This post is part of Still Wading: Forty years of resistance, resilience and reclamation in communities of color, a blog series by Strong Families commemorating the 40th anniversary of Roe v Wade.

An important fact that is often missing in the debate around abortion is that, for many women, the decision to have an abortion is informed by an already existing family unit. Six out of every ten American women having an abortion already have a child, and more than three out of ten have two or more children. At the same time, more than 40 percent of American women who have an abortion are living below the federal poverty level ($18,530 for a family of three). For poor women with children, abortion can be a critical financial issue for their families.

Yet, our policies on abortion in the United States don’t reflect this reality. Federal funding—and public funding in general—for abortion is nearly nonexistent. This became headline news again in 2011 when Congress imposed a ban prohibiting the District of Columbia from using its own locally-raised revenues to provide abortion services to its residents, thereby obstructing a local government’s autonomy.

The debate around public funding for abortion isn’t a new one. In 1973, before funding for abortion in the U.S. was cut off, the Helms Amendment to the Foreign Assistance Act passed, prohibiting the use of U.S. funds for the performance of abortion as a method of family planning, or to motivate or coerce any person to practice abortions. In 1976, we were given the Hyde Amendment, which forbids federal funding for abortion except in cases of rape, incest, or danger to the life of the woman.

Millions of women in the United States and around the world benefit from U.S.-funded programs that improve maternal health. Yet the Helms and Hyde Amendments undermine that important work, harming women, particularly low-income women and women of color. The Helms Amendment has effectively been applied as a total ban on speech and services for safe abortion and on any activity that might enable a health worker to know what to do or to have the means to help when a woman has an unwanted pregnancy. In fact, the United States is the largest single donor for family planning—which of course is a way of preventing abortion—and a huge supporter of post-abortion care programs designed to treat complications from unsafe abortion.

In our work at Ipas, we see the impact of unsafe abortion—something that is entirely preventable—all the time. Take, for instance, the story of Meena, a 23-year-old woman with two children in Nepal, where abortion is legally permitted. Meena went to a local health clinic in the remote Kailali District with an unwanted pregnancy. Because the facility was U.S.-funded, the nurse there did not help Meena with a safe abortion and instead referred her to a hospital 60 miles away—too far for Meena to travel on foot or ox cart. So Meena tried to self-induce with sticks. She went back to the clinic two weeks later with a severe infection and was given (more traumatic and expensive) emergency treatment, considered post-abortion care and thus available in a U.S.-funded program.

The Hyde Amendment functions in the U.S. in much the same way as the Helms Amendment does abroad, restricting access to abortion care for U.S. women. I haven’t read anything quite as compelling as the testimony from Toni Bond Leonard, former president of the board of directors of the National Network of Abortion Funds and former CEO of Black Women for Reproductive Justice, who shared her story at a 2010 Congressional briefing. Toni was pregnant at age 12. Her mother, who was unable to work and relied on welfare, realized that if Toni carried the pregnancy to term, she’d essentially be raising another child, spreading the family resources even thinner. “She wanted better for me,” said Toni. So the light bill and the rent went unpaid and they didn’t have enough food—all so Toni could get an abortion. “Hyde set off a life-changing course of events for me and my family, which could have been prevented with public funding,” Toni said. “Hyde punishes women for being poor.”

The most striking part of Meena and Toni’s stories is that they aren’t unusual. Every day, everywhere, women make these choices for their families—both the ones they have, and the ones they hope to have. But U.S. abortion funding bans don’t reflect the complexity of women’s reproductive lives and the challenges of low-income women with children. After 40 years, isn’t it time that our policies reflect real women and real families?