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August 28, 2013
Viewpoints: Bills would protect women's, children's health

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(Aug. 28 - By Tracy A. Weitz and Sierra Harris, Special to The Bee)

As Californians, we all want the best future for our state's children. This requires that we act in ways that help families and communities thrive and to avoid touting disingenuous support for children and women's health. Unfortunately, last week we saw the latter on full display during a Senate Appropriations Committee hearing for two interconnected but separate bills, Assembly Bills 154 and 271.

AB 154, by Assemblywoman Toni Atkins, D-San Diego, would allow properly trained nurse practitioners, certified nurse midwives, and physician assistants to perform first-trimester aspiration abortions (these same providers can already offer abortion with medications) - expanding access to abortion services throughout California.

Currently, half of the state's counties lack an accessible abortion provider and women in those areas are more likely to receive their health care from these non-physician clinicians. The safety of the provision of abortion by these clinicians is not in question, having been proven by a five-year study conducted by one of this editorial's authors, Dr. Weitz, of the University of California, San Francisco.

Supporters of the bill include the California Women's Health Alliance, comprised of 33 groups representing a wide range of professional and grassroots organizations. Yet, opponents of the bill asked the Legislature to oppose it in the name of concern for women and children. Legislators opposed to the bill reiterated those concerns during the floor debate in the Senate on Monday (the bill passed 25-11 and returns to the Assembly for concurrence).

It is easy enough to see through the "concern" for women when it comes to limiting access to abortion care, however. The scientific evidence has been clear for years: abortion at any time during pregnancy is always safer than carrying a pregnancy to term, and abortion itself does not cause long-term mental health harms to women. Rather, the one thing we know improves safety is helping women get abortions earlier - so expanding access to early abortions is a no-brainer.

In fact, stigma and shame, not the abortion itself, are the causes of negative coping after the procedure. New evidence from an ongoing study at UCSF finds that when compared to women who were able to obtain a desired abortion, those who had to carry an unwanted pregnancy to term were three times more likely to be in poverty two years later.

No more than 20 minutes after AB 154 was heard, AB 271, by Assemblywoman Holly Mitchell, D-Los Angeles, was taken up by the same committee. This bill would remove the states' "family cap" for CalWorks, helping keep families out of extreme poverty. Under the current law, if a child is born into a household already receiving public assistance, then that child is not eligible for the $122 in monthly support.

California is one of only 16 states to have such a requirement, known here as the Maximum Family Grant. Family Cap policies are rooted in stereotypes of women who receive welfare - namely, that they purposefully have more babies to secure increased benefits. While numerous studies have debunked this characterization, this policy has remained on the books for over 20 years, driving families further into poverty while endangering the health and wellbeing of newborns.

Tellingly, the roll call of AB 271 supporters looked almost identical to that of AB 154, including the very same women's health advocates, along with allies in the anti-poverty community. They spoke passionately about the effects of extreme poverty on children's development, and the negative fiscal consequences of these poor outcomes on the state. And supporters of AB 154, the bill supporting access to abortion care, were also vocal in sharing their concerns regarding the wellbeing of our children. Meanwhile, those most glaringly absent from among AB 271's supporters were the very people who had come to the committee to protest the abortion bill in the name of the unborn.

This is not surprising. At their core, these two bills hold the same set of values: that women and their families deserve to make the best parenting decisions for themselves. This philosophy is aligned with the experiences of women who are impacted by these policies.

People's lives are complicated and struggles are intertwined. The same women who lack access to comprehensive reproductive healthcare in their communities are also struggling to support the children they have.

We look forward to the day when activists and politicians who claim to care about the well being of children actually show up in support for bills like AB 271. The bill has until Friday to pass out of the Senate Appropriations Committee. We also call on those in the reproductive rights community to demand the repeal of policies like the family cap that specifically target low-income families and women of color.

It is important that the Legislature pass both bills. Hopefully this will remind Californians, and the nation, that support for abortion is part of a larger struggle for reproductive justice that includes not just the right to not have children, but also the right to have children and parent them with dignity.

Tracy A. Weitz is an associate professor and director of Advancing New Standards in Reproductive Health at the University of California, San Francisco. She is a principal investigator on HWPP#171 a statewide demonstration project of clinicians performing aspiration abortion. Sierra Harris is the assistant director for ACCESS Women's Health Justice, which is a sponsor of both AB 154 and AB 271. She is a 2012-2013 fellow of the Women's Policy Institute.

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