Abortion restrictions are not only a threat to reproductive freedom—they deepen America’s affordability crisis, forcing people to choose between accessing care and maintaining their financial security.
Few decisions carry more weight than whether or when to have a child. Women who decide to end a pregnancy are making an intensely personal, at times deeply emotional, decision. They deserve quality care, compassion and respect.
… Abortion restrictions are expanding and options for care are disappearing … These burdens never fall equally.
Instead, under the Trump administration, abortion restrictions are expanding and options for care are disappearing.
Four years after the Supreme Court’s Dobbs ruling, abortion care comes with a maze of logistical and financial hurdles.
As Black women leaders who have balanced careers, motherhood and the realities of navigating racist and discriminatory systems, we know these burdens never fall equally. In the United States today, abortion is increasingly reserved for those who can find and pay for it.
We urge new thinking: Instead of a return to the Roe v. Wade era ripe with restrictions and hurdles, let’s govern expansively. We envision a supportive government that makes abortion accessible to anyone who needs it.
The system we have under Dobbs doesn’t come close.
Since the Supreme Court’s overturning of Roe v. Wade, 41 states now ban abortion at some point in pregnancy. Of the nine states that fully protect abortion access, only five and D.C. have providers or clinics that care for abortion patients throughout pregnancy.
We can quantify the costs of those restrictions on a national scale. A new study from the Institute for Women’s Policy Research (IWPR) concluded:
- Widespread abortion restrictions across numerous states and the rollback of federal funding and protections costs our country $140 billion annually.
- The 16 states with the most restrictive abortion policies cost the national economy nearly $68 billion annually in lost earnings.
We also see the toll these restrictions take on pregnant people. The National Abortion Federation (NAF) represents hundreds of abortion providers and clinics across the country. Abortion restrictions are pushing people later into pregnancy when costs go up and the number of providers goes down.
Medication abortion, which is most commonly used to end a pregnancy in the first trimester, can cost as little as $5 with a clinic’s sliding scale. Compare that to procedural abortions in the second and third trimesters, which can cost as much as $20,000.
But the financial costs and logistical hurdles go well beyond the procedure itself. Patients are increasingly forced to spend weeks securing money, driving hundreds of miles and arranging childcare while they are away. The current reality of rising gas prices and high food and childcare costs has all become common parts of an abortion experience.
The impact on people’s livelihoods is stark: For the average woman, abortion restrictions result in an 8.5 percent earnings decline; for Black women, it’s 9.9 percent.
These costs are not inevitable. They are the result of policy choices. Different policy choices can produce the type of future that all people deserve. That starts with the principle NAF recently affirmed: Abortion access should be available throughout pregnancy, without viability limits or arbitrary gestation-based bans.
What does that look like in practice?
- Policies that support a person’s rights and freedoms to make deeply personal decisions about pregnancy without government interference.
- Access to care no longer being determined by geography or a person’s income, insurance or immigration status.
- Clinics that can provide care without political interference.
- Abortion should be accessible as early as possible and as late as necessary.
- Patients should not be forced to travel across state lines or drain their savings just to access medical care.
That blueprint would save lives. The United States has one of the highest maternal mortality rates in the developed world. Black maternal mortality is three times higher compared to white women, and women at the highest risk live in states that implement abortion bans.
Better pregnancy care and widespread abortion access would improve women’s health dramatically.
That approach would also make life more affordable for families. The IWPR report finds removing barriers to reproductive healthcare could mean nearly 325,000 more women participating in the workforce each year. The biggest gains would be in states that have the most severe restrictions.
More women working and receiving higher pay would be a game-changer for families. That is especially true as millions of families are facing food insecurity, the loss of insurance coverage and childcare that can cost as much as college tuition.
The U.S. affordability crisis will not disappear overnight. It will take concerted efforts from policymakers at all levels to recognize how difficult it has become for families to afford day-to-day life. We believe abortion access is an integral part of that affordability conversation. That demands a healthcare system guided by medicine rather than politics, compassion rather than judgment and access rather than obstacles.
In the country we envision, nobody would be forced to choose between reproductive freedom and financial security.
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A note from Ms. editors: We want to hear from you for The Majority, a new campaign collecting stories about how reproductive freedom has enabled readers to build the lives they want and need. Poll after poll shows a majority of Americans support reproductive healthcare access. Yet public debate overlooks the lives shaped by abortion access, contraception, IVF, miscarriage care, maternal healthcare or comprehensive sex education—countless women who chose to pursue an education, have children, not have children, protect their health and chart their own future. Add your voice and complete the sentence: “Access to reproductive choices gave me the freedom to….” Together, these stories will help show not only why reproductive freedom remains a majority value, but also what it makes possible.
Look to these trusted groups if you or a loved one needs to know more about reliable abortion care:
- A one-stop-shop for abortion seekers: I Need An A
- Other websites to explore all your options for abortion care: Plan C Pills, Abortion Finder
- Safe websites to buy abortion medication: Aid Access, Massachusetts Medication Abortion Access Project, Hey Jane
- If you need help affording abortion care, tell your telemedicine provider or contact an abortion fund near you.
- To protect your digital privacy when planning your abortion, click here.
- For free legal help as a patient or doctor, call If/When/How’s Repro Helpline—844-868-2812—or contact Pregnancy Justice.
- For medical advice, contact the Miscarriage & Abortion Hotline: 833-246-2632.
- If you need to know the abortion law in your state, look to the Center for Reproductive Rights. or Guttmacher Institute.
