The landmark 1973 Roe v. Wade Supreme Court decision legalized abortion nationwide, however, many barriers exist to block someone from getting an abortion.
In 1977, an amendment to the federal budget was passed by Congress restricting public funding for abortions only in the case of life endangerment, rape or incest.
In 1982, a Pennsylvania act was passed requiring patients seeking an abortion to have scripted counseling and a 24-hour waiting period before the procedure.
In 2012, a Pennsylvania act was passed requiring abortion facilities to be licensed as outpatient surgical centers. This holds them to higher standards for their facilities and staff.
In 2016, President Donald Trump won the election after promising during his campaign to fill the Supreme Court with anti-abortion judges. He successfully appointed conservative justices Neil Gorsuch, Brett Kavanaugh and Amy Coney Barrett.
In 2019, the Trump administration issued a Title X gag rule for the national family planning network prohibiting referrals for abortion care. So, facilities that receive federal funding through Title X can no longer speak to any of their patients about abortion.
As it stands now, there are many limiting factors for people trying to seek these services. Major barriers to access include cost, requirements for abortion clinics and accessibility. All of the barriers come together and end up impacting Black and Latinx people the most in their ability to have access to abortion services as shown in data and testimonials.
There are many hurdles that patients seeking an abortion have to overcome, and the same goes for clinics trying to provide these services.
Pennsylvania is one of 33 states that require patients to have counseling before an abortion.
Kristin Oakley is a patient educator and marketing specialist at the Allentown Women’s Center. She said before getting the procedure, patients speak with her and sign consent forms to make sure that they are certain of their decision and know what will be happening.
Another added step is a 24-hour waiting period between getting counseling and when the procedure is done. Patients have to speak with a doctor to receive state-mandated information.
“If somebody calls me and says that they want an abortion, they probably spent plenty of time thinking about their decision,” Oakley said. “I don’t think they need another 24 hours to sit and marinate on it.”
The mandatory state scripted lecture is structured to persuade the person not to have the abortion, said Melissa Reed, president and CEO at Planned Parenthood Keystone.
These extra steps become difficult if the patients are in domestic violence situations for fear of their calls being monitored or if English is not their first language, Oakley said.
It also adds more barriers for people who have to take time off work or get child care, Reed said. For someone not living close to a clinic, which applies to a lot of people, this is also an additional trip.
As of 2017, there were 43 facilities providing abortion in Pennsylvania. 85 percent of the counties have no clinics that provide abortions, so many people have to travel for care.
Pennsylvania also requires minors to have parental consent for an abortion.
“The fact that as a young person you are able to make your own decision about becoming a parent but you have to prove your emotional maturity if you want to have an abortion. It is violent and preposterous,” said Elicia Gonzales, executive director of the Women’s Medical Fund, a nonprofit that provides money to people who cannot afford the abortion procedure.
Claire Pinto, the communications and programs coordinator and the Pro-Life Union of Greater Philadelphia, said that even though it is illegal, underage girls are recieving abortions at clinics.
The Pro-Life Union of Greater Philadelphia works with a network of organizations to help people carry their pregnancy to term and provide support after the baby is born. Pinto has also spent time working at a crisis pregnancy center.
“The Pennsylvania state laws are broken when it comes to abortions and the cutoff dates for the abortion,” Pinto said. “You can’t get an abortion past 24 weeks in Pennsylvania, but I know of clinics that have done them at 26.”
Rehumanize International is a nonprofit human rights organization that aims to end all forms of aggressive violence against human beings, and advocates against abortion.
Herb Geraghty, executive director of Rehumanize International said, “Your average, everyday person might call themselves pro-choice, but they don’t know anything about fetal development. They couldn’t tell you a single thing about what the baby looks like from day one after conception to about 30 weeks.”
Geraghty said he used to be pro-choice, but when he took a deeper look into the science he changed his stance.
While Planned Parenthood is a national nonprofit that provides abortion there are many centers doing so that are privately held.
“They’re (the abortion clinics) not necessarily seeking to empower women or give them an opportunity,” Pinto said. “They’re making money off of someone getting an abortion. At the end of the day it’s for-profit.”
