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Sterilization would be tossed back as the woman didn't have capacity to consent, by virtue of being an addict (and probably at least one other mental health issue--most addicts have 1-2 other issues going on). Lawsuit city.

$50 per Depo shot or whatever might work.

I'd rather something like paraguard, which is good for 10 years and has a lower failure rate and lower side effect profile.

Many of the women who give birth to addicted babies do have Medicaid. So one avenue of intervention I see is regulating what forms of birth control Medicaid must cover, and then encouraging women to avail themselves of the more permanent ones.

If you only ever have experience with the babies that result from addiction, it's easy to demonize the mothers and see them as one dimensional monsters. This just isn't the case with the ones I've interacted with personally. They are people who have an illness. They do not feel they have choices, or resources, or control over any aspect of their lives. They usually have some form of persistent mental illness. They think as badly, or worse, of themselves as everyone else does, and the weight of the guilt and shame that hits them during moments of sobriety makes it much, much harder to sustain those moments of sobriety. I believe many of these women would gladly utilize long term birth control if they were given information about it and it were provided to them. I believe we can reduce the incidences of babies born addicted without strong arming, shaming, or reducing the rights of a group of people who are as vulnerable and sad as the group we are trying to protect. I have seen some of these women struggle to pull their lives together and to regain parenting rights or re-enter their kids' lives. I have seen some succeed, but I have seen most fail. Sincerity of desire is not a factor. That's just not how addiction works. And until we have any sort of reasonably successful treatment for addiction to offer, I just don't think focusing intervention efforts there makes sense.

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