David Brooks recently made an argument in The New York Times that should resonate with conservatives: Inequity, and many other related crises, stem from the family and the way we raise our kids. His argument speaks to the sense among most conservatives that deep changes in our culture, and the decline of the family as a preparative institution, is the root of many evils from debilitating loneliness to widespread drug addiction.

But Brooks stopped short of offering a truly effective solution to the problem. Why? Any solution would have to start with an obvious but controversial truism: If we want to ensure families prepare children to succeed, we need to start before those children are born and actually ensure that parents are ready to raise and develop children responsibly. That process does not happen magically.

How Family Planning Should Be Reformed

It requires reforming the way we plan families. How, exactly? As a recent Having Kids research paper published in the Loyola Chicago Law Review pointed out, one step forward would be to successfully incentivize prospective parents to wait to have kids until those would-be parents have met certain milestones. The cost savings of taking these steps to ensure responsible parenting are unparalleled, especially when we factor in the huge impact on pressing crises like climate change and extreme child poverty.

In other words, it’s good to make sure the state will not have to pay the costs of parents failing to actually raise the kids they have, rather than our paying taxes to make sure the state continues to do a horrible job of post-hoc parenting. Moreover, this process can reduce population growth and the big government, centralization of power, and mind-numbing bureaucracy that comes with it. All this moves us toward governance that’s actually representative of the people themselves. That vision of freedom is the opposite of Mao’s policy of pushing women to have more kids, which made China, now with well over 1 billion people, the greatest threat to freedom in the world today.

In short, ensuring every kid a fair start in life, in part by paying would-be parents to prepare, is a policy that works. Conservatives should support family planning reform because it embodies these fundamental conservative values:
• Promoting responsible parenting and families
• Ensuring our promotion of responsible parenting is efficient by acting before problems arise, and
• Guaranteeing the American idea of freedom, or personal autonomy, that is possible only in a democracy of well-prepared citizens capable of self-rule and with true access to equal opportunities in life.

Where Personal Freedom Really Begins

There is, of course, a push among conservatives to ignore values like responsible parenting, fair starts in life, and participatory democracy in favor of policies that create kids as consumers, future workers, and compliant taxpayers because promoting a high birth rate will inflate the economy. That is simply selling out our values and foisting on our kids the costs of bad parenting in what Nobel Laureate Steven Chu called a pyramid Ponzi scheme. We are a democracy before we are an economy, and there is no reasonable conception of personal freedom that does not start with accounting for and developing the people who actually constitute our political systems and, as such, have power over us. And accounting for future citizens of our democracy means ensuring responsible parenting.

The many who gave their lives to protect what they perceived to be a unique form of freedom did not die so that the United States could become a threat to itself, ecologically through the climate and other environmental crises, and socially through the decline of the family as an institution that prepares kids for functional society. Better family planning is our best solution to both the environmental and social problems we face.

Learn more here.

By Sarah Johnson

I can’t help but admire the strength and resilience I see on display every day in my nursing colleagues with whom I’ve served for the past 22 years. Like many Americans, we confront this next phase of the epidemic with a mix of worry and hope. 

However, as medical practitioners on the front lines battling the coronavirus, it is impossible for us to ignore a feature of American life that the virus has made all too clear: the deep inequality facing communities of color, who are dealing with disproportionate infection and death rates from COVID-19, as well as longer-term health challenges like lack of access to birth control. In these communities, the epidemic will cast a long shadow — not only as families struggle to recover spiritually and economically, but as young women navigate critical moments of their lives with limited or nonexistent support from medical experts. 

For our society to rebound, we must understand and address the root causes of the inequality that the virus has laid bare. Family planning has played a significant role in improving the lives of women and people of color since it was declared a human right, but we still have a ways to go. As we imagine a world after the arrival of this pandemic, we must ensure that the U.S.’ outdated family planning model is replaced in order to address lingering inequality and to prioritize children and communities over corporations and profits. A common-sense set of solutions is the “male pill” and long-acting, reversible male contraceptives such as Contraline and the RISUG. If fully tested and approved in the U.S., such options could empower men to share more equally in family planning, leveraging their own bodies. And studies indicate that men may be open to the idea.