The largest barrier to abortion access is cost. Medicaid does not cover abortion services, and almost three million people in Pennsylvania are enrolled in Medicaid. Abortion is only covered on Medicaid in the case of life endangerment, rape or incest.
“There shouldn’t be state funded abortion unless it’s a mother’s life being in danger… Other than that I don’t think that we should be placing value on one life over another.” Pinto said.
Geraghty said, “I think there’s a case to be made that we should have conscience protections for taxpayers who don’t want to fund abortion. It is a pretty popular opinion in almost every state that people don’t want to fund abortion, even if they think it should be legal.”
Medicaid is for people who are low income, pregnant, have disabilities or are seniors. An abortion procedure can typically cost $500 if there are no complications. When someone needs an abortion, it is a time-sensitive situation in which the money is required at the time of the procedure, which for some is extremely challenging.
“Indigent people don’t have $500 just sitting around for an emergency procedure,” said David Cohen, a professor at Drexel University, who has extensively written and taught on the topic of reproductive rights. “No one plans on having an abortion.”
Twenty-five percent of those on Medicaid in Pennsylvania are Black and 13 percent are Latinx.
“Finding the money to cover the procedure, I think, is the biggest problem and that has a disproportionate impact on women of color,” Cohen said.
Clinics that provide abortions are also not able to receive as much money in grants as they once were. Title X clinics that offer family planning were able to receive funding from the government, but the Trump administration has taken any centers that refer for abortions out of the program, making them unable to access funding.
Any clinic that accepts money through Title X cannot provide abortion counsel or refer for an abortion. Even when talking about options, or if it is what the patient wants, abortion cannot be talked about if the healthcare provider has accepted the money from Title X.
Before the gag was put on Title X, “it really allowed people of very low income to access sexual and reproductive health care,” Reed said.
It allowed people that were uninsured or underinsured to get access to things like breast and cervical cancer screens and STI testing and treatment, she said.
“When the Trump administration kicked Planned Parenthood out of that program, it left a significant tear in the safety net in Pennsylvania,” Reed said.
One in four women has an abortion by the time they turn 45, and 49 percent of abortion patients are people below the poverty line. The implications of this also are that Black and Latinx people are disproportionately impacted by abortion restrictions since they are disproportionately impacted by poverty.
“It’s not what you see televised,” Pinto said. “It’s not what you see these celebrities who stand and say like, I could not be here, had I not had the choice. It’s women who feel they don’t have a choice.”
Whether it be a conversation about keeping a pregnancy or terminating it, money and other resources can often play a part in the decision for many people.
“People of color have been economically disadvantaged for centuries based on white supremacy and structural racism,” Reed said. “They continue to be underinsured and have the least access to health care.”
The Women’s Medical Fund is a service that patients can use if they need help paying for an abortion. Their average pledge is about $175, Gonzales said.
“Political interference by way of medically unnecessary restrictions on abortion access disproportionately impact low-income people,” Murtha said. “That’s always been the case with abortion.”
Gonzales said that 82 percent of the people that call their help line asking for aid to pay for abortion services identify as Black or Latinx.
“Overall access to care, in general, is more restricted for folks who are living at the intersection of living in poverty and also being a person of color, and or other marginalized communities as well,” Gonzales said. “We know that Roe v. Wade did nothing for the Black and brown people who call our helpline every day.”
Rep. Mike Schlossberg, a member of the Pennsylvania House of Representatives, said Pennsylvania has a very right-run senate. Still, there are things that both sides have in common, like wanting greater access to birth control. They all understand that abortion is never someone’s first choice, Schlossberg said.
In the last four years, the appointment of Supreme Court justices that are anti-abortion as well as hundreds of lower court judges by the Trump administration solidifies a conservative bench for the foreseeable future. There are cases involving abortion steps away from the Supreme Court.
Regardless of what the future of abortion may look like in Pennsylvania or the U.S., in the present, there are still many restrictions that exist, making access harder so that not everyone who chooses to have an abortion can get one.
With all of the barriers, Roe v. Wade “is the floor, and not the ceiling of access for a lot of people,” Murtha said.