Episode 28
· 31:37
When you look at a broader lens of reproductive justice, it's not just about bringing children into the world or not bringing children into the world. It's, you know, what kind of a world are we bringing them into?
Carmina Ravanera:Reproductive health care is often framed as a social, moral, or personal issue. It doesn't come up a lot in conversations about economic prosperity. But the reality is that reproductive care is actually very closely connected to the economy. It can shape people's financial stability, their education and career opportunities, and the future of their families. For women in particular, safe and affordable access to reproductive care can have a major impact on whether they're able to work, stay in school and make decisions about their futures.
Carmina Ravanera:In this episode we explain why reproductive health care is an economic issue and why reproductive justice framework is crucial to how we think about the economy. I'm Carmina Ravineira, senior research associate at GATE.
Dr. Sonia Kang:And I'm Doctor Sonia Kang, academic director at GATE. Welcome back to Busted, our podcast that debunks myths that get in the way of progress on equality.
Carmina Ravanera:Today, we'll be talking about why we need to center reproductive health care and reproductive justice when we talk about the economy. Something we've seen a lot lately, especially in conversations about Canada's economic growth, is a focus on big investments in things like pipelines and AI. But those conversations often overlook something more fundamental. People's health is also part of the infrastructure that supports the economy.
Dr. Sonia Kang:Right. And to be clear, we're not saying reproductive care is important because it will boost the economy. It's important because access to health care is a human right. Everyone deserves to be able to decide whether, when, and how they have children. And they deserve the support they need to raise their children in safe and healthy conditions.
Dr. Sonia Kang:That said, we do still need to talk about how reproductive health is closely connected to economic outcomes because that connection is often sidelined.
Carmina Ravanera:Just so we're all on the same page, when we say reproductive health, we're talking about all forms of sexual and reproductive health services. According to the World Health Organization, that includes contraception, abortion, fertility and infertility care, and maternal health care.
Dr. Sonia Kang:So who did you talk to to help us challenge this myth?
Carmina Ravanera:I talked with Doctor. Diana Green Foster and Doctor. Yana Rogers, who are experts in reproductive health care and in feminist economics.
Dr. Diana Greene Foster:My name is Diana Green Foster, and I'm a professor in the OBGYN department at the University of California San Francisco. But I'm not an OBGYN. I am a demographer, so looking at the broader life consequences of access to reproductive health care.
Dr. Yana Rodgers:I'm, Yana Rogers, and I am a professor at Rutgers University, which is the state university of New Jersey in The US. And I'm a professor in the labor studies and employment relations department there and also the department chair and former faculty director of the Center for Women and Work at Rutgers University. Over the years, I've done a lot of research in the area, that we call feminist economics. In feminist economics, we often look at issues that are considered social issues, and we argue why they really are economic issues. And that includes access to reproductive health care, just like it includes unpaid work and care work that happens in homes.
Dr. Sonia Kang:Great. Let's get into it. How does reproductive health care affect economic outcomes?
Carmina Ravanera:Yana explained how access to reproductive care is connected to the economy on multiple levels, starting with the individual level. Access or lack of access to reproductive health care can directly affect women's education, employment, income, and financial security.
Dr. Yana Rodgers:You can think of why access to reproductive health care is a microeconomic issue because it shapes women's decisions and their options around fertility, their timing of when to have a child, or their ability to prevent unwanted pregnancies and so forth, but largely the timing of birth, the spacing, how many children to have, if they want children at all. And these have economic outcomes because it affects how much women can invest in their educations, how much or when to invest in their careers, what kind of jobs to have, when they can work, if they can participate in the labor market. And these are examine examples of economic outcomes at the micro level. Even health effects. Women who have more children, say, because of access to reproductive health care are often having children in tighter intervals, and that's not as good for their health.
Dr. Yana Rodgers:And that could affect their economic productivity and ability to participate in the labor market. It also can affect the health of children. And there's quite a bit of evidence showing that children's health is a strong determinant of their economic outcomes in the future as adults. And then one other aspect of the economic outcomes that we discuss at the micro level also is that when women lack access to, let's say, abortion of an unplanned pregnancy, that child is more likely to grow up in poverty. And there's quite some research coming out now showing that link between poverty and the lack of access to legal safe abortions.
Carmina Ravanera:Diana has also done some compelling research on abortion access and economic outcomes. Her most well known study, the Turnaway Study, looked closely at what happens when women seek an abortion but are turned away.
Dr. Diana Greene Foster:I am best known for the Turnaway Study, a study I led over ten years that, was responding to a conversation that was being hap that was happening in The United States about does abortion hurt women? And this idea that people would come to regret their decision and be depressed. It was a mental health argument, and, you know, there weren't reliable data to say yes or no. So many people have abortions. Something between, you know, a third and a fourth of one in three and one in four women over their lifetime will have an abortion.
