Family Planning as a component of early education programs

The recent crop of state-funded “early childhood education” programs are driven by the 2010 Affordable Care Act (Obamacare), which gives “states resources that will be used to promote the health and development of very young children. The Act’s Maternal, Infant, and Child Home Visiting Program will provide $1.5 billion to states over the next five years to implement the Early Childhood Home Visiting (ECHV) Program.”  For their part, states are “required to submit information to the Department of Health and Human Services (HHS) on the data they will use to assess the need for ECHV services,” sounding as though there is a good bit of pressure to move in this direction.[i] 
 
There are many concerns to consider with the intrusion, even voluntarily granted – of government into family life.  One is that ECHV programs typically come with a family planning component.  Poverty is understood to be a “risk factor” for pregnancy[ii] and the reasoning goes that family planning is a tool to “improve family economic self-sufficiency.”  Prominent ECHV model programs – the Nurse-Family Partnership[iii], Healthy Families America[iv], Parents as Teachers[v], and the Parent-Child Home Program,[vi] to name several – all contain this component.
 
One study, about a New Mexico ECHV program, First Born, is extremely interesting.[vii]  First Born was developed by the Los Alamos National Laboratories Foundation as the culmination of research into programs that most effectively would serve the birth-to-three population and their families. First Born began offering services in 1997 and has been identified as a particularly successful at rallying community collaboration and achieving a high level of its predetermined outcomes. With so much to recommend it, the program has been replicated around the state.[viii]
 
The First Born study approaches its analysis methodically, explaining that the program was “initiated to address risk factors affecting child well being in the country” (p. 323), of which living in an area of “concentrated poverty” (elsewhere referred to as “family poverty”, p. 327) would be one.   “Higher fertility rate” (p. 326) is considered another risk factor that negatively affects a child’s well-being.
 
The program’s goal, therefore, has been to identify “desired outcomes” (p. 323) for these at risk children and their families.  One that logically follows from the “risk” of higher fertility is “control over fertility” (p. 326).
 
It’s worth one’s while to take some time with this study because much of its concern is with how behavior can be changed:  “Through the process of identifying a theory of change, the program determined that key outcomes would include positive interaction between parent and child; positive parenting behaviors; increased factual knowledge about pregnancy, delivery, and child health; knowledge about the effects of alcohol, tobacco, and other drugs; and decreased risky behaviors on the part of the parent. The research focused on measuring change in these outcomes and conceptualizing these qualities as enhanced family functioning and resilience capacity.” (p. 324)
 
There are several difficulties with the above.  The one most pertinent to this discussion is that while few people would disagree that a parent ought to have “positive parenting behaviors,” we don’t all define them in the same way.   Using contraceptives might be seen as a responsible, “positive” parenting behavior to someone who believes that “high fertility” increases the “risks” to existing children.  “Positive changes in these areas [which includes utilization of medical and/or health services] are considered to decrease the risk factors.” (p. 330)
 
If the social engineer has a preconception that contraceptive use is “responsible” behavior, he will justify a program that changes “irresponsible” behavior…without reference to a participant’s own values.   He is only concerned with the outcome of a smaller family unit.
 
This is intrusive and manipulative: “FBP identified theories of human ecology and resilience as guiding frameworks. Together these theories suggest that behavior change is a function of a family’s social context and an individual’s beliefs, motivations, and emotions. To be effective, the intervention program would need to influence parents’ beliefs, attitudes, and an array of factors that constitute the social and family environment.” (p. 325)
 
Who is FBA – a government-funded program (p. 328) – to be changing anyone’s beliefs and attitudes?  It is certainly not operating from a Catholic perspective. “All [First Born] home visitors receive a core training prior to service initiation. …Core training components include mission statement and core values.”  These “core values are enumerated and include “family planning and/or sexuality issues.” (p. 329)
 
Given that the New Mexico Catholic Conference is supporting legislation designed to fund “early childhood education” programs like First Born – and that similar programs around the country have widespread support among Catholics – it’s critical that they understand the complete package they are being asked to buy. 
 
Catholics get bullied a lot.  “How can you be so fanatical,” we’re asked.  “Look at all the good work of this program.  Would you really jeopardize that good work simply because of one, small aspect that you don’t like?”
 
This is the response: “How can you be so fanatical that you will jeopardize the good of this program to force acceptance of this one, small aspect?”  
 
Maybe, looked at like that, it’s not so small.
 
Spero columnist Stephanie Block is the author of 'Change Agents: Alinskyian Organizing Among Religious Bodies', which is available at Amazon.
 
[i] “Early Childhood Home Visiting Program: Take Action Now to Promote Quality Services for Children Experiencing Homelessness,” www.familyhomelessness.org/media/179.pdf    
[ii] Ivan A. de la Rosa, Joanne Perry, Lisa Dalton, and Victoria Johnson, “Strengthening Families with First-Born Children: Exploratory Story of the Outcomes of a Home Visiting Intervention,” Sage publications, 2008:  http://www.sagepub.com/kgrantstudy/articles/13/delaRosa.pdf. 
[iii] See: http://www.nursefamilypartnership.org/assets/PDF/Policy/HV-Funding-Guidance/NFP_Overview_Planning, pp. 9, 28.
[iv] See http://www.healthyfamiliesamerica.org/downloads/sdg.pdf, pp. 226, 279.
[v] See: http://www.parentsasteachers.org/images/stories/documents/PWTP_SamplePacket.pdf, p. 285.
[vi] See http://www.parent-child.org/assets/newsletters/summer2004.pdf, p 5.
[vii] All further quotes and references will be from this document (see note ii) unless otherwise noted.
[viii] Los Alamos National Laboratories Foundation: www.lanlfoundation.org/First-B
The views and opinions expressed herein are those of the author only, not of Spero News.

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