A Deeper Look at the Prenatal Care Debate

Details: 19 March 2010

Two weeks ago in this column I explained the reasons why the Nebraska Catholic Conference supports LB 1110. This bill would allow Nebraska to continue to offer prenatal services to unborn children of low-income women, including those who are undocumented immigrants.

Since then, I’ve received or witnessed a variety of communications from individuals who oppose LB 1110. Some were downright nasty, some were more interested in venting than understanding the Church’s view, and some were challenging but thoughtful.

The third category of communications prompted me to think more deeply about the legitimate concerns on both sides of this debate. On one side is the concern that a nation must have a just and fair immigration policy and this policy must be enforced as best as possible or many social, economic and now security problems can result.

Immigration policy, however, is set by the federal government and states have little authority or ability to affect or enforce this policy. States are largely left to deal with the human realities and injustices of an extremely deficient federal immigration policy.

On the other side is the important good of providing prenatal care to unborn children. It is well documented that providing prenatal care greatly increases the likelihood of a healthy start to a child’s life. It is important to emphasize that the recipient/beneficiary of prenatal care is the unborn child (who has no immigration status and will be a citizen if/when born in this country) not the undocumented mother.

Another good is that providing coverage for prenatal care can be a contributing or even decisive factor in keeping an abortion-vulnerable woman from having an abortion. Sadly, I’ve already heard of a few confirmed cases of impoverished pregnant women in Nebraska who have had or are considering having abortions (at least in part) because of losing this benefit for their unborn child.

A final good is that this area of federal policy/law (Children’s Health Insurance Program or CHIP) which is reflected in LB 1110, recognizes the unborn child as a person and recipient of benefits on his or her own account—separate from the mother’s interests.

Some, however, have presented the straightforward argument that if undocumented pregnant mothers present themselves for prenatal care, why not just send them back to their home countries? Doing this, however, is much more complicated than it appears.

For example, if it becomes known that pregnant undocumented mothers will be deported if they present themselves for prenatal care services, they simply won’t present themselves. The likely result will be that their unborn children will not get needed prenatal care and the mother will continue to stay in our country.

This means that when these children are born, they will be citizens and will likely be eligible for Medicaid. And, because of not getting prenatal care, they will likely need even more expensive medical care at taxpayer expense.
The bottom line is that this is a very complex problem with legitimate concerns and goods (and potential unintended consequences) on both sides of the debate. I find it helpful to consider the fact that this complexity and balance of concerns is present in other areas of serving our least brothers and sisters.

For example, in serving the poor through the St. Vincent de Paul Society or other outreaches, we often find people in dire need because of irresponsible choices on their part. Sometimes federal social policy enables such behavior (or at least provides little incentive to change it).

But when a person is in need of basic human needs (food, shelter, clothing, medical care, etc.) we rightly help them with those basic needs. At the same time we rightly work to address the underlying social and public policy problems that contributed to this situation.

I think that balance of concerns/goods applies to this debate on prenatal care as well. At the very least, when conflicted about the balance of such goods, it seems right to err on the side of helping vulnerable human beings over strict adherence to human laws.