New Survey: Abortions More Concentrated Among Poor, Stigma Forces Women To Pay Out Of Pocket

A new survey from the Guttmacher Institute reveals that poor women are obtaining abortions in greater numbers than women from other income brackets. From 2000 to 2008, “the proportion of abortion patients who were poor increased 59%,” as women found it more difficult to access affordable birth control during an economic recession:

The survey occurred during an economic recession, which may account for some of the substantial increase in poverty among abortion patients between 2000 and 2008…. More indirectly, recent studies have found that because of financial constraints, women want to delay childbearing or limit the number of children they have, but these same constraints have made it harder for them to access contraceptives and to use them consistently. In these situations, poor women may have found it more difficult than better-off women to obtain and use contraceptives and prevent unintended pregnancies. Additionally, when confronted with an unintended pregnancy during the recession, poor women who might have felt equipped to support a child (or another child) in financially stable times may have decided that they simply were not equipped to do so now.

Significantly, 57% of the women who had abortions paid out of pocket for the procedure, regardless of their insurance status. As Guttmacher observes, “We suspect that several factors contributed to the lack of reliance on private insurance among women who had it. First, some may have had health care plans that exclude abortion services…Others may have been unaware that their plan covered abortion. Some women may have been reluctant to have the abortion on their insurance records out of concern that an employer, regular health care provider or family member whom they did not want to know about the abortion would have access to this information.”

The results are fairly consistent with earlier surveys, which found that continued stigmatization of abortion — treating it as if it is something wholly different something different than “normal” health care — forces women to pay out of pocket and disproportionately disadvantages poor women, who undergo the procedure at higher rates. Ironically, the passage of health care reform — which will certainly help women obtain access to better health care — could indirectly undermine access to abortion coverage and increase the financial stress of poorer women. The Nelson amendment “reignited the abortion wars in the states” and “opened the door for them to legislate away private insurance coverage of abortion.” The next Guttmacher survey may very well find more women paying out of pocket for abortion coverage than ever before.