What One Week on an Abortion Fund Hotline Taught Me About the Economics of Stigma

To say abortion is stigmatized in this country is to state the obvious. But we have a special brand of taboo that we foist atop even that stigma, which is the taboo of having someone else pay for a service you need – especially if it’s an abortion. Yet while abortion may be legal, but if you cannot afford it, it’s inaccessible.

Here in the US, where Americans spend an average of $110 million on fast food each year, some will spend $10,000 for breast implants, and still others will drop $90 on yoga pants, somehow covering the costs of an abortion is one of the most lavish and morally egregious things you can do. Recently, I completed my first shift as a hotline advocate for the CAIR Project, where we proudly do just that.

The CAIR Project is a volunteer-run non-profit abortion fund, which provides financial help to women seeking abortions. It is part of the National Network of Abortion Funds. Women call us from Alaska, Idaho, Oregon, and Washington and we help them with small grants of $50 to $200 (vouchers are faxed directly to the clinic, so no money changes hands).

If you want to witness the collision of poverty in America, sexual health stigma, and the fissures in our healthcare system, volunteer for an abortion fund. Granting money is a privilege, and doing it for something so critical as abortion access – so heavily under assault in this country – is an honor. And if you want to counteract anti-women sentiment and policies in this country, donate to one. Abortion may be legal, but if you cannot afford it, it is not accessible. 

For a week, I fielded about six calls a day from women across the Pacific Northwest. These were women in tight spots: in high school, homeless, unemployed, undocumented, disabled, down on their luck, about to head into the army, just found out their wanted pregnancy had a fatal defect, rape survivors, or just having a hard time pulling together several hundreds of dollars in a few days. It really ran the gamut.

To say abortion is stigmatized in this country is to state the obvious. But we have a special brand of taboo that we foist atop even that stigma, which is the taboo of having someone else pay for a service you need – especially if it’s an abortion. Three years after Roe v. Wade, the Hyde Amendment was passed in 1976, prohibiting federal Medicaid coverage of abortion, in most circumstances. It was in this spirit that the No Taxpayer Funding for Abortion Act was passed last year. And if you think the US would only limit financial support for women seeking abortions in the US, you’re wrong. The Helms Amendment, passed in 1973, makes sure that not a dime of US foreign aid goes toward abortion services in other countries – even if it’s legal and even if unsafe abortion is a leading cause of maternal death. In fact, the failure to provide funding and program support for those conditions for which even Helms allows exceptions means that women who have been raped — such as victims of rape in war — and those whose lives are threatened by pregnancies gone terribly wrong are denied support by U.S.-funded programs.

The idea that an abortion shouldn’t be paid for by the government comes from the broader stigma of abortion – that it’s a luxurious service we seek after we (women) do something bad. It’s this notion that receiving financial aid for the consequences of our promiscuity or carelessness only reinforces for lack of virtue. Or, more simply put, it’s a financial slut- shaming.

Yet spend a week on an abortion fund hot-line and you will awaken to the reality of abortion and economics, and believe me, it’s not what you might think:

Myth #1: Women who need help paying for their abortions for are “gold diggers” or just looking for a hand-out

Abortion funds are critical safety nets, but we are not made of money. The funding we offer women is nominal and more often we offer financial advice. Far from expecting or receiving full funding, women almost always come up with some money themselves, even if it’s just $6, and go to great lengths to do so. Women regularly borrow money from friends or family (not an easy thing to do); one woman had her dog up for sale, while others try to sell DVDs or jewelry. Some put off rent, delay other bills, or take out credit cards. Some women reschedule their abortion procedures for the following week just to give themselves more time to raise funds.

Myth #2: Women are happy to have their abortions subsidized and they expect it (or will lie to get financial help)

Every woman I spoke to was extremely stressed out. No one was happy to be calling a financial services helpline (though they were grateful it existed). Not being able to afford something that you need and want is tough. Not being able to afford something you really need is excruciating. Over the phone line, I heard a client reflect back to me the stigma that society had placed on her. After explaining that we could not provide full funding for her procedure (only because we didn’t have enough money), she interrupted apologetically: “Of course! And I wouldn’t expect you to have to pay for my abortion.” Because society tells us that if we as sexually active women make our bed, we’ve got to lie in it. One grant I doled out was $54. The woman at the other end of the line could not have been more grateful. There is no entitlement – although I wish we lived in a society were women could feel entitled to have their abortions paid for – but rather women are truly appreciative for any support. (Did you hear that, Kanye West?)

Myth #3: If a woman can’t afford an abortion, it’s her own fault and she should bear the consequences

Though the consequences of an unintended pregnancy are most often borne by a woman along, she did not get to pregnancy alone. In short, it is not the woman who fails, but rather it is an entire society that fails her. What causes unintended pregnancies? Sometimes a women can’t afford birth control, which in this country is hidden at the end of an expensive obstacle course of doctor’s appointments and prescriptions. In other cases, inadequate sex education has left individuals ill-equipped to navigate sexual risks. And sometimes a woman was raped. Sometimes birth control just doesn’t work. And finally, it’s often state policies that put women in precarious positions. For example, there are only two abortion clinics in Idaho, which means women may have a day’s drive to get to an appointment. In addition, state law mandates an informed consent class followed by a 24-hour waiting period. That’s gas or bus fare, a hotel room, and possibly childcare. These intrusive policies create additional financial hurdles for women and mean any given abortion will be later and possibly more expensive than without such obstacles.

Myth #4: Abortion clinics are only in it for the money

This is a favorite punch line among anti-choice advocates, but unfortunately it’s just not true. How much does an abortion cost? Well, it ranges from about $500 to more than $5,000, depending on the stage of the pregnancy and other factors. But almost all of the abortion clinics we work with will do whatever they can to help a client out of a tough financial situation. Some clinics offer payment programs. Others will simply eat the cost, especially if a woman needs an abortion for a health reasons. More often, clinics offer immediate discounts for their services. That’s right, an abortion discount. Doesn’t sound like a very successful business model, right? That’ because it’s not a business, but is about women’s rights, lives, and futures. Bottom line.