January 22nd marks the 34th anniversary of Roe v. Wade, the landmark U.S. Supreme Court decision that provided constitutional protection for abortion. The Roe decision recognized American women’s right to safe, legal abortion services; however, the right to abortion is still an empty promise to thousands of poor women. Since 1977, the federal Hyde Amendment has prohibited federal funding for abortion, except in cases of rape, incest or life endangerment. Thirty-three states have since followed suit by restricting public funding for abortion in all but the most extreme circumstances.

These funding restrictions affect seven million women of reproductive age who obtain their health care through the Medicaid system. As a result of the Hyde Amendment, many women are first faced with the need to raise the funds to pay for their abortion, a task that can force them to choose between paying for their medical care and paying their rent, for their groceries or for their children’s health care needs. Research indicates that while many women may be able to ultimately scrape together the funds, the time this effort takes forces many poor women to delay the procedure, increasing their health risks. State-level restrictions such as waiting periods and counseling laws require women to make several visits to the doctor, which may involve taking additional time off work and finding child care. Further, because of a shrinking provider pool, one-quarter of women having abortions have to travel 50 miles or more for the procedure.

Efforts by state and federal legislators to limit access to abortion are misguided in that they overlook the underlying cause of abortion—unintended pregnancy, which disproportionately affects poor women. In fact, poor women are four times as likely to have an unintended pregnancy, five times as likely to have an unplanned birth and more than three times as likely to have an abortion as their higher-income counterparts. Most unintended pregnancies could be prevented with consistent, correct use of contraceptives, yet poor women are being let down at this early stage as well. Therefore, we also need to better help women avoid unintended pregnancies in the first place, even as we do all we can to guarantee women’s access to safe, legal and early abortion services.

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Facts on induced abortion in the United States

State facts about abortions

A comprehensive resource on abortion in the United States

Policy efforts to reduce unintended pregnancy

Who has abortions in the United States and why