Ian Millhiser and Tara Culp-Ressler have an important article at ThinkProgress with a provocative but mostly accurate title: The Greatest Trick The Supreme Court Ever Pulled Was Convincing The World Roe v. Wade Still Exists. They correctly note that, for many women, especially poor women, reproductive rights have been eliminated for all practical purposes.
This is the landscape facing thousands of women in a nation where the right to choose an abortion is still ostensibly protected by the Constitution itself. “[T]he essential holding of Roe v. Wade should be retained and once again reaffirmed,” according to the Supreme Court’s seminal decision in Planned Parenthood v. Casey. But for women like Marni Evans in deeply conservative states, the world does not look very different than it would look if Roe had been overruled.
In that alternate universe, where Justice Anthony Kennedy joined with his fellow conservatives to end Roe v. Wade, Marni would still be able to seek an abortion in liberal Seattle, while poorer women would still struggle to obtain the cash and the time off necessary to receive safe medical care — or, worse, they would try to end their pregnancies by taking illegal drugs intended to induce stomach ulcers. The real world and this alternative world are far more similar than Casey‘s promise to reaffirm Roe‘s “essential holding” would suggest. And neither bears much resemblance to a nation where abortion rights are fully protected.
Before Roe v. Wade, back in the days of botched back-alley abortions that killed alarming numbers of women, a woman’s reproductive autonomy was inextricably linked to her privilege. By the early 1970s, abortion was legal in a handful of states — so if a woman was lucky enough to be born into wealth, she had the resources to travel to one of those areas of the country. If not, she likely resorted to seeking out an illegal abortion. And since women of color were far more likely to be economically disadvantaged at that time, they were also far more likely to lack access to safe abortion. Consider two telling statistics from 1969. That year, 75 percent of the women who died from abortions were women of color. On the other hand, white patients received 90 percent of the legal abortions performed during the same time period.
Four decades later, many of the same dynamics are still at play. Women who can scrape together the money to travel to areas with more permissive abortion laws, women like Marni, are still crossing state lines. Poorer women — particularly low-income women of color, who have less access to affordable planning services and higher rates of unintended pregnancy — aren’t always so lucky.
The Hyde Amendment, the federal policy that prohibits taxpayer dollars from funding abortion services, was enacted just three years after Roe. Abortion access may be a theoretical “right” for every U.S. women — but thanks to Hyde, that right can often only be realized for the women who have money in their bank account. Since poor women’s public insurance coverage won’t cover abortion care, they’re forced to pay for the procedure out of pocket, an expense that can range anywhere between $300 and $3,000 dollars. And, of course, the actual cost of an abortion is much more than that. It also includes the lost wages for the time off work, the potential child care arrangements, the transportation to get to a clinic, and — depending how far a woman has to travel — lodging for the night. Again, this economic reality disproportionately impacts women of color, who are more likely to rely on Medicaid for their health care.
The anti-choice community isn’t succeeding at its ultimate goal of ending all abortion, but its agenda does threaten to eliminate that option for economically disadvantaged women.
That’s because the increasing number of state-level restrictions on abortion only deepen these economic divides. All of the extra hurdles to abortion care — the mandatory ultrasound procedures, the 24-hour waiting periods, the unnecessary regulations on the abortion pill, the restrictions intended to drive clinics out of business — ultimately drive up the cost of this type of reproductive care. It often takes low-income women so long to save up the money for all of the costs associated with their abortion that they run out of time: They’re turned away because their pregnancy is too far along. And it gets worse from there. The women who are denied an abortion are more likely to fall deeper into poverty.
My friend Robin Marty has written a book on this very subject, Crow After Roe: How “Separate But Equal” Has Become the New Standard In Womens Health And How We Can Change That. This process of chipping away at Roe and denying equal access to abortion for poor women, especially minorities, goes back at least a couple decades but it has really sped up since 2010, when so many state legislatures were taken over by Republicans.