Beyond Legality

With all the focus on simply keeping abortion legal, we often miss the fact that access to abortion remains highly limited and even impossible for some women.

“It’s a sad calculus … It helps if they are farther along in pregnancy rather than earlier. Or if they are living with their batterer, and he would know if they’d pawn anything. Or, if they are homeless … like we got this call last week from a woman whose house burned down and her three children were taken away. We were able to get some money for her.”

That’s what happens when women call abortion hotlines, desperately seeking some way to pay for the procedure.

“Could you ask your friends for $40? If they say ‘no,’ maybe ask for 20 or even 10?” I hear her ask in her calm voice. Later she tells me that this woman has been evicted from her house for lack of rent, and is crashing with her three children at a friend’s. To another caller, I hear her say, “Well, do you have anything you might pawn? Some jewelry? A TV set?” And to another, “Is it possible you could postpone your car payment until after the abortion?”

This is all too familiar. I’ve mentioned before that I volunteer for the Haven Coalition, and through my work there have met several women and girls coming to New York for second-trimester abortions, which are highly limited in many other states. These women vary in age and background, but they all have one thing in common: They’re poor. And they’re usually desperate. They scrounge up all the money they have, pawning what they can, not paying their bills, and begging friends for some spare cash.

What ends up happening is that it takes them a few months to raise enough money — and at that point, their pregnancies have progressed even further, abortion is more expensive, and it may not even be allowed or accessible in their home state.

Abortion also isn’t covered by Medicaid funds in most states (New York is a notable exception, but you have to be a state resident). And while there are supposed to be exceptions for rape and maternal health/life, government bureacracies do their best to prevent all women from accessing these services.

Laura tells me of a woman from a mid-Atlantic state with a mind-numbing series of problems. Already the mother of several young children, she was in the midst of a difficult divorce from an abusive husband, against whom she had acquired a restraining order. “My husband would kill me if he found out I was pregnant,” she said. She was about to be evicted from her home, because of difficulty in paying the rent. She had become pregnant after being given a “date rape” drug. The woman had duly reported the rape to police and was determined to get her state’s Medicaid program to pay for her abortion.

This involved a massive effort on the patient’s part. Though so poor that her phone was disconnected (communications with the hotline took place via a neighbor’s phone), she managed to find a public internet connection and download the necessary form for a Medicaid payment for an abortion involving a rape. Then she embarked on a Kafkaesque series of phone calls with state Medicaid officials, all of whom were determined to prevent approval of her abortion. Through the help of a public interest lawyer in the hotline’s network, the patient finally was able to access someone high enough, and sympathetic enough, in the Medicaid hierarchy who could approve her request.

The next obstacle was to find a provider in her rural area who would accept a Medicaid-paid abortion. Neither her “anti-abortion” primary care doctor nor her equally anti-abortion OB/GYN were any help. Finally, after much frantic calling around, with the hotline’s help she located a clinic that performed her abortion.

Many women never get that far.

Anti-choice legislation has certainly been effective here in preventing some abortions, and forcing women into childbirth. But it’s also been effective at pushing abortion to a later point, when it’s more expensive and not as safe as earlier procedures (although still safer than childbirth).

Low-income women not only lack access to abortion services, but access to those things which prevent abortions in the first place: contraception and pregnancy-prevention education. Financial hardship is an oft-given reason for terminating a pregnancy; a pregnant woman may have to pawn her TV and put off her car payments in order to afford the procedure, but that’s still more affordable in the long run than raising another child. Many women who terminate pregnancies have given birth before. Even more of them will give birth at some point in their lives after the abortion. These women know what motherhood entails. They know what pregnancy entails. They would almost certainly rather prevent an unwanted pregnancy in the first place than be put in a situation where they have to terminate one.

But “pro-lifers” don’t seem to care much for this reality. Instead, they try to make it more difficult on women from all sides: They cut funding for contraception and sex education, making it more difficult for women to prevent pregnancy in the first place; they limit abortion, making it more difficult for women to terminate their pregnancies; and they cut various forms of aid to women with dependent children, making it more difficult for women to make the decision to give birth, and more difficult for women to raise the children they have.

