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The Atlantic Highlights Ongoing Disparities in Abortion Access

The Atlantic Highlights Ongoing Disparities in Abortion Access

July 28, 2015 — A woman's firsthand account of obtaining an abortion in the 1960s "illuminates a relationship between class and abortion that, 50 years later, is no less complicated," The Atlantic reports.

The account -- originally published in The Atlantic in the 1960s -- was written anonymously by Mrs. X, "a married, middle-class mother of three living in a large East Coast City" who "found herself with an [unintended] pregnancy at age 46." According to The Atlantic, Mrs. X's account "details a series of surprises: the cleanliness of the office, the speed of the procedure, and most importantly, the ease with which she found someone willing to perform it." Reflecting on her experience, Mrs. X noted, "There must be hundreds like me" who "undergo the same fears, search for the same kinds of operative resources, and find the money necessary to terminate the pregnancy." She adds, "I am sure that my experience is not unique."

According to The Atlantic, "Her experience was not unique. But nor was it universal."

Abortion Access in 1960s

According to the Guttmacher Institute, 44 states in the decade preceding Roe v. Wade permitted abortion only to save a woman's life, while four other states and Washington, D.C., permitted exemptions for the health of the woman. Meanwhile, one state allowed abortion in instances of rape while another, Pennsylvania, banned the procedure under any circumstances.

However, according to the Atlantic, "in many places" that permitted abortion in limited circumstances, "even a woman who met the health criteria for a legal abortion would need her doctor to help her make a case to a hospital review board." Further, women seeking abortion care in some states were required to consult with or gain approval from a second physician or a psychiatrist.

Given the rules, "most legal abortions" were obtained by "women who had private insurance or could otherwise afford the review process -- and, more than that, on women who could lay the groundwork for it," The Atlantic reports, adding, "Whether a pregnancy constituted a 'danger' was often a subjective call; the chance of securing a diagnosis was greater if a woman went to a doctor she knew well, skewing the odds against those who didn't have the funds for regular healthcare."

For example, a 1969 Atlantic piece by Harriet Pilpel, a lawyer and women's rights activist, found that the majority of abortions performed in hospitals in New York City in the early 1960s were "for 'psychiatric' reasons, 93 percent were performed on white patients, 91 percent in private rooms." Further, Pilpel noted that women who were not able to have an abortion in a hospital were often able to find a safe abortion if they had "sufficient means," The Atlantic reports. Pilpel explained, "The out-of-hospital abortions performed by doctors are obtained by" middle- and upper-income white women, who also "accoun[t] for the bulk of in-hospital abortions."

Meanwhile, during that time, low-income minority women comprised a small proportion of in-hospital abortions but a majority of abortion-related deaths, according to The Atlantic.

Abortion Access in the U.S. Today

In 2015, the connection between class and abortion access remains "messy," The Atlantic reports. Low-income and minority women have accounted for an increasing proportion of abortions since 1973, partly because that demographic is at higher risk of unintended pregnancy.

However, just 22% of abortion clinics in 2011 were in neighborhoods that are minority dominant. Further, an uptick in laws that impose delays before a woman can obtain abortion can present additional access barriers, particularly for low-income women, according to The Atlantic. The Guttmacher Institute reports that an abortion in the first-trimester costs $470 on average, not including the other costs associated with accessing the procedure, including about $198 in lost wages, $57 in childcare costs and $44 in costs for transportation (Romm, The Atlantic, 7/24).