Dr. Diana Greene Foster:So if it causes depression, we need to know. And there were no there wasn't much evidence saying that it does cause depression, but the way you would actually find out is to compare people who want abortions, those who get it, and those who don't. And if you compare women who get abortions to women who never got pregnant, that's not an equal comparison. It's not people at the same time in their lives, under the same circumstances. So when we did this study, which was primarily to look at mental health, we asked people why they were seeking an abortion, and, we included tons of questions about all those other factors to see what are the consequences, not just mental health, but physical health, socioeconomic, children's outcomes.
Dr. Diana Greene Foster:What are what are what happens? You have these two groups of people. They both want abortions. Some got it. Some didn't get it.
Dr. Diana Greene Foster:What happens after that?
Dr. Sonia Kang:That's a super interesting study. What did her findings show about the effects of abortion access on women's lives?
Dr. Diana Greene Foster:What we see, is that the two areas with the absolute biggest differences are physical health because carrying a pregnancy to term is a massive, massive physical experience with tons of risk that lasts through pregnancy, through delivery, and years beyond, but also economic. So people tell us they can't afford to have another child or they can't afford to have a child right now, and they're right. When when the group who's denied an abortion has years of telling us that they can't afford, basic living expenses like food, housing, and transportation, they're more likely to experience that subjective poverty, and they're more likely to experience a lower, household income to family size. So objective, subjective poverty are both higher if you're denied abortions. And I published those, you know, women's self reported economic outcomes in the American Journal of Public Health.
Dr. Diana Greene Foster:And an economist named Sarah Miller from the University of Michigan reached out to me and said, okay. What you really should do is take your sample and match them to their credit report, what credit agencies collect. They have archived credit data you can use for research, link them to their credit report, and see for years before they ever got pregnant, years after with no loss to follow-up, what do credit agencies who have no idea about pregnancy, abortion, kids, What do they think is happening economically with these two groups of people? And what she showed was that, the the two groups, those who received an abortion, those who were denied, looked very similar for years before they even got pregnant. But the year of the birth after which year that one group gave birth because they were denied an abortion, their economic trajectory takes a turn, and they don't recover for the entire period that she followed them, which was something like five years.
Dr. Diana Greene Foster:And, if you invite me back, I think she's done followed it for even more years, but that's that's just to try and get another invitation to your podcast. So in any case, what has been published by Sarah Miller, in collaboration with me, is and Laura Wery, who's now at NYU, the three of us, this paper showed that higher debt, higher chance of bankruptcies, evictions, you know, bad credit scores, the economic burden of having a child when you're not ready to have a child is, large and persistent. And we want kids, no matter what you think about abortion or women's decision making or anything like that, everybody agrees that children should be well taken care of. And, I led a study that from this turn away study, I led a paper that showed that, if you compare the kids born because the mom was denied an abortion to the next child born to someone who did receive an abortion, there's an economic difference there too. You know, those kids born mostly because the you know, from the pregnancy where the abortion was not denied, those, kids do better economically.
Dr. Diana Greene Foster:So, yeah, it's a it's abortion contraception are economic issues with very large impacts for women's economic well-being, children's economic well-being. I don't have men in my sample, and I don't have trans men, but I think those people would also experience economic consequences.
Carmina Ravanera:Basically, women who were denied abortions were more likely to experience poverty, lower credit scores, and more debt even years after childbirth.
Dr. Sonia Kang:Right. Reproductive health decisions are closely tied to the economic well-being of women and their families. They can shape whether they can pursue education and build careers, whether they feel financially stable and able to provide the kind of life they want for their children.
Carmina Ravanera:And as Yana explained, reproductive health care is linked not just to individual economic outcomes, but also to the broader economy.
Dr. Yana Rodgers:At the mesoeconomic levels, we're looking at communities and labor markets. And we see that in communities where family planning needs go unmet, there are more shares of women who are stuck in informal, unprotected work. And at the macro level, there's quite some research done there showing that when you aggregate all these effects in countries, you know, around the globe where we see access to legal safe abortions and access to contraception that's linked to higher labor force participation rates for women, more education among the entire, you know, women in the workforce, and that has economic repercussions for GDP, gross domestic product per capita, and economic growth. And our Nobel Prize winner in economics two years ago, Claudia Golden, actually is known for some of her research around she called it the power of the pill that the birth control pill led to a huge increase in women's labor force participation. So that's, you know, a clear link between reproductive health care and economic outcomes.
Dr. Yana Rodgers:And more recent research has shown that in the case of abortion rights, some of those effects for women's labor force participation are even stronger than the measured effects of access to contraception. Contraception. So that would be my answer in terms of why, you know, access to reproductive health care is very much more than a social issue or a health issue. It is indeed an economic issue at those levels.
