The New York Abortion Access Fund (NYAAF), a reproductive health organization that helps finance abortions for low-income people who cannot afford to pay for them, sought emergency donations this week for one of its clients. Identified only as Paulina (which isn’t her real name), the young woman is a recent immigrant to New York City. She’s a full-time student with no monthly income — and by the time she discovered she was pregnant, she was past New York’s 24-week legal limit. She will need to travel to Colorado this week to receive care at one of the last clinics in the country that will be able to provide this type of late-term service.
The abortion procedure will cost Paulina $8,000 — on top of travel and lodging expenses — and her insurance coverage will only cover part of it. On Monday morning, NYAAF reported that it was still trying to raise $3,100 for Paulina. Just a few hours later, the organization announced that it had met its funding goal.
Paulina’s story is one of relative success, since she will ultimately be able to access the reproductive health care that she needs. But she is hardly alone. Her case points to some hard realities in the current reproductive rights landscape in the United States:
The people who need late-term abortions tend to be in the most desperate of circumstances. Abortions that occur after 20 weeks of pregnancy are already very rare, representing just 1.5 percent of all abortions performed in the U.S. The people who need these type of procedures typically fall into a few categories: economically disadvantaged women who need to delay abortion until they can save up the money for it, women who discover serious fetal health issues only after their pregnancy has advanced, and women who don’t realize they’re pregnant until they’re past the limit. Denying those women the reproductive health care they need often leads them to resort to dangerous options, like seeking care at illegal abortion clinics.
Low-income and immigrant individuals especially tend to struggle to access abortion services. Because of the high cost of abortion services, poorer women often can’t afford to exercise their reproductive rights. Seventy percent of the women who have later abortions say they would have opted to have the procedure sooner, but they couldn’t afford it. Immigrant women like Paulina also especially struggle to access safe abortion care — partly because they may be undocumented and lack health insurance, and partly because they may be part of a socially conservative community that won’t support them if they seek out an abortion. Several of the women who fell prey to illegal abortion provider Kermit Gosnell’s unsanitary clinic were immigrant women who felt as though they had no other options.
Having insurance doesn’t necessarily guarantee that abortion will be affordable. Paulina had some form of health insurance, but that ultimately didn’t mean she could afford her abortion care. That’s true for women across the country, too. The majority of abortions are paid for out-of-pocket, partly because some insurance plans don’t cover abortion and partly because the stigma surrounding abortion leaves many women too nervous to ask their insurance provider about it. The average amount that U.S. women end up paying for an abortion is $382, and 50 percent of the people who get abortions are forced to ask for outside help because they can’t afford all of the costs on their own.
Paying for an abortion encompasses much more than the cost of the procedure alone. On top of the cost of abortion itself, women typically must pay to travel to an abortion clinic. For those like Paulina who must travel out-of-state — or those who must travel hundreds of miles because they live in areas of their state that don’t have an abortion clinic — those costs can add up quickly. Low-income women struggle to afford the trip, as well as the cost of providing additional childcare while they’re away. And the average woman incurs about $198 in lost wages while she’s taking time off to travel to get an abortion.
The political debate over reproductive rights currently hinges on late-term abortions. Abortion opponents have seized on later abortions as a tactic to leverage support for banning the procedure. Often spurred by news of illegal providers like Gosnell, the anti-choice community conflates later abortions with legal abortion rights as a whole — claiming that terminating a pregnancy is always a bloody, barbaric procedure. Several states have enacted 20-week abortion bans, and the House of Representatives passed a national 20-week ban in June. Pushing for later-term bans allows abortion opponents to position themselves as moderates, while effectively chipping away at the rights of disadvantaged women like Paulina. One of the reasons there are so few late-term abortion providers left is because they have been driven out of business — or, as in the case of the late Dr. George Tiller, murdered.