Changes to legislation will almost always have consequences beyond those that were intended. The result of Texas laws banning abortion will be no different. It could lead to an influx of children with Down syndrome and other genetic conditions born during the next year. If the state’s goal is to encourage families to take on the extra demand of special needs parenting, several policy changes are needed to promote a supportive environment.
First, we need to deepen our investment in our state-run early child intervention programs and provide mental health care for participating parents. Receiving an unexpected diagnosis during pregnancy or at the birth of a child is a shock even under the best of circumstances. Emotional support to process and grieve the loss of their imagined child is needed to ensure new parents can be present for their new child and the additional set of needs. Programs such as the perinatal psychiatry access program (PeriPan) built off the child psychiatry access program offer an initial skeleton for expanding supports. PeriPan includes several services to support the mental health of pregnant and postpartum women, and it would benefit from expanded services specifically for families receiving unexpected diagnoses about their child.
Second, paid family leave policies should be thoughtfully considered at the state level. In the wake of the pandemic, women have shouldered much of the extra child care burden due to day care and school closures. Family leave policies have the potential to support all families, but they can be particularly helpful to families that endure a neonatal unit stay. For many individuals, the financial and time burden of traveling to and from the hospital prevents them from being able to fully participate in the process. This is damaging to caregivers and children alike. We must ensure our current policies are nimble to the array of birthing experiences, including a long-term stay in the hospital.
We also need to re-evaluate our state Medicaid policies to ensure families are not automatically placed at an economic disadvantage due to the pure chance of having a child with a disability. Having a child with a developmental, psychiatric or physical disability is costlier no matter the situation, yet only half qualify for extra financial assistance. With the additional constraint of having to be available for and shuttling a child to and from appointments and therapies, many parents (usually mothers) struggle to maintain employment and meet their child’s exceptional needs.
Finally, we need to reform Social Security Insurance, the financial assistance provided to individuals deemed unable to work. These policies were originally crafted half a century ago and have much room for improvement. Social Security Insurance forces individuals to choose between trying to work and potentially not being able to make enough to cover living expenses, or being trapped at home not working. It would better serve these individuals as a safety net that allows and encourages them to engage in meaningful work while still providing financial assistance as needed.
Changes to abortion laws in Texas are done under the narrative of being in support of families, and this discussion must include children with disabilities. Texas legislators have the opportunity to step up and to prove that they are truly pro-life. Having a child, especially a child with a disability, should not be an event that forces families into poverty and takes women out of the workforce. Now is the time, through robust policy change, to create an environment where having a child with a disability does not represent a lifelong financial burden but is rather a lifelong enrichment to a family.
Cohen is an assistant professor in the Dell Medical School and the Steve Hick School of Social Work at the University of Texas. She is the mother of a child born with Down syndrome.