Living on the Edge in Suburbia: From Welfare to Workfare

mandy — Thu, 30 Sep 2010 16:00:00 +0000

Living on the Edge in Suburbia is Terese Lawinski’s comprehensive examination of welfare in the United States using ethnographic research on suburban families in Westchester County, New York. Lawinski leaves no stone in the welfare debate unturned, from the infamous myth of the “Welfare Queen” (introduced to America’s vocabulary by a Reagan campaign speech in 1976) to the fallacy of “illegal immigrants” coming to the U.S. in droves looking for easy money.

With the recession weighing on almost everyone’s mind, Lawinski’s book is timely and relevant. Many suburban Americans like the ones profiled here are losing the economic security they took for granted and are being forced to turn to government programs to get by. But misconceptions about how the system works and who benefits from it (and how much they benefit) shape the general public’s view of welfare as a cushy, well-funded government trust fund for lazy people.

The vitriol aimed at immigrants and people of color is growing as working class and middle class Americans draw an ever deeper line in the sand between “deserving” and “undeserving” aid recipients, as well as “acceptable aid,” like unemployment, versus “unacceptable” programs like Medicaid, TANF, and food stamps. Lawinski addresses this phenomenon adeptly and swiftly.

The word welfare is often associated with so-called urban problems (i.e., people of color, most often women). Instead of yet another examination of the stereotypical recipient of public assistance (young, poor, black, female), which often only serves to further reinforce welfare fallacies, Lawinski focuses on a variety of families, many of whom slipped into the vicious cycle of public assistance after relatively minor circumstances propelled them into major financial crises. Lawinski makes it a point to emphasize the fact that once a family (or individual) is stuck in the system, a myriad of confusing and conflicting rules make it nearly impossible to get back out without an additional support network.

Lawinski does a thorough job of putting the current welfare system in an historical context. She draws connections between society’s disdain for “welfare mothers” and the beginnings of the Aid to Families with Dependent Children program (AFDC), part of 1935’s New Deal. At the time, mothers had to show government workers that they "deserved" assistance, which was usually limited to white widows who met “suitable home” requirements. Racist overtones took over the welfare debate when programs were opened to women of color.

Lawinski points out that one of the biggest offenses of President Clinton’s Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) is that states began to claim the new law a success based on the number of people collecting benefits rather than the number of people living in poverty. As Lawinski explains, welfare rolls were cut by fifty percent, or even more, due to new regulations, but that didn’t mean people had found gainful employment (or any at all).

Where AFDC had once allowed people to survive (however meagerly), the 1996 welfare reform program, Temporary Assistance to Needy Families (TANF), left families without even that ability. After AFDC changed to TANF under PRWORA, lifetime limits (five years maximum by federal law, although individual states can further restrict time limits, and many do) meant that recipients were being cut off from public assistance without the means to support themselves. Additionally, TANF work requirements prevent the job training or education opportunities that are necessary for true self-sufficiency, and in a Catch-22, also reduce benefits. For those who can meet work requirements or attend education programs, the next hurdle is inadequate or nonexistent childcare subsidies.

In the epilogue, Lawinski offers solutions and guidelines with the Obama Administration in mind, but in the current political climate, it is doubtful that public aid will get the national attention and restructuring it needs.

Written by: Stephanie Sylverne, September 30th 2010

Willing and Unable: Doctors' Constraints in Abortion Care

admin — Sun, 22 Aug 2010 00:00:00 +0000

By Lori Freedman

Vanderbilt University Press

Ninety-three percent of all abortions are done in abortion clinics. Only three percent of non-metropolitan counties in the United States had an abortion provider in 2005, while thirty-one percent of metropolitan counties had at least one. After completing their residency, half of physicians who plan to perform abortions as part of their practice actually do so.

These startling facts prompted Lori Freedman to embark on the study summarized in Willing and Unable: Doctors' Constraints in Abortion Care. Freedman is a sociologist working for Advancing New Standards in Reproductive Health (ANSIRH), a collective of researchers and scholars at the University of California, San Francisco. Through this study, she “primarily wanted to find out what keeps physicians who feel positive about providing abortion from doing so.” She interviewed thirty ob-gyns—twenty-two women and eight men—who graduated between 1996-2001 from four residency programs in which abortion training is routine. The interviews, along with historical context and analysis, make up the core of the book.

While some may assume that doctors don’t “have the guts” to do abortions or are primarily afraid of violent retaliation—which is understandable given that eight abortion clinic workers and/or doctors have been murdered since 1993—the reasons are more complex and wide-ranging. The reasons Freedman uncovers include the managed care currently regulating doctors’ services, the stigma attached to being labeled an “abortionist,” the fact that abortions do not often result in a significant amount of revenue, the efficiency and quality of care provided by abortion clinics, and the extent to which physicians see providing abortion as a professional duty.

Willing and Unable begins with the introduction of Freedman’s research question and methods, establishes the various factors influencing physician autonomy, and provides context for the debate over abortion. Most notably, Freedman points out that the loss of fetal life is not, in fact, the most morally offensive element of abortion for those who rabidly oppose it—despite their propensity to wave around graphic pictures of aborted fetuses—since many support abortion in the cases of rape, incest, and fetal anomaly. Rather, the element of abortion that rankles many anti-choicers is “the notion that women can shirk the mother role. Deeply embedded in American society is the belief that women who have sex implicitly become obligated toward parenthood more so than men.” Therefore, any woman who avoids this responsibility is assumed to be irredeemably selfish.

From here, Freedman’s book covers a wide span of topics. The next five chapters trace the history of abortion care in U.S. medicine, the various ideological reasons why doctors are willing or not to provide abortions, the choices surrounding “learning, doing, and having abortions,” the various manifestation of the “institutionalized buck-passing of abortion care,” and the dynamics of miscarriage management within Catholic-owned institutions. The concluding chapter recaps Freedman’s main points and outlines ways to increase the number of abortion providers and integrate abortion into mainstream practice, both of which would lessen the stigma attached to abortion.

Freedman’s balance between analysis and physicians’ interviews is highly engaging. In chapter four, she teases apart the variety of choices involved in abortion care—not simply a woman’s choice to have an abortion or not—through the prism of Dr. Rina Anderson’s experience. After initially opting out of abortion training, Dr. Anderson chose to re-enter the program, then chose to perform abortions in private practice primarily in the case of fetal anomalies, and finally, chose to carry her own pregnancy to term despite the fact that her baby had a fatal condition and would die soon after birth. Dr. Anderson’s story is not only moving but also reveals the layers of choice involved in abortion care for both provider and patient, especially when they are one in the same.

While Freedman’s book explores a unique perspective within the abortion debate, I couldn’t help but want more—more interviews and information pertaining to a wider sampling of physicians. Perhaps I wanted more because what Freedman provides is so compelling. These are memorable portraits of physicians who find themselves confronted with the “choice” of either providing abortions or practicing obstetrics and gynecology, which—like the options available for many women faced with an unwanted pregnancy—isn’t much of a choice at all.

Written by: Dr. Jennifer A. Smith, August 21st 2010