When it comes to abortion, women literally can't afford to wait

Some funds are available, but not enough -- even in states where Medicaid is required to help.

Published October 4, 2006 6:47PM (EDT)

Anyone still wondering why it's not enough just to "save Roe"? Or why -- though most abortions actually occur in the first trimester -- some women seem to "wait" until the often more complicated, and more expensive, second? If so, your questions will be answered once and for all in sociology prof Carole Joffe's "Abortion Hotlines Feel the Crunch," appearing on today's AlterNet.

Among the 100 daily calls to the National Abortion Federation hot line -- which has access to some limited funding of its own, as well as that of scattered underfunded nonprofits -- some of the most heartbreaking come from women who literally do not have the money for a procedure they so desperately need. "Could you ask your friends for $40? If they say 'no,' maybe ask for $20 or even $10?" the case manager asks of a mother of three who's already crashing at a friend's because she's been evicted for not paying rent. Of another, she asks, "Well, do you have anything you might pawn? Some jewelry? A TV set?" Yet another: "Is it possible you could postpone your car payment until after the abortion?" To the degree that NAF can help these women in the first place, one case requires an average of 15 phone calls.

One mother of five, believing she was about 15 weeks along, was told the cost would be $450. With the help of NAF -- and a yard sale -- she scrounged up the cash. But there's a coda in her chart: "Pt sono'ed [had an ultrasound] at 18 weeks [gestation age], and clinic raised cost by $440. Pt decided to continue pregnancy since she didn't have sufficient funds to have abortion."

Just for the sake of argument, let's say certain thoughts are sneaking into your head. Thoughts like "what are these destitute mothers-of-many doing getting pregnant again in the first place?" First of all, you don't have to have kids in order to not have $450. But more to the point, the Guttmacher Institute reports that not only have 33 states cut funds for birth control, but also half of all poor women who need birth control services are not able to afford them. (Also, let's say they did get pregnant for thoroughly dumb-ass reasons. Does that mean that having the child, which, P.S., costs more than $450, is the right way to "teach them a lesson"?)

Also, many callers seeking help have been raped. Morally, this does not make them more entitled to a funded abortion. But legally, it kind of does. Check this: "If state governments were obeying the law, the hotline would have to raise far less money for rape victims," writes Joffe. "The Hyde Amendment, a measure passed in Congress shortly after Roe v. Wade, forbids the use of Medicaid funds to pay for abortions but makes exceptions for rape, incest and threats to the life of the mother. Many of those rape survivors who ask the hotline for help are on Medicaid. The problem, however, is that numerous state Medicaid programs simply refuse to enforce this provision. Fighting with anti-abortion state bureaucrats often drags on indefinitely and pushes women later into pregnancy -- making the procedure even more expensive and a provider more difficult to find. [Joffe requires three paragraphs just to summarize one woman's encounter with this bureaucracy, which basically required a harrowing journey to and from Mordor.] Therefore last year nearly 28 percent of the $136,000 that the hotline helped raise went to those who are theoretically eligible for state funding."

So, yeah, this should (in part) be Medicaid's job. But if you're so inclined, you can make a donation to the NAF's hot line fund here.

By Lynn Harris

Award-winning journalist Lynn Harris is author of the comic novel "Death by Chick Lit" and co-creator of BreakupGirl.net. She also writes for the New York Times, Glamour, and many others.

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