How might abortion restrictions impact child welfare in WNC?

It’s clear that abortion access is now different in Western North Carolina. Less than two months after the U.S. Supreme Court’s 6-3 ruling in Dobbs v. Jackson that abortion is not a right under the Constitution, a federal judge on Aug. 17 allowed enforcement of an existing North Carolina law that bans abortion after 20 weeks except for medical emergencies.

Before that move, abortion had been legal in the state until the point of fetal viability, typically considered to be 24-28 weeks into pregnancy. According to data from the Guttmacher Institute, a national nonprofit focused on sexual and reproductive health, 31,850 pregnancies were terminated in North Carolina in 2020, a 9% increase from 29,320 abortions the previous year.

(Per 2019 data, the most recent available, from the federal Centers for Disease Control and Prevention’s Division of Reproductive Health, the vast majority of North Carolina abortions were performed before the end of the first trimester. Of the state’s remaining abortions, 7.6% were performed at 14-20 weeks’ gestation, and 0.1% were performed at 21 weeks or later.)

WNC retains abortion access through Planned Parenthood’s Asheville Health Center, the region’s sole provider of the procedure. What is less clear, at least at this moment, is how restrictions on abortion will impact the area’s child welfare system.

On the way

One potential consequence of making abortions more difficult to obtain may be more children relying on social services such as foster care. “We know that, across the country and in North Carolina, the safety net is stretched thin, and it is not able to provide sufficient care to those in need,” wrote Elizabeth Nash, principal policy associate on state issues at the Guttmacher Institute, in a statement to Xpress. “And we anticipate that the need will increase as states ban abortion and force people to continue pregnancies to term.”

Quantitative estimates of that increased demand are hard to come by. Xpress was unable to find a predictive model for anticipated new births in North Carolina as a result of abortion restrictions, with both national nonprofits and local health officials saying they hadn’t conducted or come across that analysis.

“Planning for increased need [in foster care] is not happening at the local level,” says Stacey Wood, spokesperson for the Buncombe County Department of Health and Human Services.

Meanwhile, N.C. Department of Health and Human Services spokesperson Bailey Pennington Allison acknowledged the issue, noting that, “Over time, it is likely that restrictions on access to reproductive health services will result in more children in foster care and more children in need of adoption.”  She declined further comment in a followup email asking if NCDHHS is planning for that “likely” scenario, or how it is doing so.

Based on personal experience, however, a licensed clinical social worker who provides therapy for Henderson County foster children and their foster families believes the child welfare system will be strained. “My gut feeling — and obviously there’s no research to back this up because it’s so new — is that our [child welfare] system is already severely overtaxed and is going to be even more overtaxed” due to abortion restrictions, Allison Becker tells Xpress.

Becker is researching foster care nationwide, but with a focus in WNC, for Northcentral University’s Doctorate of Marriage and Family Therapy program. “There are so many kids in foster care, and then now we’re forcing people who don’t want children or can’t care for children to have them anyway,” she says. “That just seems to me like a recipe for more foster kids.”

Research does exist on other aspects of how having a child due to a lack of abortion access can impact an individual’s life. The 2020 Turnaway Study, published by the University of California San Fransisco, examined 1,000 women who were seeking abortion; those who were turned away and went on to give birth “experienced an increase in household poverty lasting at least four years relative to those who received an abortion.”

The study also found that after being denied an abortion, a woman was more likely to not be able to cover basic living expenses like housing, food or transportation.

‘Not enough spaces’

North Carolina had 11,213 youths in foster care in 2021, according to federal Adoption and Foster Care Analysis and Reporting System data shared by The Imprint, a nonprofit news outlet dedicated to child welfare. That’s a roughly 30% increase from a decade prior, when the state had 8,601 children in care; the rate far outpaces the approximately 9.5% increase in overall state population over the same period.

During fiscal year 2021-22, the average monthly foster care caseload is 321 children in Buncombe County, according to Wood from BCDHHS. (An average of 11 children enter the foster care system, and an average of 12 children leave, each month.) Over the same period, the county had an average of 86 foster homes.

