Should we incentivise contraception?

elocal Magazine, ed. 219. 1 June 2019

Like many of you I suspect, I was distressed reading the account of the attempt by Oranga Tamariki, the fashionable name for the Ministry for Children, to remove a new-born baby from its 19-year-old mother in Hawke’s Bay a few weeks ago.

Then I read that three Maori babies are taken into state custody every week around the country, and that in the particular Hawke’s Bay case, the baby was the second to be taken from the teenage mother.

This is crazy stuff involving enormous social and financial cost.

The young mother pays a huge emotional cost if her baby is taken from her, and an enormous lifetime cost, in terms of educational and employment opportunities foregone, if it is not.

The chances are depressingly high that the child will be the victim of physical and psychological abuse, often from the male partners of its mother, the natural father of the child whose responsibility it should normally be to protect his child having long gone.

Even in the best of circumstances, with the mother trying hard to protect her baby, the child is likely to be living in relative poverty and may struggle in school and, later, in employment.

Vastly worse, if the child’s mother was drinking heavily during pregnancy, or taking drugs during pregnancy, the child may be permanently damaged and have insuperable problems at school and in holding down a job, with a high likelihood of suffering mental illness later in life and/or ending up in prison.

And these are just the personal costs, to the mother and her child.

For taxpayers, the costs are enormous with no offsetting benefits. The mother is likely to need long-term income and accommodation support, particularly if the first child is followed by several others. The education system will need extra funding for the seriously misbehaving and anti-social children. There may well be ongoing costs to support the unemployable adults, or imprison those who end up committing crime. It has been estimated that the cost of each baby born with foetal alcohol syndrome disorder is some $1.6 million over its lifetime, and that there are some 600 babies born with that disorder in New Zealand each year.

What’s to be done? A few years ago, Paula Bennett, then Social Development Minister, announced that the Government was willing to offer free long-acting contraception to beneficiaries who wanted it, and to cover the cost of removing the contraceptive device for those who later decided they wanted to have children. It was a purely voluntary scheme and involved no cost to any women taking up the offer.

The reaction was fast and furious. David Shearer, then Leader of the Labour Party, said the scheme should be available to all women, not just to beneficiaries.

But Green co-Leader Metiria Turei denounced the scheme, suggesting that it would coerce women into taking up the offer out of fear they would otherwise lose their benefits.

And the co-Leader of the Maori Party, in theory one of the National Government’s allies, strongly opposed the scheme, saying it was insulting to tell somebody how many children they should have.

Well, yes, people should certainly be able to have as many children as they want if they can provide for them themselves. But what if the children born into the world are doomed from the start by being born to a hard-drinking mother on methamphetamine, with not the slightest prospect of ever being anything other than a very heavy drain on the incomes of others?

At the moment, the incentives are all wrong. Having a baby may seem the easiest way for some women to get an ongoing income courtesy of the taxpayer.

What if, instead, the government were to offer an incentive for accepting some form of long-acting reversible contraception, possibly an IUD, with a commitment to reverse that procedure after, say, seven years if desired at no cost?

If the incentive were, say, $25,000, it could be highly attractive to many young women who are in situations where they are under considerable pressure to engage in sex and where the alternative to some form of long-acting contraception is either abortion or an unwanted child.

At very least, free long-acting contraception should be available to any woman who requests it. The cost of providing that contraception is utterly trivial in comparison to the financial and emotional cost of an unwanted pregnancy. And providing an incentive for such contraception, perhaps limited to those under some specified age, would also be a worthwhile investment in both human and financial terms.

Any such scheme would have to be strictly voluntary of course, but who could seriously object to such a voluntary scheme? The money paid out could not only avoid an unwanted pregnancy, it could also enable young women to establish their independence, perhaps repay debt, or improve the life of an existing child. It’s hard to see what objection there could be to such a scheme.

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Copyright © 2024 Don Brash.