It is not, in any way, shape or form, about protecting or promoting “life.” It’s about punishment, for little more than being born in a female body. And if you’re still under the erroneous impression that “pro-lifers” actually want to prevent abortion in the first place, consider this:

In the short run, however, accessible and affordable contraception and abortion would make an enormous difference. The Centers for Disease Control states in a recent report that 98 percent of heterosexual women use contraception “at some point.” But this number masks the fact that use of birth control use is gradually decreasing, especially among poorer women. The Guttmacher Institute, the leading research organization on reproductive health, has pointed out that, between 1994 and 2001, 33 states cut funds for birth control and that half of all poor women who need birth control services are unable to afford them.

In what might seem like a ray of hope, House Democrats have just introduced legislation, the Reducing the Need for Abortions and Supporting Parents Act, that would require states to cover contraceptives for women with incomes of up to 200 percent of the federal poverty level. The bill would also establish grants for sex-education programs that include information on both contraception and abstinence. It also contains various other family-friendly measures, including increasing funding for health care for low-income women with children, providing no-cost visits from nurses to teens and women who have given birth for the first time, expanding tax credits for adoption and increasing child care funding.

No Republicans publicly support this effort, and it is opposed by the Democrats for Life caucus, “because of the pregnancy prevention emphasis.” This lack of support for what should logically be common ground in the abortion wars reflects the new aggressive stance by much of the anti-abortion movement. Contraception itself is now being reframed as another form of abortion. This bill has virtually no chance of passing in the current political climate. And the calculus for the hotline callers just keeps on getting sadder.

It’s worth remembering that abortion rights go beyond simple legality, and reproductive rights go beyond abortion. The pro-choice movement has always been about giving women access to the widest variety of choices possible, including making it possible for them to carry wanted pregnancies to term.

Sadly, the same cannot be said for the anti-choice movement, which, as I wrote above, continues to make life more difficult for mothers and would-be mothers. Case in point:

According to a new 50-state report on child care policies just released by the National Women’s Law Center, the Bush administration has successful dismantled government services for children. State funds for child care assistance have fallen for the fifth year in a row. The problem will soon become catastrophic when large numbers of single mothers bump up against their five-year life limit on welfare.

Some states, like New Jersey, also cap the number of children that a woman can have to qualify for extra benefits. So, if she’s living on welfare and gets pregnant, she won’t get any extra resources for the additional child. She’ll have to stretch her already limited finances even further. If that’s not a financial incentive to terminate a pregnancy, I don’t know what is — and yet this program was created by conservative, “pro-life” politicians.

Poverty — like the child care crisis — remains invisible to mainstream America and largely outside the national political discourse. Yet, in 2004, the U.S. Census Bureau announced that poverty rates in U.S. had increased for the fourth straight year and had jumped from 31.6 million people in 2000 to 37 million, including 13 million children.

Rather expanding Head Start, the government issues vouchers that all too often result in inadequate child care. And many mothers who can’t get subsidized child care assistance reluctantly leave their children with irresponsible relatives or babysitters they have good reasons not to trust.

While the media celebrates the highly-educated career woman who quits her job to become a stay-at-home mom, the government requires single mothers on TANF to leave their children somewhere, anywhere, so that they can fulfill their requirement to work and get off welfare.

And poverty isn’t the only issue (although it’s a huge one). Even middle-class families have a much more difficult time finding affordable childcare, as the economic growth in this country has benefited the highest social classes only. Middle-class families are worse off today than they were 50 years ago. And there are few, if any, institutional options for them.

For all their talk about loving life and babies and being “pro-family,” social conservatives and pro-lifers have done nothing to back up their claims. They’ve simply backed legislation that harms families, harms children, and harms women. And even their fetus-fetishism isn’t backed up with positive action: They’ve cut healthcare for pregnant women, and cut off funding to international organizations that provide pre-natal and well-baby care. Instead, they fixate on punishment, “protecting babies” in ways which truly only serve to hurt women.

There’s nothing pro-life or pro-family about it.

If you want to do something to help low-income women to obtain abortions, consider donating to the National Network of Abortion Funds.