The Dangerous Rise of the IUD as Poverty Cure and the History Behind It
Over the past decade, more and more women have begun using long-acting, reversible birth control methods like intrauterine devices and implants. These birth control methods are highly effective at preventing pregnancy but were previously not widely accessible because of high costs and lack of knowledge among health care providers. Increasing access to these methods, for women who want them, is a sign of progress.
However, many researchers, advocates and policymakers aren’t selling their rise solely as a victory for women’s health. They claimIUDs and implants may be a powerful new tool to fight poverty. This sort of language should set off alarm bells because the idea that limiting women’s reproduction can cure society’s ills has a long, shameful history in the United States.
Between 1909 and 1979, about 20,000 people were involuntarily sterilized in California — one of 33 states where compulsory sterilization in the name of eugenics and social well-being was legal in the 20th century. In the 1990s, multiple states proposed laws to incentivize or even require welfare recipients to use the new contraceptive Norplant — and while none of these became law, they helped shape public discourse. Even in recent years, some judges have offered reduced sentences to defendants who agree to be sterilized or use birth control. All of the above are instances in which the state sought to limit the reproduction of the poor, people of color and other groups, because of a belief that doing so would be for the good of society.
Today, this age-old idea that reproduction is to blame for societal problems has seen a resurgence in the current enthusiasm around long-acting, reversible contraception.
We can see echoes of this view in how some politicians argue for expanded access to birth control as a tool to address intergenerational poverty. We can see it in the priorities of philanthropic funders and in glowing media coverage about the promise of long-acting birth control that produces headlines like “Can the IUD Prevent Poverty, Save Taxpayers Billions?”
Promoting IUDs and implants is certainly less egregious than state-sponsored eugenics. But promoting them from a poverty-reduction perspective still targets the reproduction of certain women based on a problematic and simplistic understanding of the causes of societal ills. Such tactics could also, ironically, harm the quality of family-planning care for the very women they are intended to help.