality rate, is a barometer of the grotesque levels of inequality in American society, highlighting the brutal reality that the birth and health of the next generation is being placed increasingly at risk.

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