Few states can match Alabama in its zeal to protect the unborn. Our lawmakers happily flout U.S. Supreme Court decisions in their efforts to close down abortion clinics. Every year, bills appear at the Statehouse that would prohibit abortions closer and closer to the date of conception.

Such efforts to limit abortions are, of course, easy for lawmakers. Regulating clinics out of existence has no effect on the state budget, and the effort to do so generally receives public approval.

The sincerity of the state’s concern for the unborn does not stand up to scrutiny.

The annual March of Dimes report card on premature births came out recently, and Alabama was one of three states to receive an F.

Compared to an 11.4 percent rate of premature births nationally, Alabama’s rate is 15.1 percent. Louisiana had the same rate as Alabama, and only Mississippi — at 16.6 percent — was worse. Failing to meet the national rate is an embarrassment, as 130 countries have a lower percentage of premature births than the United States. America has about the same rate of premature births as Somalia and Turkey.

And while the national rate has been creeping down, Alabama’s rate is rising.

To put Alabama’s 15.1-percent rate into more global context: Only 11 countries have a rate over 15 percent. All but two are in sub-Saharan Africa.

Does the state’s high rate of preterm births matter? Absolutely. Premature births are the No. 1 killer of children under the age of 5. Alabama has 10,000 premature births a year, contributing to 520 annual deaths of children less than one year old.

Does the state have the ability to reduce preterm births? Again, absolutely.

Not surprisingly, there is a direct correlation between the percentage of uninsured women — 21.2 percent in Alabama — and the rate of premature births. States with relatively low rates of premature births invariably are states that have liberal Medicaid coverage. A healthy mother is far more likely to deliver a full-term and healthy baby, but women without insurance are less likely to be healthy.

So in a state such as Alabama, where almost every politician vows publicly and often to protect the rights of the unborn, why do we not do more to reduce premature births?

Partly because of money, and partly because of politics.

Improving the health of prospective mothers — through Medicaid expansion, education and preventive care — costs money. In a cash-strapped state, that means raising taxes on the wealthy. And those who control Montgomery through political contributions are both wealthy and resistant to taxes.

Railing against abortion and passing laws that close abortion clinics costs nothing. Protecting unborn children from the health risks of premature birth, however, requires funding.

It’s also, however, simple politics. Most Alabamians oppose abortion, but they also oppose the most direct route to preserving the lives of the unborn: Medicaid expansion.

It is time for Alabamians and their elected representatives to either abandon their avowed enthusiasm for protecting unborn children, or to recognize that supporting the sanctity of life is not just about rebelling against the U.S. Supreme Court. We can save the lives of children by expanding access to health care.

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