Arguments Q+A: Isabel Sawhill, Author of Generation Unbound

The culture wars have made many progressives suspicious of appeals to “marriage” and “family”—often, the words are deployed by champions of outmoded gender roles, defenders of abstinence-only sex education, or opponents of LGBT equality. But social conservatives are not the only Americans who should care about changes in marriage and parenting: as economist (and Democracy Editorial Advisory Committee member) Isabel Sawhill shows in her new book, Generation Unbound, changes in marriage and parenting affect the well-being and social opportunities of children, the ability of single mothers and poor couples to enter the middle class, and inequality and social mobility. Sawhill’s book reports that among American women under 30, half of all babies are now born outside of marriage, and
a majority of births to unmarried young women under 30 are unplanned. The cost and disruption that these unplanned children introduce into the lives of women—especially women with lower levels of income and education—make this an important economic issue. Sawhill’s chief suggestion: We should encourage the widest possible use of Long Acting Reversible Contraception (LARC)—especially IUDs, which would safely allow women to control when they want to have children.

Sawhill, who served as an associate director at the Office of Management and Budget in the Clinton Administration, is a senior fellow in economic studies at the Brookings Institution, where she co-directs the Center on Children and Families and the Budgeting for National Priorities project. We spoke earlier this week about her latest book.

One of the interesting things about this book is the way it expands the way marriage is perceived as a political issue. How did you come to think of marriage and the family—often “coded” as a social-conservative issue—as a progressive issue?

There’s a tendency to think that marriage is something that only conservatives care about. My argument is that liberals should care about it as well. And that the reason is: If you care about poverty, if you care about inequality and social mobility, you have to focus on and care about what’s been happening to the family and to marriage in America. My analysis shows that for every child that you pull out of poverty with some social program, you’re going to find another child falling into poverty because of the breakdown of the family.

To a lot of people, encouraging certain kinds of family and parenting choices sounds paternalistic. But you portray it as a matter of actually enlarging personal autonomy. Can you explain why?

I think there’s been a tendency to view talking about marriage, childbearing, and especially birth control as telling women—and especially low-income women—what they should do. And that is paternalistic.

But what my research shows is that women themselves—and especially low-income women and women of color—are having more children than they want, and they’re having them before they feel ready to have children, or get married. So this isn’t about what some social conservative thinks about the world; this is about what young people—women themselves—say they want and yet are not being empowered to obtain. Empowering women to achieve their own preferences is going to require two things. First of all, more opportunities to climb the economic ladder. Second, though, is empowering them to have children when they want them, and with whom, and under what circumstances.

Your recommendations about effective contraception are informed by behavioral economics. What has that research taught us about this issue?

I have a whole chapter on behavioral economics, and my exposure to this research has radically changed my view of the way the world works, and in particular how people behave. I’m an economist, and most economists have been trained to think that people are rational and self-directed—that they look at different options and then make informed and rational choices.

And the reality is that we don’t often make choices at all: we simply drift into certain behaviors that are not necessarily in our self-interest; things that, if we could control, we wouldn’t do. We’re all drifters to some extent. And the research on sexual behavior shows that even when people don’t intend to get pregnant, they nonetheless do so in large numbers because they make mistakes.

We’re all human. We forget to take our birth control pills; we find it difficult to use a condom in the passion of the moment. We are just naturally flawed creatures. Think of the story of the Odyssey, in which Odysseus ties himself to the mast and has his sailors plug his ears with wax, so that he wouldn’t be thrown off-course by the sirens. We all need to learn tricks about how to prevent our own worst failings from derailing our plans and our intentions—and that’s doubly true in this arena.

That’s why I stress the idea of changing the default: instead of someone getting pregnant unless they work very hard not to, we should change the default to one in which you have to take active steps in order to get pregnant. And the way to do that is through Long Acting Reversible Contraception (LARC). That’s how we change the default.

When people have been offered LARCs at low or no cost, changing the default to one in which you cannot get pregnant unless you take active steps to do so, the unintended pregnancy rate has dropped dramatically. We have evidence from studies in St. Louis, Colorado, and Iowa. These studies are not based on randomized controlled trials. But the differences are so dramatic that it’s pretty hard to even imagine that they could be the result of unobserved differences.

What about the politics of LARCs? Is this a feasible area of compromise with conservatives?