Dr. Sonia Kang:So the research shows that reproductive health directly influences our economies at every level, from individuals and families to the country as a whole. This isn't surprising because we know that women's ability to work is affected by childbirth and caregiving. And having kids is super expensive. If people aren't ready to have them, whether economically or otherwise or don't have the support they need, the effects can last for years and even shape their children's futures. We've put some links in the show notes if listeners want to learn more about this research.
Dr. Sonia Kang:So what did our experts say about the policy implications of their work?
Carmina Ravanera:Both of our experts talked about how their research suggests that policies need to better support women and families throughout their lives. This doesn't just mean having the choice to have or not have children. It also means making sure that people who do have children have the support they need to raise them.
Dr. Diana Greene Foster:To me, what this study reveals is that we our policies, our public programs for children are, and poor families are grossly insufficient. If we wanna talk about supporting the next generation and encouraging people to have births or, supporting reproductive autonomy, we need much better supports, health insurance, childcare, income supports, paid leave to help people have kids. Having kids is expensive, it shouldn't be so entirely born individually, and right now, the social safety net is completely failing low income parents and kids, and that is important no matter what you feel about abortion. Abortion legal or illegal, the social safety net is not sufficient, and that hurts our country and hurts children and women and families. So that's one first obvious one.
Dr. Diana Greene Foster:And the other is that, you know, people can make their own decisions about pregnancy and should be able to make their own decisions about when and whether and with whom to become pregnant. And that that's an there are economic consequences when they can't. People know about their own family's needs and their own ability to provide. So not just financial resources, but emotional resources, physical resources to invest in a family, and we have to be able to let people make their own decisions. That means no abortion bans.
Dr. Diana Greene Foster:That means, insurance coverage for abortion. That means, you know, taking the government out of reproductive decision making.
Dr. Yana Rodgers:I think first and foremost, you know, this is true in, The US and in other countries that have, restrictions on access to safe legal abortions is we need to provide that access to safe legal abortions. And I think that that first and foremost is a policy change. We need to see as soon as possible, ideally, and it's been happening in other countries. And research does show that there are economic benefits to having fewer restrictions access to abortion. And the same goes with access to modern contraceptives, especially in lower income countries.
Dr. Yana Rodgers:And I think, you know, greater reproductive health freedoms and rights is critical for women's reproductive health, but also their economic empowerment. It's a bottom line. But when you look at a broader lens of reproductive justice, It's not just about bringing children into the world or not bringing children into the world. It's, you know, what kind of a world are we bringing them into? And we need to support working families, working parents with other kind of policies, whether it be employer policies or government policies that support workers when they have children, especially paid sick leave, paid parental leave, and things like minimum wage so that children are being born into households that can support their children, that can support the children economically.
Dr. Yana Rodgers:So it's really a case of reproductive justice that we have, you know, access to reproductive health care, but without the economic devastation that comes with living in poverty when having children. So again, this is not only, say, paid parental leave or sick leave, but also and especially, I would argue, for universal affordable child care. So don't just leave child care up to market forces. I think governments have a pivotal role. I think in The US, it's been largely left to market forces.
Dr. Yana Rodgers:And it can be really difficult for parents with young children who don't have access to affordable, high quality childcare. I think many Western European countries have done a better job with governments supporting families with childcare. But I would say that that's just critical. And this is also a matter of reproductive health. It's not just abortion policy or contraceptive policy.
Dr. Yana Rodgers:It's other policies that support working families.
Carmina Ravanera:Even though both Diana and Yana are speaking primarily from a US perspective, their policy suggestions apply in the Canadian context and in other contexts too. For example, even though abortion is legal in Canada, people still face barriers to access here. Someone might live in a rural or remote community and have to travel long distances to find a provider. While Canada has recently implemented a federal affordable child care program, access to child care is still uneven, especially for low income and racialized families. And the high cost of living may lead people to feel like they can't afford to have a child, even if they want to.
Dr. Sonia Kang:As Yana mentioned, a helpful framework for thinking about the connection between reproductive health and the economy is reproductive justice, a term coined in 1994 by a group of black women activists. Reproductive justice is about three rights, the right to have children, the right to not have children, and the right to raise children in safe and healthy environments. That means reproductive justice goes beyond individual choice. It also requires addressing systemic issues such as poverty, lack of access to child care, food insecurity, and housing, all of which influence whether people can raise children in a safe and healthy way.
Carmina Ravanera:Right. And speaking of policies, Yana has also done some interesting research on workplaces offering benefits that include reproductive technologies, like in vitro fertilization or IVF, and what those benefits mean for reproductive justice. I'll let her explain.
