Parenthood

Giving Birth Is Expensive. Birth Care Funds Are Working to Fill the Gap.

Birth care funds are working to provide support to new parents and combat predatory "crisis pregnancy centers."

Illustartion of Southeastern states with hands passing each other jigsaw pieces. A mouth over them with a text bubble reads,
Birth care funds in the South are working to help parents better manage child care. Austen Risolvato/Rewire News Group

When Maleeha Aziz, deputy director of the abortion fund and reproductive justice organization Texas Equal Access (TEA) Fund, needed an abortion when she was younger, she initially encountered a “crisis pregnancy center” (CPC), a fake clinic that tries to dissuade people from getting an abortion.

“They sort of misled me and caused me trauma,” Aziz said. “I had to go out of state to get my abortion.”

She later became TEA Fund’s community organizer, and when the deputy director position opened up in June 2022, Aziz already had an idea for the application’s required project proposal.

“My focus was the anti-abortion center campaign,” Aziz said. “I had been wronged and harmed by these centers. So now, it’s important to me, whether someone needs an abortion or whether they want to have a family to offer them the support they need.”

Aziz’s project proposal was a program where Texans could access the reproductive support they needed without coercion. This project proposal became TEA Fund’s My Choice, Not a Crisis campaign, which disseminates information about the dangers of CPCs and features an infant care resource drive.

Aziz’s experience underscores the importance of people being able to actualize their reproductive decisions. In a country where parents can spend an average of $21,681 annually on a child, in their child’s first year of life, only 13 states have family and medical leave laws, and 14 states force pregnant people to carry to term, birth and infant care funds help women and trans people give birth and care for their families according to their terms.

Not all organizations with the alleged mission of helping people with their reproductive health fulfill that goal. CPCs lure pregnant people by promising “free” birth and infant care items and medical care, but then spread abortion misinformation and stigma. Many CPCs are inspired by evangelical Christian ideology. They abound and outnumber abortion clinics 3-to-1 nationwide.

Because of anti-abortion centers’ deceptive tactics, Aziz emphasized the importance of unconditional and noncoercive resources for families. The TEA Fund’s Infant Care Resource Drive provides families in Texas with “diapers, wipes, hygiene items, diaper rash, clothing, toys, books, summer toys, water toys, activity kits, coloring books, shampoo, conditioner, sunscreen—a whole bunch of items basically for families about three times a year,” Aziz said.

“If someone has specific needs, where they may need baby formula, a pack of diapers, or something else, they can call our helpline or text our textline and they can request those supplies,” Aziz added. “We don’t really have a waiting list; it’s sort of no questions asked. We don’t ask for ID, we don’t make people fill out paperwork. If you need supplies, if you make that request to our volunteers, you will get the supplies you need.”

According to a 2021 Equity Forward report, at least ten states diverted federal Temporary Assistance to Needy Families (TANF) funds, which are supposed to go to low-income families, to launch or sustain CPCs. Since 2010, CPCs have received almost half a billion dollars from state governments, and a Rewire News Group investigation found that these anti-abortion centers may be spending nearly $1 billion a year. In contrast, Aziz said the Infant Care Resource Drive relies on grassroots funding, donors, and grants.

Leah Jones, deputy director at SisterSong Women of Color Reproductive Justice Collective, said SisterSong launched its Birth Justice Care Fund in 2020 in response to the COVID-19 pandemic.

“SisterSong began doing birth justice programming in 2017, and in 2020 when the pandemic hit was really when we ramped up the birth justice work,” Jones said. “We were going to do ground advocacy and education and get into the rural areas of Georgia. As a team we came up with this idea of, ‘What if we put our money that we were going to use for programming, curriculum, and training and just give it to birthing folks?’”

In its first year, the Birth Justice Care Fund only serviced people in Georgia. It now serves people in nearby North Carolina, Kentucky, and Florida.

Jones said the Birth Justice Care Fund’s expansion happened at an opportune time for pregnant Floridians.

“This year we added Florida, which seemed to be perfect timing because around the time the fund opened up, it was not far from when Florida went from a 15-week abortion ban [and then] to a six-week abortion ban,” Jones said. “What’s happened ever since Roe v. Wade was overturned and the abortion bans came through is that people are understanding the importance of access to health care … We’re seeing the connections between birth and abortion.”

Jones said the Birth Justice Care Fund provides people with the money to access full spectrum and postpartum doulas, midwives, lactation education consultants, maternal mental health therapists, and other items such as diapers, wipes, and car seats.

Why people need birth funds

Just giving birth is expensive: On average, labor and delivery cost $18,865, with average out-of-pocket costs of $2,854 for people with insurance. Without additional assistance, parents may be unable to afford this perinatal support. Depending on their years of experience, the pregnant person’s geographic location and their birthing needs, birth doulas could cost anywhere from $800 to $2,500 depending on where you live. As of January, only 12 states and Washington, D.C. have Medicaid coverage for doulas, though others are “in the process to implement Medicaid coverage for doula care, or have taken some related or adjacent action,” according to the National Health Law Program.

For pregnant people, having a doula or maternal mental health therapist could spell the difference between life and death. In 2022, 817 people died from pregnancy-related causes, a decrease from 1,205 deaths a year prior. But the maternal mortality rates for Black women were still more than twice as high than the rates of white and Latinx women. Data collected from 2017 to 2019 by maternal mortality review committees found that more than 80 percent of pregnancy-related deaths were preventable. Research demonstrates that having a doula is associated with positive birthing outcomes and a reduction in anxiety and stress, specifically in low-income pregnant people.

Jones said the Birth Care Justice Fund serves low-income and other marginalized communities.

“The majority of the people who come to our fund are low-income or young people from ages 13 to 22,” Jones said. “Some queer and trans folk reach out to the fund looking for access to lactation consultants who specialize in chestfeeding or doulas. We see people who are solo parenting, Black, Indigenous, and other people of color, people who are impacted by incarceration, housing insecurity, or domestic violence, and refugees.”

How birth funds support the people who need them most

To reach these diverse communities, Jones said SisterSong partners with organizations that truly care about reproductive health advocacy—and were already doing it with SisterSong beforehand.

“We told them that we don’t just want you to provide a service to supplement income for yourself,” Jones said. “This is advocacy. This is not where you come to get rich and make money; this is where you come to help communities. So if you don’t put that principle first, this is not the fund for you [to collaborate with].”

Both Aziz and Jones said providing people with access to birth and infant care items are a necessary component of reproductive justice.

“Reproductive justice means if someone wants an abortion, we support them,” Aziz said. “If someone wants to have children, we support them and give the resources to them that they need for their families to thrive.”

“This is just education, information, and access to health care that people just desire and deserve,” Jones added.