RH Reality Check, May 15, 2012 by Kirsten Moore
Mothering. Abortion. Two very big topics that may seem antithetical to one another.
But when you pull back the curtain a bit it’s easier to see how they are inextricably linked.
First — let’s look at the “WHO.” Who has abortions? According to the Guttmacher Institute, six in 10 American women seeking an abortion already have a child, and more than three in ten already have two or more children. Surprised?
Not when you find out the second point: WHY. The fact is that one of the most common reasons a woman will give for deciding to seek an abortion is that she fears she cannot meet the responsibilities of parenthood and family life. Three-fourths say that having a baby would interfere with work, school, or the ability to care for dependents; and half say they do not want to be a single parent or are having problems with their husband or partner
That’s not surprising when you stop and think about it. The National Poverty Center found that families headed by single women have the highest poverty rates, particularly if they are black or Hispanic. In 2010, 31.6 percent of households headed by single women were poor.
And it’s not just single moms. There are plenty of couples who are struggling to get by. More than six percent of married-couple households are living in poverty in the United States. When a couple is living paycheck to paycheck, the idea of another baby may feel like a blessing from God. Or it may feel like the tipping point between holding things together and losing complete control.
Today, a pregnancy can still mean the loss of a job if a woman can’t go back to work soon enough, or the loss of health if a woman isn’t able to pay for her prenatal visits. Either of these scenarios can easily spiral into loss of a place to live. Besides the not-so-simple economic calculations, what about the mom who already feels she can’t face another 18-hour day of balancing work, childcare, kids, groceries, bills, and keeping her home together – even on the best days?
To me, this feels like a thoughtful and honorable reason to end a pregnancy. She knows how big the job is. She knows what it demands of her and her partner. And she knows she is already stretched to the max. She has thought it through, weighing whether she can really take care of another child and give him or her what they need to live with dignity. If she decides she can’t, why would I want to convince her otherwise?
Unfortunately financial resources – or the lack thereof – can adversely affect not just a woman’s decision about whether to carry a pregnancy to term. They can also dictate her ability to access care. Imagine a woman who realizes she is pregnant, makes a decision to end the pregnancy, calls to schedule a procedure and learns it will cost at least $450 out of pocket. It takes her a few weeks to come up with the resources and she shows up at the clinic only to learn the pregnancy is further along than she believed. So now the procedure is potentially riskier and will cost more than $1,000. She starts again, but eventually, the clock runs out.
People like to assume that “oh, she’ll just find the money for an abortion.” But that doesn’t always happen. A National Bureau of Economic Research study on the variation of funding through a Medicaid program found that three in ten women ended up having a child because they could not afford an abortion.
Given how important this decision is, how far-reaching the impacts are for women and their families, why would we as a society want to put the option of affordable abortion care out of reach?
But that is what our public policy does for all too many women who live near or below the poverty line. For the past 35 years women who get their health insurance through Medicaid have been dealing with the Hyde Amendment, which prohibits the use of public funds for abortion care unless the procedure is necessary to save the woman’s life or if the pregnancy is the result of rape or incest.
And it’s not just Medicaid. Women in the military, federal employees, Peace Corp volunteers, disabled women who are enrolled in the Medicare program, women in federal prisons, and women who receive care from Indian Health Services also have restricted access to abortion care. And now, policymakers are trying to extend these restrictions to the new health care exchanges that will be created in states.
Fortunately, this is not the case in every state. State Medicaid programs in 15 states currently provide coverage for abortion care. These policies are often under attack, but have been successfully defended in several states including those you might not think of such as West Virginia and Montana.
Let’s recognize that the way to honor motherhood is to respect and support a woman’s decision about whether she is ready to be a parent. That means making sure that every pregnant woman, regardless of her ability to pay, has health care insurance coverage for all of her medical needs, including abortion.