When I arrived to provide medical care, the four-year-old girl was unconscious. She had multiple bruises, skull fractures, a brain contusion, vaginal and anal tears, venereal disease, and was hemorrhaging from places a little girl should not. The perpetrator? Her stepfather.

I actually sighed with relief when I learned she later died of her abusive injuries in the hospital; at least she was spared the anguish of surviving such brutality. Pediatricians across America have witnessed countless similar tragedies. A new BBC documentary has investigated why the US, one of the most prosperous nations on earth, has the worst child abuse record in the industrialised world. America's child maltreatment death rate is triple Canada's and 11 times that of Italy. Over the past decade, more than 20,000 American children have been killed their own family members – that is nearly four times the number of US soldiers killed in Iraq and Afghanistan.

What differentiates us from other countries? The single best predictor of child abuse is poverty. Children raised in families with annual incomes of less than $15,000 are 22 times more likely to be abused. Since the economic downturn, there has been a 30% increase in child maltreatment. The recession is, quite literally, a slap in the face of American children. The vast social programs available to low-income families in other countries are gapingly absent in the US. Social programs are also suffering funding cuts at the hands of Republicans, who persistently paint citizens in need of social programs as manipulative pariahs on the populace.

Since entering the bid for the 2012 presidential election, Gov. Rick Perry has boasted Texas' pseudo-success, bedazzling voters with misleading statistics. His swagger is rooted in the fact that Texas is a low-tax, low-social service state. He neglects to mention that children from Texas are four times more likely to be incarcerated, four times more likely to be uninsured, twice as likely to drop out of high school, and nearly twice as likely to die from abuse and neglect. In order to perpetuate the façade of "traditional family values", Child Protective Services in states with strong Republican leanings prefer to keep the faux family together, even in cases of flagrant abuse, instead of taking custody and removing children from their cruel environment. Nearly half of all Texan children killed by abuse belonged to families investigated by CPS, but the service's myopic political masters would rather leave a child in the hands of a sadistic, torturous family than have a child raised by a gay couple in a safe and nurturing home.

Thus Texas has the lowest rate of removal for abused children from their homes. Not surprisingly, it also has the highest number of child abuse fatalities in the country.

Amid these dire circumstances, House Republicans passed an atrocious bill this month that would deeply impact pregnant women of lower socioeconomic status. Currently, hospitals receiving federal funds must provide emergency healthcare, including abortions, which can sometimes be life saving for the mother. The deceptively named Protect Life Act – which does anything but - would permit hospitals receiving federal funds to refuse to perform an emergency abortion, even if a woman's life was at stake. A vicious attack on the most basic right to life, HR 358 ambushes poor pregnant women into a bleak decision: either deliver an unwanted baby and raise the child in an unstable home, or have an unsafe abortion that could jeopardise your life. Will the GOP, our bastion of God-sanctioned moral righteousness, also be providing discounts on rusty coat hangers to further hasten the death of pregnant women?

In contrast, a new UN report released this week demonstrates that restrictions on abortions do not impede abortions; they only impede safe abortions and endanger women's lives. The report also shows that that access to sex education and contraception are proven to reduce the need for abortions.

The GOP's shrill moral indignation will force low-income mothers to have children who are born into poverty, rendering them at risk for abuse. Once the babies are born, however, Republicans abandon them in their most vulnerable moment by vehemently opposing social programs that would ameliorate their deplorable conditions. Love those fetuses unconditionally … until they take they take their first breath, when they magically transform into wretched, handout-seeking leeches on society. Abortion? A sinful abomination! Allowing a toddler to die because of lack of access to social programs? Man up, kid; God helps those who help themselves.

Inevitably, adoption is always the suggested panacea, but many children are just filtered through foster programs, which are themselves horrifically abusive. A 1986 survey conducted by the National Foster Care Education Project found that foster children were 10 times more likely to be abused than children among the general population. A follow-up study in 1990 by the same group produced similar results.

Republicans can cry "scary socialism" all they want. If that is what it takes to prevent blindness in a shaken baby, or anal tears in a seven-year-old resulting from knife sodomy, bring it on. Jonathan was an seven-year-old I treated whose relatives used to starve him, hang him from his shirt on the coatrack all night, dip his feet in boiling oil, and threaten to cut off his penis while holding a hot knife to his genitals. His caretakers had suffered similar abuse in their youth. Abused children are 74 times more likely to commit crimes against others and six times more likely to abuse their own children. This is why it is of paramount importance to offer therapy and rehabilitation to those from broken homes.

Ultimately, the blame of abuse always lies with the perpetrators who commit these heinous acts. But while those to the right of the aisle use melodramatic rhetoric to demonise social programs, studies have shown that preventive measures and therapeutic rehabilitation can, indeed, diminish the cycle of violence. Furthermore, women who are unable to provide a safe environment for children should be allowed to terminate their pregnancies safely, rather than risking their own lives and subjecting their children to a wretched existence full of misery and pain.

The narrative of healthcare reform and social programs must stop reflecting the agenda of morally bankrupt politicians whose eyes only fix on the next election. Propagandised myths need to be replaced with an empathic truth that reflects the needs of catastrophically shattered children who are struggling to survive and begging for our compassion.

• Details of patients, including names, have been changed to protect their identities

• Editor's note: the figures originally given for problems with foster care, involving the prevalence of substance abuse among foster carers, may not have been reliable. So the article has been amended to give accurate information, at 6.30pm (ET; 11.30pm UK time) on 24 October