While the Republican Congressional push to cut all federal funding for Planned Parenthood is mired in a political debate, the economics of women's health and child rearing profoundly affect U.S. Latinas due to the country's changing demographics.
Hispanic women are generally younger than U.S. women of other races with a greater share in their childbearing years and with higher fertility rates.
Undercover videos regarding donation of fetal tissue by Planned Parenthood for research purposes have been the catalyst for a Republican push to strip Planned Parenthood of all federal funding, about 45 percent of its revenue.
The debate is steeped in partisan views on abortion and issues of women’s health and reproduction. But while the target is Planned Parenthood, reproductive health advocates say its impact is broader and some Latinas already have experienced the repercussions of state-level efforts to eliminate federal funding of Planned Parenthood clinics and others affiliated with them that offered abortions.
We are right in the square of the reproductive age,” said Jessica González-Rojas, executive director of the National Latina Institute for Reproductive Health. “We are exactly at the age when we should be getting the care we need.”
A Texas study found after 25 percent of the publicly-funded family planning clinics were closed, the remaining served only 54 percent of previous women patients.
In 2013, 6.3 million Latinas were in their prime childbearing years of ages 20 to 34, compared to 18.3 million white women, 4.5 million black women and 2 million Asian women, according to a Pew Research Center analysis for NBC News.
Additionally, Latinas have a higher fertility rate, 2.4 children on average versus 1.8 for whites and Asians and 2.1 for black women, Pew has reported.
The demographics don’t necessarily equate to support from Latinas for federal funding of Planned Parenthood or the reverse. But they do show that Latinas have a major stake in the outcome of this debate and the political fallout from it in the 2016 presidential election.
Despite that, the issue of funding for Planned Parenthood, on access to abortions, birth control and other women’s health and family planning services are not always framed with the attitudes, views, economics and culture of Latinas in mind.
“I do think we need more data and we need to ask more Latinas young, old and everyone, how they feel on the issues,” said Vanessa Gonzalez-Plumhoff, director of Latino Leadership and Engagement for the Planned Parenthood Action Fund.
“We need to understand who we are talking to. I do think there are differences generationally and racially. For many of us, our (parents, grandparents) are coming from places where abortion was not available so there is a different familial history than some of our non-Latino counterparts,” Gonzalez-Plumhoff said.
At this time, Latinas are not having the most babies when women of all ages are considered, but the younger demographic of Latinas and the aging of white women creates that potential.
In 2013, there were 901,000 babies born to Hispanic mothers of any age, 2.1 million to white mothers and 584,000 to black mothers, according to an analysis of the most recent data from the National Center for Health Statistics by Pew.
González-Rojas said the current debate isn’t just one that should concern Latinas having children, but is important for Hispanic women who are young professionals and may want to delay starting families, are lower on the income scale and may want to make decisions about spacing out children or don’t want any children or additional children.
“Women are at different points in their decision making. In fact, Latinas are young and sit in place that we can become pregnant,” González-Rojas said.
While more women overall are delaying childbirth, a greater share of white women – 16 percent – had children at 35 and older, with 331,000 births in 2013. That compares with 14 percent of Latinas in that age group who gave birth, accounting for 128,000 births. Among black women the percentage was 12 percent for 69,000 births.
Latinas are more likely to experience unintended pregnancies, González-Rojas said. This is not just an issue of teen pregnancy - which has dropped among Latinas - or having children out of wedlock, but can include a married couple that had not been planning for a child or additional child, González-Rojas said.
Gonzalez-Plumhoff said many Hispanic women across the country are living in a "middle generation" as immigrants or children of immigrants. “There is a lot of misinformation on reproductive health in our community. There may also be a stigma, things we don’t talk about," she said. "But we have a new generation of Latinas who are growing up and pushing back against those perceptions.”
While Planned Parenthood has been put on the hotseat over its practices regarding its sales of fetal tissue, Congressional Republicans have made clear they have larger issues in mind in their mission to defund Planned Parenthood.
Reps. Bob Goodlatte, R-Va., the chairman of the Judiciary Committee and Trent Franks, R-Ariz., said in a statement issued before a Wednesday's congressional hearing on Planned Parenthood funding that in addition to investigating the practices of the organization, the intent of the hearing was “part of the Committee’s commitment to fighting for the rights of the unborn.”
But as researchers have found in Texas, where the Republican-controlled Legislature and administration enacted tough restrictions on clinics that provide abortion services and clinics affiliated with them, targeting abortion services can also take a toll on the availability of family planning services and access to them, particularly among lower income women.