This is why Having Kids calls upon the United States Congress and the National Institute of Health to prioritize the development and deployment of male contraceptives. 

Why Male Contraception Is Essential

Why is male contraception important? Research shows that smaller families benefit children. It also indicates that the economic disadvantage correlated with larger families tends to perpetuate economic inequality that undermines democracy by leaving undue influence in the hands of the few. Yet in the name of economic growth, we see corporations targeting moms with costly ad campaigns to have more children for the purpose of growing the consumer base. We see sexual stimulants prioritized over birth control, and we see the U.S. tax system incentivizing larger families when incentivizing delays in pregnancy may better position women and children for equality. Economic growth-based family planning not only puts in question the planet that we’ll be able to pass down to our children, but it also leaves us more susceptible to future pandemics due to population overcrowding and decreased distance between humans and animals.

Today in the United States, nearly half of pregnancies unintended, costing us about $15 billion each year. I remember several years ago telling one of my patients, a 37-year-old African American woman in Oakland, Calif., that her pregnancy test had come back positive. She instantly froze and began to cry. She wanted the baby, but she did not have the financial resources to take care of the child. She was then faced with a very difficult decision. Scenes like this play out every day across America and the world. 

In a few short months, the pandemic has made family planning even more difficult. Condom shortages and lack of access to birth control during this social distancing period can lead to serious socioeconomic consequences for young couples. Going forward, we must empower men with equal opportunity to safely participate in their right to family planning using their own bodies. 

Male Birth Control and Modern Family Planning

What options are already on the table? Aside from the “pullout” method and abstinence, there are more than 12 options for pregnancy prevention available to women. Meanwhile, two options are available to men on the U.S. market: condoms or vasectomy. While there have been several attempts over the past several decades at developing viable options for males, critics say that sexism may be the largest barrier, in part evidenced by the early termination of clinical trials on a male version of “the pill,” due to side effects these critics say women have been experiencing for decades.

The obstacles in front of us are not insurmountable, and we cannot afford to decelerate on the road to scientific breakthrough. In today’s politically polarized America, any solution that pushes us forward while side-stepping traditional political divides should be a no-brainer. Falling squarely within the pre-fertilization category of birth control options, male contraceptives are less politically contentious, in part thanks to the current pope’s less stringent stance on contraceptives. Abortion tends to dominate the family planning public discourse, but the real conversation should be about modernizing family planning, so that women and their partners can have equal access to resources and information to plan better lives for themselves and their families. 

Downstream approaches to improving children’s welfare are failing kids and endangering our future. The most effective way to eliminate the greatest threats to children, the environment, and our democracies is to ensure better conditions for every child from the moment they are born. Let’s start at the source. When communities and parents cooperatively embrace better family planning, we can invest more in every child and create the future we all deserve.

For these reasons, we at Having Kids call upon the National Institute of Health and U.S. Sen. Rand Paul and U.S. Rep. Anna Eshoo, who lead the congressional committees on health that oversee family planning matters, to increase funding for the development of male contraceptives. 

As we salute nurses for their work on the front lines of the pandemic, we should also think about the long-term resilience of our healthcare system and our communities, and how state-of-the-art family planning drives better patient outcomes for a healthier, better-functioning society.

Sarah Johnson, a family nurse practitioner with 15 years serving patients in critical care and 22 years in allopathic medicine, graduated with an M.S. in Nursing with high honors from Georgetown University and currently lives and works in the San Francisco Bay Area. She is a founding board member of Having Kids, a U.S.-based nonprofit organization dedicated to raising awareness for The Fair Start Model, a human rights-based, child-focused approach to family planning.