The 24 hours after Belle found out she was unexpectedly pregnant were a blur of phone calls, highways and panic. Her home state of Texas had recently outlawed the right to an abortion after around six weeks, leaving her just days to secure a procedure in a region where there’s a dearth of clinics.
Belle and her husband didn’t want to risk her health with a pregnancy — she is diabetic — nor the economic stability they had worked so hard to build. So they raced to meet the new legal deadline, dialing clinics in-and-out of state, cashing in their savings, and driving through the night to get a scarce appointment on Christmas Day.
“It was overwhelming. There was no time to really think about it. You have to make a decision, right then and there,” said Belle, who is in her early 30s, speaking from her Dallas apartment in May. “I was just in such a rush to figure everything out.”
Belle’s ability to access care came down to chance, timing and money. About 1 in 3 women aren’t even aware they’re pregnant before six weeks, meaning the clock runs out before they know it’s started.
In the same city, Jane, a student from Honduras in her late 20s, had more stacked against her. Texas law requires at least two appointments with the same physician, 24 hours apart, to get an abortion. Taking that time would have meant losing her job — plus she didn’t have the money. Jane would end up breaking state law by getting a friend to mail her abortion medication. She terminated her pregnancy just after six weeks.
Should the Supreme Court overturn Roe v. Wade in coming weeks, as expected, Belle's and Jane’s experiences are a harbinger of what’s to come across the US. Twenty-six American states are set to ban or severely restrict abortion if the landmark legislation is toppled, making access to the procedure even more difficult than it already is for about 33 million women of child-bearing age. That will create logistical nightmares, long waits and increased health risks for those seeking abortions — even in less restrictive states — not to mention financial costs that can last for decades.
Roe v. Wade isn’t just about the right to an abortion: It's about economic security. Decades of research link abortion access to expanded roles for women around the world. Those forced to carry an unwanted pregnancy to term are four times as likely to fall into poverty, and face higher job losses and lower earnings potential. The U.S. is poised to join only three other countries, Poland, El Salvador and Nicaragua, that have rolled back legal grounds for abortion in the last three decades, compared with nearly 60 nations that have liberalized laws.
“All of the barriers just get bigger and worse,” said Cristina Parker, communications director at Lilith Fund, a US charity that pays for abortions when patients can't afford them. “If cost is a barrier, it's going to cost more. If time is going to be a barrier, you're going to have to take more time off work. If taking care of your kids was a barrier, that's just going to be more difficult to access. And on, and on. It's pretty grim.”
Abortion restrictions come down hardest on people like Belle and Jane, women of color who already face discrimination and barriers in other parts of their lives. For Jane, it’s an additional burden as she has few financial resources, no medical benefits and isn’t an American citizen. Belle asked not to be identified by her last name because her family doesn’t know about her decision and she doesn't want to be targeted by anti-abortion activists. Jane is not using her real name for fear of deportation or a lawsuit.
Both Belle and her husband can point to relatives who left jobs or dropped out of school as a result of surprise pregnancies. The couple were among the first in their families to complete college and secure full-time employment in white-collar industries. At the beginning of 2021, they’d finally begun to save some money, and had about $1,000 tucked away toward a deposit on a new car.
Almost all of it would end up being spent on an abortion. A thousand dollars is now the average cost of the procedure in Texas, up from $600 since the state passed SB8, according to Lilith Fund. The law bans abortion after active embryonic heart cells are detected, which typically occurs at around six weeks. About a third of Americans don't even have $400 in savings to cover that kind of expense.
It was only by chance that Belle was able to find a provider in her home state, though she still had to make a five-hour trek 300 miles away. Roughly 1,400 Texans are forced to seek abortions out-of-state each month in order to access timely care, according to the University of Texas at Austin. They travel further from home, wait longer and pay more as clinics in haven states overflow.
For Belle, getting an abortion meant driving all night to enter a clinic in an unfamiliar town on Christmas morning. To meet Texas requirements, it meant signing a pamphlet illustrated with creepy cartoon fetuses and dire medical warnings, and booking a hotel to bridge the state’s mandatory 24-hour waiting period between ultrasound and abortion. The cost of that, plus the procedure and gas wiped out her and her husband’s savings. But compared to what many others go through, it could have been worse.
“It was hard,” she said. “But I can’t imagine the people who don’t have resources or time off work.”
When Jane found out she was pregnant, she knew she couldn’t afford to be a single mother. The problem was, she couldn’t afford to get an abortion, either.
Despite living in the U.S. for more than seven years, where she’s finishing an MBA on a student visa, she isn’t permitted to work. When morning sickness struck in April she was working as a secretary for a renovation company and a night-shift janitor, both under the table for less than $15 an hour, neither with medical benefits or paid time off.
When she found out she was pregnant during a visit to the emergency room, she was five weeks along — still within the legal window to get an abortion in Texas, but she couldn’t take time off and couldn’t risk losing the work. The decision was clear: She would take care of it herself.
She called a friend in another part of Texas who mailed her the pills to induce an abortion, which is illegal in the state. They arrived crushed and unusable and the second set didn’t arrive until two weeks later, by which point Jane was more than seven weeks pregnant. One week too late for a legal abortion, she took the pills anyway.
One month since her abortion, Jane is dealing with heavy bleeding and takes Advil regularly for pain. But she’s terrified of seeking medical attention.
Texas’ law deputizes people to bring civil lawsuits against anyone they think helped a woman end a pregnancy after six weeks. While SB8 exempts the person who received the abortion from penalties, it has nonetheless created confusion among doctors and fear among patients.
In April — the same month as Jane’s abortion — a Texas woman named Lizelle Herrera was charged with murder for allegedly inducing an abortion after six weeks. While those charges were later dropped because the county district attorney said she “cannot and should not” be prosecuted under the law, Jane is still terrified.
“I’m scared of going to that hospital — I cannot go,” Jane said. “If I go and they say ‘OK, she’s not pregnant anymore,’ you know? It can happen, the same thing that happened to this girl Lizelle.”
Still, Jane doesn’t regret her decision. Her life in the U.S. rests on three already-tenuous legs: staying in school, keeping her jobs and regularly paying rent for the apartment she shares with her cousin, who's undocumented. The pregnancy would have toppled each of those.
Five years after having an abortion, more than 95% of women say it was the right decision, according to research from the University of California, San Francisco’s Advancing New Standards in Reproductive Health.
Belle is already one of them.
On a sweltering May afternoon, she stands at the edge of a rally outside Dallas City Hall, days after the draft opinion overturning Roe v. Wade was leaked, sparking nationwide protests.
It’s the first protest she’s ever attended. The event was a painful reminder of her experience — but she said she needed to be there.
“It shouldn’t be that way,” she said through tears. “I should be able to just get care.”
