Although the 1973 Roe v. Wade ruling enshrined the right to an abortion in the US, its cost has shut out many people from accessing the procedure. With the leak of a draft opinion in May signaling the Supreme Court majority’s intention to overturn the landmark ruling, abortions are likely to become far costlier as more people are forced to travel farther to obtain a procedure.
In the past decade, many states have passed increasingly oppressive abortion restrictions in an attempt to challenge the ruling. Often, lawmakers who vote for them appear to misunderstand the human reproductive system and cannot explain what the bill they vote on does exactly.
BuzzFeed News spoke to five women (identified only by their first name for privacy reasons) from different states who obtained an abortion in recent years and examined how their access to the procedure might be restricted if Roe is struck down.
Their stories and reasons for terminating their pregnancies vary widely, and so do the costs, most of which are approximate. Some women paid hundreds — even thousands — of dollars out of their own pocket for the procedure, on top of the cost of childcare and travel expenses. Some had financial assistance from the clinic or a fund, and others wrestled with their insurance company for months. Some traveled hours to another state or city, others drove downtown.
These women’s circumstances differed, but the abortion restrictions in their state — particularly gestational age bans — weighed heavy on almost all of them. Several women who had welcomed their pregnancy made their decision to terminate under stressful circumstances worsened by the limits their state placed on when a person can get an abortion.
“This is such a huge financial burden, even for somebody who, theoretically, it shouldn’t be that hard on,” one person told BuzzFeed News. “I can't even imagine what other women are going through. And that makes me angry.”
These women’s experiences mirror the uneven, inconsistent abortion measures across the country, which are certain to be exacerbated if the court overturns Roe. Here are their stories.
Bianca had just started the night shift of a full-time job in November 2021, allowing her and her partner to take turns looking after their toddler. She was slowly clawing her way out of the debt she had accumulated in the past year while unemployed. Then she found out that she was pregnant.
“I was taking the mini pill because I was breastfeeding and apparently it just doesn’t work as well,” she said. “It was not a good time. I just started my new job a week before and we were still struggling financially.”
Bianca scheduled an abortion with Allegheny Reproductive Health Services. She took two days off work and asked her brother to babysit her son while she took the first set of medication. Despite the mountain of debt she was already in, Bianca paid for the abortion with a credit card.
Bianca said she had always believed that people should be able to determine their own family planning. “I think given any other circumstances, even if we were financially OK, I still think that I probably would have done it. Just because it was so early after having my son,” she said. “I want to be able to control what I do. And reproduction is part of that. I want to be able to choose when I have my family and when’s the best time for me.”
She was heartened by Democratic Gov. Tom Wolf’s assurances that he will fight for abortion rights, which, she said, “always makes you feel more comfortable, makes you feel a little bit better about your government.”
But abortion access in Pennsylvania is on the line. Wolf has fought off abortion restrictions in the past, but his term is ending, and the Republican gubernatorial nominee, Doug Mastriano, supports a ban on abortions with no exceptions for rape, incest, or the health of the person carrying. He has called for the General Assembly to vote on his six-week abortion ban if Roe is overturned. The Pennsylvania state legislature is also considering a constitutional amendment saying there is no guarantee to a right to abortion, which could criminalize abortions down the line.
Alexa found out she was pregnant in February 2022, one day after she quit her job. She wasn’t feeling well, but thought it highly unlikely that she was pregnant: She has polycystic ovary syndrome, which lowered her chances of getting pregnant, and she was on birth control.
Her sister asked if she thought she could carry a pregnancy to term and become a parent. “Her actually saying that question out loud made me think about all the reasons why I couldn't,” Alexa said, considering her mental health issues. As someone who struggled with an eating disorder and borderline personality disorder, Alexa said she didn’t feel “safe in my own body, let alone carrying someone else.” But she was also worried that she could not afford an abortion.
“My family’s very conservative. I am not. I grew up Catholic and I’m Mexican,” she said. “We’ve talked about abortion before and it’s always been a very heated topic. And I couldn’t ask [my parents] for that much money for no reason.”
Alexa first went to Planned Parenthood in San Antonio but there were no appointments available until the next week. She knew she was up against a clock; Texas’s SB 8 law empowers citizens to sue anyone who helps a person get an abortion after fetal cardiac activity is detected, usually around six weeks, before many people know they’re pregnant.
“My heart sank because it was no longer gonna be anything that was within my control [if I waited],” she recalled. “And this was like — I found out two days ago that I was pregnant.” She called the Alamo Women’s Reproductive Clinic and made an appointment for the next day.
She reached out to the Lilith Fund, an abortion fund in Texas, which offered to cover the cost of the procedure for her: $100 for the first visit (including the ultrasound, which is required by Texas law to be performed 24 hours before an abortion) and $550 for the medication. The clinic ended up informing Alexa that it did not need her voucher from the Lilith Fund after all because an anonymous donor was covering abortion procedures at the clinic.
