As abortion rights disappear, Louisiana's poor climate for mothers and children comes into focus.

Post World Landscape By the numbers, Louisiana is among the most difficult places in the country to bear and raise a child. Pregnant Louisianans have long died during childbirth at higher rates than women in the rest of the country. Black women, who have been more likely to seek abortions, are four times more likely to experience pregnancy-related death than White women, according to one study. Louisiana has the third-highest teen birth rate in the nation, the third-highest share of preterm births and the second-highest share of low-birthweight births. It is not one of the 10 states with paid family leave requirements. Louisiana doesn’t require insurers to cover birth control or sterilization, and state law bans contraception from being distributed at schools, where sex education is optional and, when taught, must focus on “abstinence between unmarried persons.” The state ranks second in the nation for both poverty and child poverty. “If we’re going to be a pro-life state, let’s be pro-life, not just pro-birth,” said Marketa Walters, an Edwards appointee who serves as secretary of the Louisiana Department of Children and Family Services. “And take care of the children that come into this state. Better mental health services, better behavioral health services. Let’s teach sex education in the schools.” Walters said the agency in recent months has already increased the amount of money people can get through welfare payments, as well as a program for family members to take care of kids. But she said she’s worried about an increase in domestic violence if pregnant women don’t have the financial stability to leave a relationship. “We desperately need more money for child welfare and staff,” she said. “You’ve heard me say that for six and a half years at the Legislature.” Some doctors are also raising alarms about the trigger law’s implications for prenatal care. One of the key reasons death of pregnant women is higher in Louisiana is because mothers are forced to travel long distances for care in many areas of the state, where health providers are sparse. New Orleans Health Director Dr. Jennifer Avegno said she’s concerned maternal mortality could get worse once the state’s strict anti-abortion laws go into effect, especially if patients in rural areas with few health providers have pregnancy complications that can only be fixed by removing a fetus. “We have to make very quick decisions with critical patients,” Avegno said. “Anything that creates confusion around that is detrimental not just to the physician but to the health and life of the patient.” “Any confusion, any limiting access...has a pretty clear effect that more women are likely to die,” she added. “As physicians, that’s incredibly hard to take.” Widespread poverty and other social ills also mean people typically have a harder time raising children in Louisiana than elsewhere. Jan Moller, head of the left-leaning Louisiana Budget Project, said the root causes of Louisiana’s grim climate for mothers and children can be traced back to poverty. “By almost any way you count it, Louisiana is one of the toughest places to have a kid and raise a kid,” Moller said. The state has already taken some key steps to expand health access to people who will be affected by the repeal of abortion rights. Since the late 1990s, lawmakers and governors have steadily expanded the Children’s Health Insurance Program, or CHIP, to provide Medicaid coverage to children in poor families. More than half of Louisiana children are covered by the program or by Medicaid. And Medicaid, federal health insurance for people with low incomes, covers a wide swath of residents, driving down the state’s uninsured number and other metrics, like the number of women who don’t have a doctor. Gov. John Bel Edwards expanded Medicaid in line with the Affordable Care Act, the law known as Obamacare, in 2016. Even those changes haven’t been enough to turn the tide for women and kids, Moller said. The state has the highest gender pay gap in the country, no minimum wage, and residents have little access to paid leave. He also noted that the federal government sent a monthly check to families who qualified for the child tax credit as part of President Joe Biden’s covid relief package. But federal lawmakers let that program lapse. https://www.theadvocate.com/baton_rouge/news/politics/article_86e68eae-f995-11ec-890d-8bbe50ae7bff.html