The CDC released data last month showing how women fled NYC at the height of the pandemic to give birth, largely as a reaction to fear of overwhelmed hospitals as well as restrictive birthing policies.
What’s interesting about the data, from my perspective, is how clearly it demonstrates that it’s those with wealth who can avoid the limitations regulations create. New York State has regulated birth centers out of existence, largely through the burdensome and outdated Certificate of Need (CON) process, resulting in fewer options for precisely those people who can’t buy themselves out of these limitations.
Predictably, from the CDC data, white women were most likely to successfully escape the city. Black and Hispanic women were left behind, likely as a result of less flexible employment and fewer financial resources overall. Meanwhile, at the same time women downstate were desperate to find safe places to give birth during a pandemic, New York was prosecuting midwives who served an upstate maternity desert of low-income Mennonite women. The absurdity of the entire situation should be obvious, but in reality it demonstrates one of the primary ways in which regulations have regressive effects.
Certified professional midwives, licensed in 35 other states, are illegal in New York. As a group they tend to serve underserved communities, including low-income rural communities and communities of color. So when low-income New Yorkers looked around for out-of-hospital birthing options during a global pandemic it turns out they couldn’t find any, not because of a market failure, but because of simple and obvious government failure.
There’s a broader lesson here for classical liberals. Most people acknowledge that classical liberalism has a diversity problem, but it’s been hard to know what to do about it. I think one clear way libertarians and classical liberals can appeal more strongly to diverse populations, including women and people of color, is by emphasizing the way government regulations overwhelmingly harm the most vulnerable among us. While there’s been a lot of work done in this area in terms of criminal justice reform, the drug war, and immigration, women’s issues haven’t yet really gotten as much attention. And regulation in particular is still often discussed as an efficiency issue rather than a justice issue. Yet government-imposed barriers place real and disparate burdens on women and communities of color, creating serious impediments to accessing diverse providers on the one hand and wealth building among would-be entrepreneurs on the other.