With some of the most extreme anti-abortion measures in the country, Texas is one of 13 states with a “trigger law” that would immediately or almost immediately ban abortion if Roe is struck down. Since the Supreme Court declined to intervene in September 2021, allowing SB 8 to go into effect, nearly 1,400 Texans have traveled out of state for an abortion each month, the Texas Policy Evaluation Project found. Nearly 75% of those people traveled to two neighboring states: Oklahoma and New Mexico.
Alexa said the Lilith Fund offered to cover her expenses if she had to travel to Oklahoma for an abortion, a trip that she would not have been able to make without her parents’ knowledge. “I knew that if it came to that I wasn’t going to be able to go out of state,” Alexa said. “If I were farther than six weeks long, I would very unfortunately have to keep the pregnancy and I would probably give up the baby for adoption.”
Traveling to Oklahoma is no longer an option for Texans seeking an abortion. In early May, Oklahoma’s governor signed a bill similar to SB 8, which took effect even though Roe remains in place. Weeks later, Oklahoma became the first state to ban abortion wholesale, allowing private citizens to sue people who they believe helped someone get an abortion. Oklahoma has passed a series of abortion bans in the past year, some of which contradict each other, Insider reported, and lawmakers could not say which law would be enforced if Roe is struck down.
Sarah discovered that her baby had Hydrops, a condition where fluid is found in the body and brain caused by a genetic condition called trisomy 18, at her 12-week ultrasound appointment. When they found out that their baby was a boy — which decreased the statistical likelihood that their baby would be born alive and survive beyond a couple of months — she and her husband decided to terminate the pregnancy.
“I remember thinking like, it’s what makes sense and it’s what seems like would be the least suffering for him, for us as a family, for me,” Sarah said.
After her abortion in February 2019, Sarah received a bill from the Chicago hospital for $14,200. The hospital’s billing department assured her that it was most likely a mistake on the insurance company’s part, and the hospital would help them clear it up. She came away from that phone call relieved and put it out of her mind.
Then in January 2020, Sarah gave birth to their second child. The day after Sarah got back home, she and her husband received a letter from the Chicago hospital informing them that the $14,200 for the abortion was due, and that their insurance would not cover it because it was considered an elective procedure.
“It was like a slap in the face, it’s just so hurtful,” Sarah said. Carrying her pregnancy to term was not considered life-endangering, but she said it felt cruel that her insurance company was denying her coverage for a procedure that she believed was the most compassionate, and essential to her mental and emotional health.
“We had the money in our savings account, but it still was such a big amount,” Sarah said. “I just couldn’t even look at the paperwork without weeping.”
Her husband, James, wrote to the hospital’s CEO and CFO about the couple’s ordeal, threatening to pursue legal action and report the hospital to the attorney general “[i]f the situation is not resolved in a realistic way,” according to the email reviewed by BuzzFeed News. After months of back-and-forth, in July, the hospital agreed to accept $3,000 for the procedure. Their insurance company rejected their motion appealing the denial of their claim.
As stressful as their situation was, the couple said they were lucky to have been in Illinois, where they were able to make their decision on their own time and not worry about the logistics of getting an abortion. Illinois is a crucial state in the Midwest for abortion access, surrounded by states that are expected to ban the procedure.
“We felt like we were really lucky in terms of that,” Sarah said. “It wasn’t a concern of where am I going to be able to get this done? Or traveling, or access. We were lucky that that was not an obstacle.”
With Illinois abortion providers preparing for an influx of people traveling from out of state to obtain an abortion, anti-abortion extremists are also expecting to ramp up their presence in public, NPR reported, harassing people seeking abortions and steering them away from clinics.
Taylor was slightly more than 20 weeks pregnant in 2019 when, during her anatomy scan (an ultrasound detecting the fetus’s anatomy), she found out that her baby had holoprosencephaly, a condition in which the brain develops abnormally.
“She had the back part of her brain, but most of the front was gone,” Taylor said, describing how the condition could affect a person’s cognitive and physical development.
Taylor scheduled an abortion at a hospital in Indianapolis, two hours north of where she lived. It was a three-day process, and she and her then-boyfriend, now-husband, stayed at a hotel. The hospital was out of network with her insurance, but her doctor was in-network, so insurance covered some of the services and not others. She also paid for a state-mandated cremation of the fetal remains, which Taylor said she would have done anyway.
She had a week of PTO from work, and estimated that she took another six weeks of unpaid time off to recover emotionally from everything she had gone through. A nurse’s aide, she ended up leaving that job after missing so many days of work and struggling with her mental health; she had intended to give birth at the hospital where she worked.
She did not think of the cost of the abortion until she received the bill. “It was very stressful at the time, and I knew that if I’d actually birthed the baby, my insurance would have covered way more,” she said. “I kept saying like, ‘Well, if I’d had this child and she needed all the extensive medical care that she was going to need, the insurance company would have had to pay way more. So why are they charging me so much to terminate the pregnancy?’”