Dr. Yana Rodgers:So it seems like we should be, celebrating, you know, this trend that employers are providing their employees with access to, let's say, in vitro fert fertilization, IVF,
Dr. Sonia Kang:or
Dr. Yana Rodgers:egg freezing, or even abortion related, travel costs. They're covering those costs. But in this article that my coauthor Annie McGrew and I published in Feminist Economics, we argue we need to be cautious about these benefits that companies are providing because there's a real business logic behind the companies providing these benefits. And what we argue, it's not really their altruism per se. They are, you know, looking at the bottom line and profits, because motherhood is expensive for employers.
Dr. Yana Rodgers:When, women go out, either if they leave their jobs altogether or even if they go on maternity leave, but especially if they leave an employer completely because of becoming mothers, there's turnover, there's loss of firm specific human capital, and replacement costs that can be quite expensive for companies. So these employers really are looking at the bottom line. They know motherhood is expensive. So what they'd like to do is delay motherhood, and they'll push it off into the future. So that's why they are, you know, subsidizing or providing benefits that cover egg freezing or even IVF.
Dr. Yana Rodgers:The other reason that we are just cautious besides the fact that it's not just pure altruism, that it makes business sense for employers, is that there's a lot of economic stratification. These benefits are really expensive. You know, egg freezing costs around $7,000. IVF is easily at least 10 to 15,000 US dollars. And these kind of benefits overwhelmingly reach white collar workers in large companies.
Dr. Yana Rodgers:They tend to be employees with higher incomes. So part time workers, contractors, people who work in smaller companies are not included among covered workers. So there's a real stratification going on here. We found some a news article about Amazon warehouse workers who were taking some of these jobs with Amazon specifically to get the fertility benefits. And one worker in in the story we found, said she felt like she was hostage to the job, that if she lost the job, she would lose these benefits.
Dr. Yana Rodgers:So what we call that is job lock. Some women feel like they're locked into these jobs. So, again, it's it's not a problem that women are providing these benefits, but we just need to be cautious and also encourage firms to look at other policies that help support women in the child, you know, rearing child care decisions that they have. And it's not just employers. It's governments as well.
Dr. Sonia Kang:So while these benefits might look generous and can be genuinely valuable, we do need to be cautious about how they might encourage women to put off childbirth to support a company's bottom line. And relying on workplaces to provide reproductive health care can increase inequality and access to care because not everyone has access to the kinds of jobs that provide these benefits.
Carmina Ravanera:I think this research shows why a reproductive justice approach focuses on everyone having the reproductive care they need, no matter how old they are and no matter what job they're in. There's already inequality in who can access reproductive health care, with low income and racialized communities facing more barriers. Workplace benefits may help some people while leaving those broader inequalities untouched.
Dr. Sonia Kang:So let's bust this myth once and for all. If someone were to say to me or imply that reproductive health has nothing to do with the economy, what's something I could say to challenge that?
Carmina Ravanera:First off, reproductive health is closely tied to the economy because health issues are also workforce issues.
Dr. Yana Rodgers:I think they could say that, you know, every let's say every dollar spent on health care, it's not just spending on health. It's spending on the workforce. So we really need to think about reproductive health and women's reproductive empowerment as an economic empowerment issue. And that comes largely through their abilities to get more education and to participate in the labor force in more meaningful jobs. So money spent on reproductive health care is also money spent on the workforce.
Dr. Yana Rodgers:And in that way, reproductive health care is an economic issue in addition to a health issue.
Carmina Ravanera:And you could also point out that just because something is seen as a women's issue or a social issue doesn't mean it's also not an issue. In fact, treating reproductive health care as separate from the economy is part of the problem. It allows conversations about economic growth to ignore the health, care, and everyday realities that make economic participation possible in the first place.
Dr. Diana Greene Foster:I think there's a basic sexism that says that anything that has to do with women is somehow less serious and less important, and there really isn't anything more important than the health of families. That's true in Canada and The United States. And the health of families, the well-being of children is, you know, is valid to care about and serious and, you know, shouldn't be trivialized because we think it's somehow in women's realm and therefore less important. So, yeah, economic the labor market is tied to people's access to reproductive health care. You know, the quality of people's lives is highly associated with their ability to make their own decisions around childbearing.
Dr. Sonia Kang:Reproductive health care shapes people's ability to work, study, support their families, and plan their futures. And reproductive justice reminds us that real choice depends on having the resources and conditions needed to act on it. With that, this myth is busted. Make sure to subscribe so you don't miss what's coming next. We'll be back soon with a new episode.
Carmina Ravanera:In the meantime, happy myth busting. Gates Busted podcast is made possible by generous support from BMO. If you liked this episode, please rate and subscribe to Busted. You can also find more thought provoking podcasts from the Institute for Gender and the Economy by searching for Gate Audio wherever you get your podcasts. Thanks for tuning in.
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