Foster care isn’t the answer to overturning Roe

In December 2021, Justice Amy Coney Barrett posited that both the Roe and Casey decisions “emphasized the burden of parenting.” In her mind, proponents of these landmark decisions were most concerned with the encumbrance of forced parenting and hindered access to employment opportunities for women. Almost reflexively, as a mother to two adopted children, she posed Safe Haven laws and the foster care system as simple and obvious alternatives to abortion in a post-Roe America.

Not only does this ignore the grief, trauma, and mourning that relinquishing a child imparts upon the birth mother, as well as the long process of reckoning, but it would also predispose a growing number of children to adverse childhood experiences and poorer health outcomes.

In a country that grossly undersupports child welfare, this socalled “solution” by Justice Barrett could irreparably affect our future generations, particularly as many states sit with “trigger” laws ready to fully ban abortion.

Placement in the foster care system, though born out of beneficent intent, is by no means a benign intervention. The most recent data from 2020 shows that 21,689 children in Pennsylvania are served by the foster care system, and over 10% reside in Allegheny County. Children in foster care are more likely to experience adverse childhood experiences, which have been strongly linked to negative health and wellbeing outcomes.

According to the Allegheny County 2021 State of Welfare report, children with long periods in the foster care system have higher rates of not completing high school and are more likely to experience mental health challenges. A largescale meta- analysis from 2017 showed up to a three-fold increase in suicidality for children in the foster care system. The effects don’t cease after childhood, either.

One in four Pennsylvania youth who “age out” of care struggle with homelessness, mental health difficulties, and incarceration.

Pennsylvania ranks 42nd nationally in terms of foster care outcomes, measured by a composite index that accounts for median length of stay in foster care, percentage of those who age out of the system without appropriate placement, and re-entry rate.

Certainly, not every child placed into foster care sees these aforementioned poor outcomes.

The 2020 Adoption and Foster Care Analysis and Reporting System report shows 79% of children are re-unified with their primary caretaker, adopted, or live with another relative. But this still leaves 85,600 children in tow, nationwide. Were adoption to become a pregnant person’s only non-parenting option, as Justice Barrett imagines, both the total number of children in foster care and consequentially, the burden on an already heavily- stressed system would increase.

Currently, our system lacks adequate numbers of social work staff to care for children in foster care. There is also a paucity of funding for suitable placement, and more children than available housing and foster parents. This can lead to temporary housing in congregate facilities such as group homes, detention centers, and residential treatment facilities.

Finally, it’s worth noting that former and prospective foster parents have cited paltry resources for recruiting and certification, as well as a lack of support from child welfare agencies, causing some to withdraw from fostering. Studies have shown that as many as 66% of foster parents cease providing services within one year. Much of the funding goes toward administrative costs, which data has shown not to be associated with more successful placements.

Our goal here is not a crusade against the foster care system. Rather, we feel that it’s important to note the repercussions of banning abortion, when the alternative is potentially dramatically damaging to a child’s physical, mental, and emotional development.

As two physicians who care for children every day, we urge you to vote to protect our future generations from unnecessary harm by upholding the right to choose.