Changes to legislation will almost always have consequences beyond those intended. The outcome of Texas laws banning abortion will be no different. This could lead to an influx of children with Down syndrome and other genetic conditions born in the next year. If the state’s goal is to encourage families to meet the additional demands of parents with special needs, several policy changes are necessary to promote a supportive environment.
First, we need to deepen our investments in our state-run child early intervention programs and provide mental health care to 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 mourn the loss of their imaginary child is necessary to ensure the new parents can be there for their new child and the additional set of needs. Programs such as the perinatal psychiatry access program (PeriPan) built from the child psychiatry access program offer an initial skeleton for the expansion of 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 regarding their child.
Second, paid family leave policies should be carefully reviewed at the state level. In the aftermath of the pandemic, women shouldered much of the added burden of childcare due to the closure of daycare centers and schools. Family leave policies have the potential to support all families, but they can be particularly helpful for families enduring a stay in a neonatal unit. For many people, the financial and time burden of traveling to and from the hospital prevents them from fully participating in the process. This is detrimental to caregivers and children. We need to ensure that our current policies accommodate the range of childbirth experiences, including a long hospital stay.
We also need to re-evaluate our state Medicaid policies to ensure that families are not automatically placed at an economic disadvantage due to the sheer chance of having a disabled child. Having a child with an intellectual, psychiatric or physical disability is more expensive whatever the situationbut only half are eligible for additional financial aid assistance. With the added stress of being available and commuting with a child to appointments and therapies, many parents (usually mothers) struggle to maintain employment and meet their child’s exceptional needs.
Finally, we must reform social security, the financial assistance given to people deemed unable to work. These policies were originally developed half a century ago and can still be improved. Social insurance forces individuals to choose between trying to work and potentially not being able to earn enough to cover living expenses, or being trapped at home without working. It would serve these people better as a safety net that empowers and encourages them to engage in meaningful work while providing financial assistance when needed.
Changes to abortion laws in Texas are being made under the guise of supporting families, and this discussion must include children with disabilities. Texas lawmakers have the opportunity to step in and prove they are truly pro-life. Having a child, especially a child with a disability, should not be an event that drives families into poverty and drives women out of the workforce. Now is the time, through strong policy change, to create an environment where having a child with a disability is not a lifelong financial burden, but rather a lifelong enrichment for a family.
Cohen is an assistant professor at Dell Medical School and Steve Hick School of Social Work at the University of Texas. She is the mother of a child born with Down syndrome.