- Most people seeking abortions are poor; not being able to afford a child is a key reason they seek the procedure.
- Research shows that being denied an abortion is linked with less educational attainment, lower credit scores, and more financial problems.
- The children of parents seeking abortions suffer financially when abortion care is denied.
Since the Supreme Court overturned Roe v. Wade and sent abortion regulation back to the states, access to abortion (or lack of it) will affect many more lives. “This is a public health emergency,” says Sylvia Ghazarian, executive director of the Women’s Reproductive Rights Assistance Project (WRRAP). “It’s really hard to forecast how many individuals will fall through the cracks, but it will be quite a few.”
A few years ago, Jessy Rosales came close to being one of the people who fell through the cracks. She was a junior at UC Riverside, age 20, when she found out she was pregnant. “It was the first time in my life that I was taking my upper-division courses, I was working, I was doing advocacy,” she says. “It was incredibly overwhelming.”
Even though she lived in California, where abortion rights are secure and was going to a state school, Rosales struggled to access abortion care. Her school’s health center didn’t offer any abortion care, and the referrals they gave her were less than helpful. When one clinic told her she had to go to her hometown and get care under her family’s health plan, “I just kind of felt lost, and I didn’t know where to go from there,” she says.
She hadn’t told anyone she was pregnant because her boyfriend was embarrassed and didn’t want people to know. She had internalized the stigma, too, but finally told a friend who suggested she go to Planned Parenthood (where she was, ironically, already a volunteer).
It took three months between that first visit to the student health center and the day Rosales was able to get an abortion, so she was in her second trimester when she finally had the procedure. She couldn’t have a medication abortion, and the copay for the procedure cleaned out everything she had managed to save from her student aid and a campus job. (Her boyfriend promised to pay half the cost but didn’t, so the burden fell entirely on Rosales.)
Being denied an abortion is linked to increased poverty
Getting an abortion allowed Rosales to graduate and start to build a financially stable life for herself. Her story mirrors that of many of the people in the Turnaway Study, a seminal and far-reaching research project spearheaded by Diana Greene Foster, a professor of Obstetrics, Gynecology and Reproductive Sciences at UCSF. Foster literally wrote the book on what happens when people want abortions but aren’t able to get them. She is currently launching a new study on the end of Roe.
The Turnaway Study looked at the consequences for people turned away from abortion clinics because their pregnancies were above the gestational limit for services in their area. The research compares outcomes for those women with others just under the gestational limit and a third group who received first-trimester abortions.
“There are long-term economic harms to families when people are unable to get a wanted abortion,” Foster told Insider via email. “We see an immediate drop in full-time employment and years of not having enough money to cover basic living needs.”
Sarah Miller, an economist and assistant professor at the Ross School of Business at the University of Michigan, collaborated with Foster and Laura R. Wherry to expand on the Turnaway Study to include data on participants’ financial health before they showed up at the clinic.
Miller’s research looked at public records, including credit reports, bankruptcies, evictions, tax liens, and judgments in court over 10 years before and after the study participants got or were denied an abortion. The study compared the two groups that were close to the gestational limit.
“Before they were denied an abortion, [the two groups] looked really similar,” Miller says. “Around the time the turnaway group gave birth, we saw a big spike in financial problems.” She notes that the economic situations of people who got abortions were flat or improved over time.
“The people in the turnaway group were more likely to be living in poverty,” Miller says. She notes that not being financially stable is a common reason women give for seeking an abortion. The Turnaway Study found that people who were denied wanted abortions were less likely to be living with friends, family, or a male partner after their pregnancy than those who got abortions. They were also more likely to use government services such as WIC.
People of color and low-income people will be affected most by new abortion laws
“I can debunk the notion that for somebody experiencing a severely mistimed or unwanted pregnancy,” they will find a way to get an abortion, says Caitlin Knowles Myers, a professor of economics at Middlebury College. Her research shows that when travel distance to a clinic increases, “there’s a substantial fraction who can’t make it.” She adds, “I grew up low-income in the deep South. I completely understand what it is not to be able to travel.”
Myers estimates that about three-quarters of the people seeking abortions in states with bans will find a way to get the care they need. The ones who don’t could number more than 100,000.
“They are going to disproportionately be people who are poor and vulnerable,” she says, particularly women of color in the deep South and the Midwest. “This is an inequality story.”
According to the Guttmacher Institute, 75% of people who get abortions are poor or low-income. Most are in their 20s (60%), and 61% are people of color.
Myers took the lead on an amicus brief submitted by a group of economists in the Dobbs case that overturned Roe, which details the ample evidence that people’s lives are materially affected when they can’t access abortion. The brief cites studies showing that Black women particularly benefited after Roe legalized abortion nationally, with a drop in maternal mortality of up to 40%. Myers notes that women of color didn’t have as much access to safe, illegal abortion before Roe. Legalization allowed them to get needed abortions and attain more education, enter more professional occupations, earn more, and reduce the chance of living in poverty.