After Texas passed a 2013 law imposing restrictions on clinics offering abortions or those affiliated with such clinics. the state saw drops in reimbursement claims for birth control and wellness exams, according to a state report.
A recent study by the Texas Policy Evaluation Project (TxPEP), found that 25 percent of publicly funded family planning clinics in Texas closed in 2011-2013. Those that remained open served 54 percent of the clients that they had in the previous period.
The restrictions closed Planned Parenthood clinics in the Lower Rio Grande Valley, the southernmost area of the state that is at least 90 percent Latino and where some of the state's poorest counties are located, even though those clinics never provided abortions. A clinic that does, and was not affiliated with Planned Parenthood, remains open, said Kari White, a co-investigator with TxPEP.
TxPEP found reductions in family planning services funding, clinics forced to reduce hours, less availability for women of the most effective forms of contraception such as IUDs, and fewer locations providing contraceptives to teens without parental consent.
The project focuses on the effect of reproductive health legislation passed in the 2011 and 2013 Texas legislative sessions and is made up of researchers from the University of Texas, Ibis Reproductive Health and the University of Alabama.
The Legislature provided additional funding for family planning services in 2013 and for primary care services in 2015. White said TxPEP has begun analysis of the impact of the 2013 funds but has not yet begun research on the 2015 monies.
Planned Parenthood supporters argue that abortion-related services are only 3 percent of the services the organization provides.
Some of the federal money Planned Parenthood receives – Title X family planning funds – cannot be spent on abortions, but Medicaid funds – which are a mix of federal and state money – can be used in cases of rape, incest or to protect the life of the mother.
The organization’s 700 clinics nationally provide other services such as cancer screenings and prevention, well-woman exams, birth control and testing and treatment for sexually transmitted diseases. Planned Parenthood also helped educate Latinos about enrolling in the Affordable Care Act, or Obamacare.
Planned Parenthood supporters say some 575,000 Latinas are patients each year of Planned Parenthood.
“I think Latinas should be upset about this. This is a direct hit on our ability to have a say on our future,” Gonzalez-Plumhoff said
Hispanics have long been considered more conservative on issues of abortion and birth control. Among all Hispanic adults, 51 percent to 57 percent polled over the last decade by Pew Research Center have said abortion should be illegal in all or most cases.
But a Pew survey before the 2014 midterm elections also showed that registered Hispanic voters are split on the issue of abortion. Among registered Latino voters, 48 percent thought it should be legal in all or most cases versus 44 percent who thought it should be illegal in all or most cases. The poll didn’t divide the results by gender or age.
“Latinas have abortions too. They have to make that decision as well … and need to be able to make it with dignity and with the sources of care that are accessible and affordable and that is provided with compassion and love,” said González-Rojas, whose group supports Planned Parenthood funding.
There are several ways to view abortion data. What is available does not account for the full population of Latinas. Latinas accounted for 22 percent of a portion of abortions in 2011, compared to 78 percent of non-Hispanic women, according to the Centers for Disease Control. The data accounts for abortions documented by health agencies in just 19 areas that keep ethnicity data that includes Hispanics.
The rate of abortions among Hispanic women – the share of Latinas who had abortions per 1,000 Latinas – was 15.8 percent, compared to 13.8 among all non-Hispanics. Seen another way, Latinas had 198 abortions for every 1,000 live births among Latinas, compared to 210 among non-Hispanics, according to the CDC.
"It's very significant to Latinas, the Planned Parenthood debate, because they are the ones having abortions,” said Dr. Grazie Christie, a radiologist who is a senior policy advisor for The Catholic Association, which supports stripping federal funding from Planned Parenthood
“The children being aborted are our children. The women being affected are us,” Christie said.
She argues that the abortion rates are higher among Latinas because most Planned Parenthood clinics are located in minority neighborhoods or within walking distance of minority neighborhoods and because black and Latina women are disproportionately lower income and can use Medicaid for their services.
"You're not going to find Planned Parenthood in a ritzy, suburban enclave," she said.
Federal funds can’t be spent on abortion. But Dr. Christie said the clinics can offer lower cost abortions because they can use federal Medicaid money to pay overhead, doctors and other costs and thus lower the costs of abortion.
"It's an ugly alliance," Christie said. In place of the funding of Planned Parenthood, should be a policy to help women who need the services. She suggested increasing adoption services.