In a sun-filled home office in Austin, a voicemail crackles to life and the pleas for help begin. “I’m eight-and-a-half weeks along. My appointment is tomorrow. I’m in desperate need. It’s safe to leave a detailed message.” Beep.
“Hi, my name is [Sabine]. I’m 21 weeks. I’m going in tomorrow. You can leave me a message.” Beep.
“My name is [Gabriela]. My appointment is next Friday. You can leave a message. I’m about 10 or 11 weeks. I cannot continue with this pregnancy, because I already have four babies. I’m in school trying to get my certificate. It’s impossible for me to have another baby right now. … If you can help me I’d really appreciate it.” Beep.
Kat Craft cocks her head as she listens to each message. “[Sabine], 21 weeks,” she whispers to herself as she taps details into a spreadsheet. “[Gabriela]: Four kids. Didn’t say we could leave a message. [Alisha]: 15 weeks, needs $100. [Rachel]: Nine weeks. This is her third time calling.” She works rapidly to capture each woman’s predicament. As Craft types, the disembodied voices of desperate strangers—fragile and breathy, resigned and confident and tearful—fill the intimate space of her home office, a small room crammed with a desk, a music keyboard, neatly labeled box files and a friendly dog on the rug. Today there are 19 messages. Within half an hour, Craft’s spreadsheet is filled with names, dates and short summaries of why they need help.
Craft works for the Lilith Fund, a volunteer-run organization that gives small grants to women seeking an abortion. It was founded in 2001 by a group of volunteers from the nonprofit, legal and medical fields. They raised $10,000 at the outset and began providing English- and Spanish-language counseling for women needing financial help to have an abortion. The group now has close to 30 volunteers fielding roughly 3,500 calls per year on its hotlines, which cater to women in South Texas. (Another abortion fund, the Texas Equal Access Fund, serves North Texas.) A pre-recorded message tells callers to leave their name, number, appointment date, how many weeks pregnant they are, and to state whether case managers can leave a message on their voicemail. “If they don’t say that it’s safe, then we don’t leave a message,” Craft says. It’s all governed by president Amelia Long and 14 volunteer board members. Kat Craft is the only paid staff member.
If a woman calls the Lilith Fund hotline, it’s because she wants an abortion but can’t afford one. For these women, the gap between their choice and what is economically realistic is wide. In Texas, the price of an abortion ranges from about $450 to $3,000, depending on how advanced the pregnancy is. For low-income women already struggling with rent, transportation, utilities and childcare (more than half of abortion-seeking women already have children), that sum is out of reach. Economic barriers to abortion are disproportionately high for African-American and Latina women. Long, the Lilith Fund president, noted that 85 percent of the group’s clients are women of color. Last year, the Lilith Fund granted money to 1,214 women—just a third of the women who called.
Having an abortion is expensive, even for women with health insurance. Though some private insurance plans cover the procedure, many abortion clinics require patients to pay up front. The Guttmacher Institute reports that two out of three women pay out of pocket for abortion, a significant challenge for the 69 percent of abortion-seeking women who are economically disadvantaged. The inequalities have grown since the 1977 Hyde amendment forbade Medicaid from paying for abortion in all but cases of rape, incest or life endangerment. As a result, the National Network of Abortion Funds estimates that nationwide more than 200,000 women a year need help paying for an abortion, and that a quarter of the pregnant women on Medicaid seeking an abortion are forced to continue with unwanted pregnancies because of financial barriers—births ultimately covered by taxpayers. To pay for an abortion, the Network notes, “low-income women sell their belongings, go hungry for weeks as they save up their grocery money, or risk evictions by using their rent money.” Low-income women are also more likely to be black or Latina, creating a triple-whammy of poverty, racial inequality and reduced abortion access, meaning that the most-vulnerable women have the least control over their reproductive health.
But nudging abortion further out of reach has become the favored strategy of anti-abortion legislators, especially in Texas. In 2004, the state forced clinics providing abortions after 16 weeks’ gestation to meet the same standards as ambulatory surgical centers. Theodore Joyce, a professor of economics at Baruch College of the City University of New York, studied the law’s effect on abortion providers and found that the following year, the number of women leaving Texas for later-term terminations increased fourfold.
In 2005, the Texas Legislature enacted a law requiring minors to gain parental consent before having an abortion. Tina Hester, executive director of Jane’s Due Process, an organization that provides legal help for pregnant minors, noted that the requirements create significant barriers for teens. They must now navigate the court system if they wish to terminate a pregnancy without telling a parent.
More recently, a 2012 law mandates that women undergo a 24-hour wait and a sonogram, which researchers at the University of Texas say increases costs for women. Meanwhile, in 2011, the Legislature slashed the publicly funded family-planning budget by two-thirds. Public health experts warned that the resulting loss in family-planning services would lead to more unintended pregnancies and more low-income women seeking abortions.To intensify poor women’s difficulties, in the current legislative session a host of anti-abortion bills under consideration would force many clinics to close and drive up prices for those that remain.
In Texas, abortion is increasingly an option only for the rich.