There are political barriers on the conservative side. Consider the personhood amendments being supported by conservative candidates, and some elected officials, around the country. These would not only effectively ban all abortions without exception; they would prohibit the use of many forms of birth control. That’s something Democrats are beginning to fight back against, and they’re getting some traction, because the public—and especially the half of the public that’s female—really doesn’t like the idea that they’re going to be denied access to birth control because there’s a group of conservatives out there who want to redefine when life begins. And of course, the irony is that birth control, especially the most effective forms, reduce the abortion rate dramatically. We have hard evidence on that.

I think the culture war that used to favor Republicans and put Democrats on the defensive is now beginning to shift. It’s Democrats who are on the offensive now, and Republicans are playing defense. And the reason is that Republicans have gotten too far away from public opinion on these issues.

Liberals, on the other hand, may have their own objections because they think poverty is the source of the problems I discuss in Generation Unbound. So I don’t think ‘what to do’ necessarily breaks down in a partisan or political way. I think we should continue to provide opportunity-enhancing programs to low-income adults, from the minimum wage to a better education system, and the usual set of safety-net programs. But we’ve been working on these programs for decades, and they’re hard. They take time and resources.

The agenda I’m proposing is something we can do right now. It’s relatively easy, and it not only does not cost money; it actually saves money. The benefit-cost ratio is very high.

You point to the implementation of the Affordable Care Act as a potentially huge development for increasing LARC use. Obviously, there’s been fighting over not only the Medicaid expansion, but over birth control provision as well. How is ACA implementation going?

Implementation of the ACA is critical, and the provision that all forms of FDA-approved birth control should be made available at no cost to women is very good. But there are lots of potential gaps in the implementation of that provision. One is that Medicaid expansion is not being accepted by all the states, and some women will fall between the cracks because of that.

And there are other issues, too: a very large fraction of adults have never even heard of a LARC and don’t know to ask for one. Many doctors are less than fully familiar or trained in these new methods, and they’re not up-to-date on the fact that the modern IUD is safe, because they remember the problems with the Dalkon Shield. There are legal challenges, such as the one that caused the Supreme Court’s ruling in the Hobby Lobby case. The result is that certain employers cannot be required to cover certain kinds of contraception in their health plans. There will probably be a workaround, but it will be complicated, and therefore difficult for most women to take advantage of.

There’s still a lot of controversy about this. The question is: who is going to win this culture war? I think the advantage is now shifting to Democrats and away from Republicans, because there is widespread support for birth control in this country. Almost everybody uses it. This is not a winnable battle for Republicans in the long run.

I’m intrigued by your discussion of LARC use as an anti-inequality and pro-social mobility policy. This conversation often focuses on things like changing unionization rates, education differences, Wall Street, welfare programs, and tax policy—but birth control is often not part of the mainstream discussion on inequality and mobility. Should it be?

This is important. I think most progressives look at what has happened to the family and they say, “Well, this breakdown—this growth of out-of-wedlock childbearing—is the result of poverty and inequality, so Sawhill has the causation wrong.” And I don’t disagree that poverty and inequality may be one reason why we’re having more unwed births and unintended births, but I think the causality also goes in the other direction. Poverty leads to less family stability; less family stability leads to more poverty and inequality.

On that point, it’s obvious that if you have two adults raising a child together, it’s a better environment for kids simply because it means there are twice as many adult hours available for child-rearing tasks: hours that can be spent either to earn more income or to spend more time with the children. You double the hours. It’s not that single parents can’t do a tremendous job against the odds, but the odds are stacked against them. They simply don’t have as many resources as two parents do.

Richard Reeves has done research here at Brookings showing that a child who has married parents has much higher social mobility than the same child born to discontinuously or never-married parents. We’ve then said: “Well, those people who are married probably have other characteristics making them different from their unmarried counterparts.” And they do. They have more income, because there are two of them. By way of comparison, there are not too many social programs that can double your income. One of the reasons that kids in married-parent families have more social mobility is that their parents have more income, even if they start out in the bottom quintile.

The other thing is that the quality of parenting—as measured by things like the warmth and responsiveness of the parent and the amount of mental stimulation for the child—those measures are all higher in married-parent families. Between higher incomes and higher-quality parenting, the children of married parents will have more social mobility than the children of unmarried parents. There’s no question that kids raised in continuously married families do better over time.

This interview has been edited and condensed.