The Reproductive Politics of Living on the Brink

Women need reproductive autonomy to achieve economic security and improved health.

Donyell Hollins holds a picture of her daughter as she learns about family planning and parenting at the Delta Health Partners Healthy Start Initiative in Marks, Mississippi on May 2, 2012. (AP/Laura Tillman)
Donyell Hollins holds a picture of her daughter as she learns about family planning and parenting at the Delta Health Partners Healthy Start Initiative in Marks, Mississippi on May 2, 2012. (AP/Laura Tillman)

Released last month, The Shriver Report: A Woman’s Nation Pushes Back from the Brink detailed the economic realities for American women seeking to balance family and work life. The report revealed that a third of all women are living at or near “the brink” of poverty despite the fact that many have more than one low-wage job to make ends meet. The reproductive politics of this balancing act are a major contributor to how women manage work, family, and health. Two challenges affecting women’s ability to be self-determinant are the need for more time in order to move beyond poverty and the social supports to live a more autonomous life.

Time as a matter of reproduction

The polling results from The Shriver Report were very telling: Women need more time to improve their quality of life—time to further their education, advance their careers, take care of their health, and give care to relatives. The policy recommendation from the poll that women most strongly supported is paid leave to use for illness or to take care of a family member. But for working women, and particularly working mothers, controlling one’s fertility is at the heart of having time to do many of the things that improve the economic circumstances for her family.

Because a woman’s socioeconomic status directly impacts her ability to control her personal and professional future, controlling the timing and spacing of having children is a critical economic issue, especially for women living in or near poverty. Accessing health care is more difficult for low-income women who may make too much to qualify for Medicaid, but are unable to afford health insurance on their own. Lack of consistent or affordable health care coverage can prevent women from obtaining and effectively taking contraception in order to prevent unintended pregnancies. Paying out of pocket for an abortion can easily bankrupt or financially cripple a struggling family, especially if the woman has to travel out of state and adhere to unnecessary and burdensome mandates such as a 48-hour waiting period or multiple visits for in-person counseling. And having a child one cannot afford makes the economic circumstances for struggling families even more dire. This inevitably leads to additional costs for women seeking autonomy to make their own health decisions.

In this context, time is about the privilege to determine the purpose of one’s time, whether it be delaying or preparing for childbirth, providing care for family, and the ability to access quality health services. Women on the brink are less able to obtain quality reproductive health services or to realize rights afforded to them under the law due to lack of money, time, or both. By ensuring that all women have access to health insurance coverage and quality services, we are investing in their economic well-being.

Unplanned pregnancy and poverty

In the discourse related to unplanned pregnancies of unwed mothers, poverty solutions—like marriage incentives and delaying childbirth—are often oversimplified to the detriment of poor women. The Shriver Report, like many reports before it, recommends that women on the brink delay pregnancy and parenting as long as possible to promote economic security. When asked about things they might do differently, women polled for The Shriver Report responded: make better financial choices—64 percent; stay in school longer—55 percent; and take better care of [my] health—54 percent. These decisions are inherently linked and play a pivotal role in how women lift themselves out of poverty. A primary recommendation for these converging issues is delayed childbirth, but preventing unintended pregnancy is not a catch-all solution.

A 2008 study of teenage childbearing in economically depressed neighborhoods showed that despite a steep decline in childbearing rates between 1991 and 2005, the economic circumstances of the young women did not improve. When income inequality did decline in these neighborhoods, there was little to no improvement for the poorest women. Simply put, while there is a correlation between the two, unplanned pregnancies do not cause poverty, nor can reducing unplanned pregnancies alone eliminate poverty, especially in communities that continue to suffer from institutional racism and generational poverty.

Women, particularly low-income women and women of color, have disproportionately struggled to negotiate both controlling their labor in the marketplace and their fertility. Access to contraception and abortion services have played a vital role for women determining when they become parents, how they will partner, and what their family looks like while pursuing other opportunities, like a college degree and career. Lifting women out of poverty goes hand in hand with providing women with the tools to determine for themselves, based on the context of their circumstances, when childbirth is most appropriate.

Aside from reproductive health services, women need policies to help them stay in the workforce and thrive. Both government and employers must promote policies that benefit working moms to help them balance caregiving activities with paid employment outside of the home. Policies such as paid sick leave and workplace flexibility are policies that should be made available not only to women in professional settings but also to women in low-wage jobs.


The Shriver Report offered a great deal of insight into what women want for themselves and their families. In the same poll, women rated their own health as a secondary or tertiary priority, vastly trailing their need to and responsibility of caring for their families. Ensuring that women are able to contribute to or lead the way in lifting themselves and their families out of poverty starts with supporting their right to health.

Heidi Williamson is a Senior Policy Analyst for the Women’s Health and Rights program at the Center for American Progress.


The positions of American Progress, and our policy experts, are independent, and the findings and conclusions presented are those of American Progress alone. A full list of supporters is available here. American Progress would like to acknowledge the many generous supporters who make our work possible.


Heidi Williamson

Senior Policy Analyst