March is Women’s History Month, and this year’s celebration starts with June Medical Services v. Gee, a current Supreme Court case that poses the latest threat both to Roe v. Wade specifically and to women’s health and economic security at large. This case is the most recent reminder of how precarious reproductive health and rights are and of how barriers to legal and safe abortion — and health care access more broadly — have always had devastating consequences for women, their bodies, and their economic choices.
Roe was decided at a time of expanding opportunities for women, when the spirit of reform from the civil rights and feminist movements were moving the needle on equity and inclusion, even if incompletely. It coincided with the founding of the Title X national family planning program and increased contraceptive access; the passage of Title IX and the prohibition of sex discrimination in federally funded educational programs; and the implementation of a range of workplace protections that improved the quality and safety of work for women.
For the first time in US history, women could legally decide whether and when to have a child, which not only improved women’s health outcomes but also enabled them to pursue their education, join the workforce, and advance their careers — changes that improved the economic mobility and security of women and their families
While Roe had an immediate and profound impact on the health and economic security of women and their families, its promise was never fully realized because the conservative backlash to women’s increased power was and continues to be swift and unrelenting. A mere three years after Roe was decided, Congress passed the Hyde Amendment, which prohibited Medicaid funding for abortion, placing the procedure out of reach for many poor women and women of color who otherwise could not afford it. More recently, state-imposed waiting periods have prevented women from accessing abortion in a timely manner, often pushing them to have more costly procedures later in their pregnancy. Medically unnecessary TRAP laws — such as those that specify width of clinic corridors and size of procedure rooms, and that require providers to have admitting privileges at local hospitals — have also chipped away at Roe one policy at a time. In the last four decades, states have passed more than 1,200 abortion restrictions, many of them implemented within the last 10 years. These efforts have left us with a patchwork quilt of abortion access that is threadbare in many parts of the country.
That’s to say nothing of the recent efforts to curb access to other forms of family planning. The current administration recently jeopardized women’s access to birth control by putting restrictions on Title X funding that have reduced services at many Planned Parenthood sites around the country; it is currently attempting to give employers more power to deny their workers birth control coverage. To say reproductive health and rights are on shaky ground would be a drastic understatement. Amid these rollbacks, it’s not hard to imagine a time when only married women could access birth control and abortion was illegal.
Just as in the pre-Roe era, that lack of access to comprehensive reproductive health care will take a steep toll on women’s health and economic well-being, and women today cannot afford any further threats to their economic security. Economic inequality today is greater than at any time since the Great Depression, and women — particularly women of color — shoulder a unique and heavy burden.
In recent years, women have provided a plethora of anectodal evidence for what research has long told us to be true: that access to abortion is pivotal to their career trajectories and long-term economic opportunities. In 2016, when the Supreme Court heard a case confoundingly similar to the June Medical Services case they heard this week, 368 women lawyers submitted an amicus brief imploring the justices to understand how abortion access impacted their and their families’ health and economic well-being. They wrote that they “would not have been able to realize their personal and/or professional goals were it not for their ability to control their reproductive lives.” The benefits of abortion access have extended to women’s families, with children born to women who had access to safe and legal abortion experiencing lower rates of poverty, being less likely to receive public assistance, and being more likely to graduate from high school and college. The Court ruled in favor of abortion rights in that case; it remains to be seen how a very different court will rule on the same issue.
While conservative policymakers are working hard to send reproductive health and rights back to the pre-Roe days, the economic changes of the last four decades threaten to compound the harm of retrograde health policies. Today, women — many of them women of color — comprise two-thirds of workers earning at or below minimum wage. Women are trapped in a wage gap where they earn 82 percent of what their white male counterparts earn, and Black and Latina women earn 62 and 54 percent, respectively. The gender wealth gap is even worse: Women own 32 cents on the dollar compared to men, and the median wealth for single Black and Latina women is a mere $200 and $100, respectively. Between 25 and 80 percent of women experience sexual harassment or assault in the workplace, which threatens their physical safety and harms their long-term economic well-being. And for the majority of American workers — particularly those in low-income jobs — paid sick leave, paid family leave, and affordable childcare are pipe dreams.
This rigged economy has left women more economically insecure just as backward health policies require them to be more reliant on their own financial means to access care and services that should be available to all women regardless of income or zip code.
We find ourselves in a moment when reproductive health and economic inequality are both in the spotlight, but policymakers infrequently discuss them as issues that are deeply intertwined. That’s a mistake. Abortion access — or lack thereof — and economic insecurity are connected in a vicious cycle. Women who have low incomes and live in poverty are more likely to seek out abortion, and less likely to be able to access it. One study showed that women who want but are not able to have an abortion have four times greater odds of ending up in poverty than women who have the procedure. Our current economic and health policies are pushing abortion further and further out of reach for the very women who are most likely to seek it out.
Thanks to changes over the past 30-plus years, women understand that reproductive health access has implications that go far beyond their health outcomes. Polls by the National Institute for Reproductive Health show, for example, that nearly three-quarters of voters in Pennsylvania said a woman’s ability to control the timing and size of her family impacts her financial stability, and 60 percent believed that laws that erect barriers to abortion access can negatively impact a woman’s financial security. Voters in New York and Virginia felt similarly. These data tell us that voters’ perceptions align with the reality that women’s power over their bodies and their economic lives is key to intergenerational economic security and well-being.
As we honor the history that women have made — and that we have yet to make — let’s not forget that an attack on abortion rights is also an attack on women’s financial security. Roe paved a pathway for women to hold more individual, social, and economic power, and the relentless attacks on that landmark decision are at their core attempts to strip women of that power and exert control over every aspect of our lives. History has shown us all that is lost when women do not have bodily autonomy. We can’t afford to return to that.