Taylor, who had her first child when she was 19, and her husband considered themselves “pretty pro-life,” she said. But when they received the diagnosis and made the decision to terminate, they didn’t see that as an abortion so much as it was “pulling the plug on somebody that's not going to make it anyway.”
That didn’t make their decision any easier. Taylor said she wished she had time for a fetal MRI to determine how severe the condition was, but they were running up against the clock. Indiana allows legal abortions under 22 weeks, though there are a host of restrictions in place that make it far more burdensome for the patient and the clinic to obtain and provide an abortion.
“Knowing how the laws were, [the hospital] straight-up told me, ‘You only have about a week and a half to make a choice if you’re gonna go that way,’” she said. “Looking back, I look at her ultrasound pictures and she was very deformed, and I know in my heart that I would have come to the same decision. But sometimes I think it would have been nice to take the time, and maybe I would have gotten some cute sneak peek 3D ultrasounds of her or something.”
Indiana has enacted increasingly restrictive abortion laws in recent years. The state does not have a trigger law in place, but Republican lawmakers have called for the governor to convene a special legislative session should the Supreme Court’s ruling on Roe “expand Indiana’s ability to protect unborn children.” Indiana Attorney General Todd Rokita, who has called abortion “murder,” also filed several legal motions supporting Texas’s SB 8 law.
Taylor said she doesn’t look at abortion in rigid terms anymore. “I know now that it’s not black and white and that it’s more gray than anything,” she said. “I think that the real little girl that was so disabled, I’m glad that I got to let her go humanely and she didn’t have to suffer.”
Jillian knew she was in the early stages of her pregnancy, but she wasn’t sure how many weeks along exactly, and she had to act fast. It was July 2020, and Tennessee Gov. Bill Lee had just signed into law a six-week abortion ban, which was promptly blocked by a court. She didn’t know if or when it would take effect.
The pregnancy, which was unplanned, was hard on her. She was exhausted and nauseous, throwing up often and unable to eat. Jillian was also not ready to be a parent. She wasn’t financially stable, and she said she didn’t particularly like the person she was dating at the time.
“I was just immediately into like, ‘figuring it out’ mode,’” she said. “I was just like, Damn, this is inconvenient and annoying and expensive. That’s really what I was worried about the most, is how expensive it was gonna be.”
The Planned Parenthood in Nashville only had appointments a few weeks out, and with the legal battle over the six-week ban playing out in courts, Jillian cast a wide net for clinics. She ended up scheduling an appointment at Planned Parenthood in Cincinnati, more than 250 miles away from where she lived in Tennessee.
Because Ohio has a mandatory waiting period for people seeking abortions, patients have to schedule two appointments, 24 hours apart. But Jillian said the clinic had a packed schedule, and so she had to drive to Cincinnati again a couple of weeks later for her abortion.
The night before her appointment, she and her friend made the trip to Cincinnati and got the cheapest motel room they could find in the area. She went in to take the first set of abortion pills the next morning (another friend helped pay for half of the cost) and the clinic sent her away with anti-nausea pills, pain medication, and the second set of abortion pills. The clinic also gave her Visa gift cards when they found out that she had traveled from another state.
“I don’t know if it was from an abortion fund or what, but they gave me a bunch of $50 Visa gift cards for travel expenses or as reimbursement,” she said. “I lived off this for a little bit because I definitely spent money that I didn’t have to get there. So it helped for sure.”
Jillian said people don’t understand how difficult it is to get an abortion. “I wasn’t financially stable at the time, but in reality I am a very privileged — like, I’m a white woman in America,” she said. “This is such a huge financial burden, even for somebody who, theoretically, it shouldn’t be that hard on. I can't even imagine what other women are going through. And that makes me angry.”
Abortion access is likely to be completely outlawed in Tennessee if the Supreme Court strikes down Roe. It too has a trigger law that will go into effect if Roe is overturned, which would make performing or attempting to perform an abortion a felony. Tennessee also banned medication abortion through telehealth or by mail in May 2022.
Tennesseans voted to remove the right to access an abortion from the state constitution in 2014. But even in more progressive pockets of the state like Nashville, whose district attorney has said he will not prosecute patients getting an abortion or doctors providing the service, Republican lawmakers last year voted to allow a special prosecutor to enforce the law should district attorneys refuse to prosecute certain cases.
If Roe falls, Tennesseeans likely would have had to travel farther than Ohio to get an abortion. With many restrictive laws already in place, Ohio officials are considering further curtailing abortion access if Roe if struck down. The state’s Republican attorney general and governor have both said they will look into reinstating a previous ban on abortion after cardiac activity is detected, if Roe is overturned. Republican lawmakers are also considering a trigger law with no exceptions for rape or incest. ●