What does it really take to get an abortion in America?
September is Abortion Access Month, and an important time to think about this question. As it turns out, it takes quite a bit to get an abortion in this country, and as states across the nation pile on waiting periods, ultrasound requirements, bans, and other barriers, accessing safe and legal abortion care is becoming more difficult by the day. One of the biggest hurdles for folks seeking abortion care is the fact that, for many, it is quite simply unaffordable. Who are the folks that cannot afford abortion care?
Outside of our paid gigs, we serve on the board of the National Network of Abortion Funds. The organization helps to bridge the gap between a legal abortion and the ability to afford one by fighting unfair laws that undermine access to safe and legal abortion care while directly helping folks who need abortions today. Through this work, and our individual work with local funds, we’ve heard countless stories – all different, yet tied together by the fact that gathering the funds for the health care they need has been made nearly impossible.
Leila* is one woman who called the Network seeking help:
My son is 11 months old with a serious birth defect. He’s been in and out of intensive care for his whole life and has three or four doctor’s appointments every month. After he was born, I had to drop out of college and I lost my job because of all the appointments. My son’s medical care is covered by Medicaid, but it won’t cover my abortion.
How can I find the money for an abortion when there’s not enough for diapers? And how could I raise two babies when the one I have now needs all that I have to give?
I just moved to this state to live with my best friend and her baby. We thought that we could do better if we worked together, took care of each other.
But now I’ve already had to take money out of our grocery fund to put toward the cost of my abortion. My friend understands, but we’re going to be short on food money for a while. I borrowed money from some old classmates. I sold my television. I managed to pull together what I needed. But when I got to the clinic, they told me that my abortion would cost $100 more.
$100 more than I had. $100 more than I could imagine finding.
There was no way I could go home without getting my abortion. So I sat down my diaper bag and started pulling things out – formula, bottles, diapers – to sell to the other women in the waiting room. Maybe I could raise that $100 right there.
I was breathing so hard and fast that I thought I might pass out.
Luckily, that day Leila wasn’t turned away, but this is what the federal ban on abortion funding, known as the Hyde Amendment, means in real life. It means that low-income folks who have their health care covered by Medicaid have to come up with some sort of way to pay for their procedures out of pocket, even though the fact that they are on Medicaid means they’re already having trouble making ends meet. It means that women of color, who are disproportionately poor, bear the brunt of these restrictions. It means that queer, trans, gender non-conforming, and genderqueer folks – also disproportionately poor, especially folks of color – bear a heavy portion of this weight, in addition to the stress of finding a reproductive health provider willing and able to provide quality care for folks of non-normative gender presentations. And yes, trans folks might need an abortion, and reproductive health care is indeed a trans health issue.
And yet, The National Network of Abortion Funds’ annual survey of our member Funds shows that on average, funds are only able to help 1 out of every 7 people who contact them for help. People who volunteer at abortion funds around the country know very well, because they speak to people seeking abortions every day, that the legal right to an abortion is a distant reality for many. The work of funds, in fact, is to bridge the gap between what they have and the cost of an abortion. This process includes determining whether the person lives in a state that covers abortion care via Medicaid (only 17 do); how much the procedure will cost, how much the person has, and what they could sell to come closer to that amount; whether there is a clinic close by, and if it requires a waiting period or a mandatory ultrasound, or any other non-medically necessary procedure; whether they have a way to get to the clinic, or a place to stay if it’s a two day procedure; and details about childcare, elder care, and work schedules.
These are just the logistical concerns – we haven’t even touched on fear, shame and stigma. This gap exists because we (as a society), quite simply, do not treat abortion as health care. We do not take it seriously as a social and medical need. And we devalue the experiences of millions for whom this gap is the difference between getting the care they need and having it unavailable to them.
We must call for an end to the bans on federal funding for abortion care. An abortion costs an average of $451 in the first trimester and can sometimes cost $3,000 or more. This is an impossible sum for many, many people – especially given that a woman working full-time at a low-wage job only makes about $1000 a month and needs to cover rent, utilities, food, transportation, and child care. Every pregnant person, must have the ability to decide whether to bring a child into the world, based on their circumstances and those of their family, no matter what their income is. We cannot continue to allow religious extremists and politicians to interfere in a family’s decision about how many children to have and when to have them.
That is why this month is Abortion Access Month. September 30th is the 37th anniversary of the Hyde Amendment, and September 28th is the Global Day of Action for Access to Safe and Legal Abortion. During this month, we encourage you to be motivated to end the deep disparity created by politicians withholding federal funds, and to remember that we are the experts on our own lives. We deserve the tools and opportunity to build the futures and families we want and need. We invite you to join us and add your voice to a loud and unapologetic call to all our policymakers: let’s end the unequal health care system that treats reproductive health care as something separate from all other health care. Let’s repeal the Hyde Amendment!
* Name has been changed to protect confidentiality