Myers sees childbearing as the most significant factor explaining the gender gap in earnings. After having a child, women’s earnings in the US drop by about 40%, while men’s stay fairly flat. The average cost of childcare has risen to more than $14,000 a year, and Myers notes that, even with subsidies, that amount is out of reach for most low-income families. “We should believe them that they are facing real challenges,” she says.
Children face hardship when a parent can’t get a wanted abortion
One group that often gets forgotten in abortion debates is children. “A lot of the women in the Turnaway Study already had kids,” Miller says. Being turned away threw people into poverty, affecting the children they already had.
Of those who come to WRRAP for financial assistance with an abortion, 74% are already parents, and 83% have been abandoned by their partner. CDC data finds that 59.8% of people who get abortions already have one or more children, as did 60% of participants in the Turnaway Study. Turnaway found that the children of people who got abortions were more likely to do better over time.
The cost to get abortions will rise, too
For 31 years, WRRAP has worked with clinics in every state where abortion is legal to provide funding for patients who need abortions but can’t afford them. “Our abortion fund is unique because we work directly with clinics, doctors, and hospitals,” says WRRAP’s Ghazarian.
Ghazarian says that a surgical abortion can cost anywhere from $300 to $30,000, depending on how far along the pregnancy is and complications for the pregnant person’s health, which increase when abortion services are delayed. Costs also differ by state, not including travel costs when there’s no abortion clinic nearby.
“It’s not always easy for a person in a state where it’s banned to go to another state within a day to get an appointment,” Ghazarian says. By the time someone can make arrangements for travel, childcare, etc., and get an appointment, their pregnancy could go from first to second trimester, as it did for Jessy Rosales, increasing the cost of the procedure. Delays in getting care could increase the price even for people who live in states where abortion remains legal, as increased demand on the remaining providers makes it harder to get an appointment.
One bright spot is medication abortions. The FDA has made permanent a pandemic policy authorizing providers to prescribe the two-pill regimen for medication abortions via telehealth. WRRAP can source this service from licensed providers for $150. Since 80% of the people WRRAP serves are in their first trimester, this could help provide more abortions in states where pills by mail remain legal. People can also get a prescription from Aid Access, an international group that mails abortion pills around the globe.
The situation “that sits heavy with me,” Ghazarian says, “is those individuals whose life is at risk.” The longer someone with an
, fetal anomaly, miscarriage, or other health risk must wait for services, the higher the price tag and the greater the risk. The cost of a complex abortion can balloon from $10,000 to $30,000 if it’s delayed. “There are states where you have to really prove that your life is in jeopardy before you can get an abortion,” she says. “The cost goes up each day that you’re not able to get abortion care.”
Ghazarian notes that WRRAP spent $600,000 to pay abortion providers last year and expects that number to grow to $1.5 million in 2022. And while her group doesn’t cover travel expenses (others do), 24% of the people it helped in 2021 had to travel out of state for services; that number has jumped to 35% in 2022 and is likely to increase further.
“Abortion care is healthcare,” she says. “We’re in an abortion access crisis at this point.” She adds, “There are people who, unfortunately, will die.”
What you can do: resources and support
Rosales’ status as a first-generation American is “one of the biggest reasons I even decided to have an abortion,” she says. “[My parents] wanted the best for me. They weren’t afforded the luxury of being born here, of being well-educated.” She was the first person in her family to go to college. She adds, “I’m the first one in my family to build wealth.”
Rosales wants other young people to have more options than she had. “It is not a privilege — it is a right for them to plan their own future,” she says.
Rosales campaigned for a bill that requires California public universities to provide medication abortions at campus health centers, so the next generation of UC students will have better access to reproductive care than she did. She is also a communications fellow at We Testify, which elevates the stories of people who have had abortions.
If you need help accessing or paying for abortion services, WRRAP has a list of clinics it works with on its website, and you can find more abortion funds through the National Network of Abortion Funds (NNAF). The Guttmacher Institute has created an interactive map detailing abortion restrictions and protections in every state.
If you want to help, Ghazarian suggests fundraising in any way you can for groups that provide financial support for abortion services. She also encourages people to have “courageous conversations to combat stigma around abortion.”
“In order for us to move forward and have reproductive justice needs met,” she says, vote for candidates who will protect abortion rights.
“I dream of a world in which we all have the option to choose,” Rosales says. “That we are respected. That we are trusted. That we understand that abortions have existed as long as pregnancies have existed.” She feels that abortion bans are aimed at “keeping people like me further and further in the margins” and that “living our best lives is the most radical thing we can do because we are working against 1,001 barriers every day.”