opinion
Like many states, the Supreme Court’s recent Dobbs decision reduced northeast Iowa to a health care desert. Despite current anti-choice rhetoric, the existence of medical privacy and health care freedoms literally saves millions of Iowans millions of dollars.
How much do taxpayers shoulder when non-medical personnel make health care decisions? Even before the Dobbs decision, Iowa was already paying the price.
Mercy Hospitals and Clinics, a major Iowa health care provider, is no longer providing birth control of any form for men or women, including family planning, vasectomies or tubal ligations. For example, long-acting reversible contraception (LARC), such as IUDs, are highly effective in preventing pregnancies and Medicaid reimburses for the very low cost, yet Mercy declined regardless. Mercy’s decision to be a birth control desert removes choices for Iowa families, including men, who know their mental, physical, and financial limits in providing for a child.
Between 2000 and 2021, 44 Iowa hospital obstetric units and birthing centers closed, causing a maternal/child health desert. Forty-six of Iowa counties are currently without birthing unit. Iowa ranks 49th of 50 states at 1.49 obstetricians per 10,000 women. Low-income Iowans do not have reliable transportation to a center for prenatal care so they merely do not get it. As a result, women may give birth outside the hospital, putting mother and baby at greater risk.
Unplanned and unwanted pregnancies are fueling Iowa’s behavioral health desert. Iowa ranks 47th for mental health services. Up to 80% of children in foster care develop serious mental health concerns. School systems with limited resources are expected to help with children with substantial behavioral challenges. Iowa closed two mental health hospitals and a children’s unit in 2015 and 2016, increasing the burden on the prison system for care. Iowa does not have enough licensed therapists and prescribers to meet the mental health needs of Iowa’s children and caregivers.
Limited reproductive freedoms contribute to a jobs desert for economically disadvantaged women in Iowa. This demographic is most susceptible for an unplanned pregnancy. Typically, these women have not completed high school before pregnancy occurs. Many women do not have the family support or childcare so they could finish high school and join the workforce.
Why do reproductive freedoms matter to Iowa taxpayers? Money.
Every human being has basic needs for survival: food, housing, education, health care, transportation, and a living wage. Eradicating access to birth control, sex education, and abortion fuel unwanted and unplanned pregnancies. Parents struggling to survive will turn to government social safety nets: Supplemental Nutrition Assistance Program (SNAP); Women, Infants and Children (WIC); Free and Reduced School Lunches; public housing; Medicaid; Electronic Benefits Transfer (EBT); Temporary Assistance for Needy Families (TANF); and the Children’s Health Insurance Program (CHIP). This list assumes a parent cares enough and can apply. Many parents are reluctant or afraid to ask for help, resulting in their children at increased risk for physical neglect and emotional damage, especially in minority communities.
Increasing the birth rate does not guarantee a greater, better-trained workforce; it does create millions of people permanently dependent on money-draining, overburdened social safety nets.
What about adoption or preventing pregnancy altogether? Only two percent of unplanned pregnancies result in adoptions. Children adopted from the foster care system often require counseling and medications for months or years. Removing sex education and access to birth control increase the chances of pregnancy. Not all sexual course is consensual or legal. A number of uncontrollable factors can influence ovulation, making that fertile period very difficult to predict. No form of birth control prevents pregnancy with 100% accuracy. Abstinence is unrealistic in a country where, according to the CDC, a majority of Americans are sexually active. You might as well forbid people from eating or walking.
Insisting that reproductive rights are only a women’s issue is just as inaccurate and dismissive as saying property taxes are only a homeowner’s issue. When access to accurate sex education, birth control, and health care is poor, every Iowa taxpayer shoulders the fiscal consequences.
Cedar Falls resident Cyd Q. Grafft is a retired nurse. Her credentials include Bachelor of Science in Nursing, Registered Nurse, former Special Education Nurse, Master of Science of Nursing, and Pediatric and Psychiatric Advanced Registered Nurse Practitioner.