US fertility prevention as poverty prevention: an empirical question and social justice issue.
OBJECTIVE
This paper examines the impact of the US welfare reform family-cap policy on the childbearing decisions of poor and low-income women by posing two complementary questions, both placed within a broader historical context. Specifically, it raises an empirical question pertaining to the family cap's effectiveness and a social justice question pertaining to the policy's ethical and legal justification in terms of human and reproductive rights.


METHODS
To address the first question, a thorough review of past and current research pertaining to the family cap at both the state and national levels is provided. The second question is addressed with an overview of international human and reproductive rights documents of relevance to the family-cap policy, as well as an analysis of the covenants' numerous components with which the family cap is in conflict. Finally, this paper situates the family cap in its historical context by investigating previous governmental attempts to control and regulate the reproductive health and rights of poor women and women of color in the United States.


RESULTS
The majority of empirical analyses of the family cap have found that the policy has not had an impact on poor women's reproductive health behaviors. In addition, the exclusive application of this policy to poor women receiving cash assistance is demonstrated to be in violation of eight international human and reproductive rights documents, several of which the US is a signatory.


CONCLUSIONS
These two findings make a strong case that policy makers and social and health researchers alike critically reexamine whether a policy that has not achieved its ostensible goal and is applied in a disparate manner-primarily to poor women and families and women of color-should continue to be implemented by the states.
Romero
Diana
D
Urban Public Health Program, Hunter College, City University of New York, New York 10032, USA. diana.romero@hunter.cuny.edu
Agénor
Madina
M
D036262:Empirical Research; D005069:Evaluation Studies as Topic; D016656:Family Planning Policy; D005260:Female; D005298:Fertility; D006801:Humans; D011157:Population Dynamics; D011203:Poverty; D046269:Reproductive Rights; D012935:Social Justice; D012946:Social Welfare; D012959:Socioeconomic Factors; D014481:United States; D014933:Women's Rights