Abortion and Low-Income Women

Abortion, a controversial medical procedure, was once declared a criminal offense in the United States (During the mid 1800’s-early 1900’s). Women during that time were conflicted between their own individual decisions and societal norms. Therefore, many of them sought ways to break this law to cover up an initial transgression (fornication) by having illegal and unsafe abortions by untrained practitioners. The rise of abortion related morbidity and mortality made this issue a moral imperative for many people in the medical, legal, and religious field. The collective effort of these different stakeholders in society pressured policymakers to take up the cause. This effort led to the creation of one of the most controversial health policy laws in the history of the United States (Roe vs. Wade).

After the decrimalization of abortion, federal funding was used to cover poor women for abortion just as they were covered for any other medical care service. Three years later, in 1976, Representative Henry Hyde (R-IL) proposed an amendment to ban the federal government’s funding (Medicaid) for abortion. This provision (effective in 1977), now known as the Hyde Amendment, specifies circumstances where abortion should be covered by Medicaid.

The current restrictive version of the Hyde Amendment does not provide coverage for abortions in cases of fetal abnormalities, or health exceptions apart from life-threatening conditions.

Over the past few years the Bush administration has become more conservative, supporting their limitations and bans on abortion procedures with moral and spiritual arguments. In his speech regarding the ban on partial-birth abortions in 2003, President George W. Bush stated, “For years, a terrible form of violence has been directed against children who are inches from birth, while the law looked the other way. Today, at last, the American people and our government have confronted the violence and come to the defense of the innocent child.” (The White House Press, 2003) President Bush further supports the decision of his administration by asserting, “This right to life cannot be granted or denied by government, because it does not come from government, it comes from the Creator of life.”

In December 2005, President George W. Bush signed a massive federal spending bill in which a “pro-life” provision was contained. The controversial Weldon Amendment (also known as the Women’s Health Care Denial Law), signed by President Bush, would allow virtually any healthcare institution (or entity) to deny to pay for, cover, provide, or even refer patients for abortions even when such actions are otherwise legally mandated (such as cases of rape or incest). While democrat’s control of the senate heightens the threat to restrictive Medicaid policies, years of debate and advocacy for the right to choose is already an empty promise for many women and girls in America. Instead of indicating how banning abortion may affect society, the government’s sole concern is that of the unborn child, a being who arguably has no rights because its life is dependent on the mother. Furthermore, it seems that the administration is relying too much on spiritual beliefs and religion rather than grounded concern in regards to their servitude to American society. This causes us to dismiss our ideals of the separation of the church and state.

Moreover, 2008 Republican presidential candidates have already signaled at their intention to work towards overturning Roe vs. Wade. Let us imagine that the government overturned Roe vs. Wade…Abortion would be outlawed in many states, and as a result of that the greatest financial burden will be on poor women who would not afford medical tourism or traveling to other states where abortion remains legal. In addition, overturning Roe would mean that we will have more unwanted children who would be brought into this life by young mothers, thus increasing the amount of federal funds (tax money) to help pay for public assistance, healthcare, and foster care.

Poor women, teenagers, women of color, and rural women will be the most who would suffer from this law. Annually, there are tens of thousands of low-income women and teenagers who against their will carry their pregnancy to term because they cannot afford to pay for an abortion. Many thousands more would be denied this constitutional right if these restrictions are not removed. The effort to overturn Roe (and the Hyde-Weldon Amendments) marginalizes and stigmatizes abortion care rather than recognizing that “sometimes” it is an essential component of women’s health. These laws bleakly target the voiceless low-income women by denying them reproductive care. ***Low-income women sometimes must use money appropriated for food, rent, or utilities to raise the necessary funds. ***In many cases, these poor women face an ever-spiraling cost that they are not able to afford. As a result, these poor women often are not able to complete their education, escape domestic violence, or climb out of poverty.

As a matter of social justice, American women (regardless of their economic or racial background) must have equality when it comes to accessing reproductive healthcare. The legal right to choose had been effective for more than thirty years, but barriers such as the Hyde Amendment must be removed in order for these low-income women practice their rights. Restricting Medicaid funding for abortion services caused an economic disparity since economically disadvantaged women will be less likely to afford the costs of terminating unwanted pregnancies. Barriers to accessing abortion services, such as the Hyde Amendment, fall disproportionately on low-income women who have limited resources with which to overcome these obstacles.

In a study conducted by the Guttmacher Institute, 20-35% of Medicaid eligible women who choose abortion end up carrying their pregnancies to term due to the lack of public funds. This lack of public funding also results in low-income women delaying their abortion so that they can raise funds. Postponing abortions raises the cost (of the procedure) and risks. The legal right to have an abortion does not much when women (who do not have insurance that covers abortion) are not guaranteed access or at least affordability. It is not clear how many low-income women are blocked from obtaining an abortion solely due to the Medicaid restrictions. However, what is clear is that the Medicaid restrictions causes abortion care to be more costly in terms of health and safety as the delay of women having the procedure is more dangerous.

Abortion will always be an emotionally charged and politically divisive issue. This divisiveness in perspectives and beliefs is the core problem that warrants attention in itself. This debate will never be resolved (given the demographics of the United States). One obvious path for the two sides to work together toward is supporting policies and programs that enhance women’s ability to avoid or postpone having a child by helping her do a better job of preventing unintended pregnancies. Roe vs. Wade (for now) remains the law of the land, but its meaning for women in the future is still vague. For the future we have nothing to fear, but our fear of our own diversity.