Xpress was unable to confirm whether local foster care or adoption agencies are anticipating an increase.

Martin Peters from Eckerd Connects, a Florida-based nonprofit that partners with CARING for Children in Asheville to recruit and train foster parents, declined to comment. Catholic Charities Diocese of Charlotte, which runs an adoption agency that serves Buncombe and other WNC counties, did not respond in time to comment.

But the BCDHHS website on fostering states there is a need for more foster families. “In Buncombe County, there are many children in care, but not enough people to help care for them,” the website reads. “This means that children could be placed in group homes, away from their siblings or sent out of the county, far from everyone and everything they know.”

Becker, the Henderson County social worker, concurs. “There are not enough spaces available to house all of the children that need to be housed,” she says. This could mean more children being placed in group home settings, such as the Black Mountain Home in Black Mountain.

To become a foster parent, individuals must take 30 hours of required state training in trauma-informed care “or an equivalent training and assessment process,” according to the NCDHHS Division of Social Services in Child Welfare. Criminal background checks, home visits and interviews are also required.

BCDHHS works with individuals to become licensed, as do private foster care placement agencies and nonprofits.

‘Their biggest cheerleader’

One local organization that has already experienced an impact from the Dobbs decision is Mountain Area Pregnancy Services, a Christian ministry with offices in Waynesville and Asheville that serves “women and families experiencing an unplanned pregnancy or a pregnancy with a life-limiting diagnosis to honor their baby’s life.”

Executive Director Kristi Brown estimates MAPS’ locations have received five additional calls each week since the June 24 Dobbs decision. (She notes that not all calls result in appointments.) More calls are coming from out of state, she adds.

MAPS has also had increased foot traffic this summer. The organization typically serves 300 clients, both men and women, each year. Brown says that in June, MAPS served 30 clients across both of its locations, and in July — after abortion restrictions went into effect in other states — the two locations served 56 clients.

MAPS is not a licensed health care provider, nor does it provide prenatal care. It does, however, provide free ultrasounds, Brown says. And the organization will provide baby-related items, like pacifiers, diapers, nursing pillows or playpens to individuals who earn “points” as they complete parenting classes.

The center’s medical director, who has a private practice elsewhere, receives ultrasound scans over email, explains Brown. Clients at MAPS are typically four-eight weeks pregnant, uninsured, earning less than $15,000 per year and “not excited, for the most part” about the pregnancy, Brown says.

MAPS parenting programs include Bible study and an encouragement to connect with church congregations for support, Brown explains. “One way she can get support is to be part of a church body of people,” Brown says of those coming to the organization with pregnancies. “We’re trying to work to connect clients with a church body of people, so that she’s got a built-in army around her.”

Many clients of MAPS do not have other supportive individuals in their lives, Brown adds. “We are often their biggest cheerleader, and we have to be,” she says.

The counselors at MAPS outline three options to someone with a confirmed pregnancy: carrying the pregnancy to term and parenting, adoption or abortion. (One of its programs, Brown explains, is called “abortion recovery” and counsels women who feel guilt or sadness over past abortions.) The center will make referrals to obstetricians, including many who accept Medicaid.

Brown says the center also directs expectant mothers or new parents toward resources, such as the Baby Equipment And Resources Closet. She says MAPS will also circle back to its donor base and ask for funding for car seats or strollers, if needed. (In a joint press release July 1, Republican state Sen. Chuck Edwards and Reps. Tim Moffitt and Jake Johnson announced $550,000 in funding for MAPS, as well as $500,000 for Open Arms Pregnancy Center in Hendersonville, another faith-based ministry.)

MAPS does not license foster or adoptive families. But staff does receive annual training on state laws regarding adoption and refers to agencies, such as Christian Adoption Services, a ministry of Baptist Children’s Homes of North Carolina, says Brown.

MAPS does not know what happens months or years later with the women they see, Brown says. “I would say, traditionally speaking, a lot of our clients don’t keep in touch after the baby has come,” Brown says. “They might pop in occasionally or send a Christmas card. … We don’t always know the final outcome.”