Abortion Creates Futures

“You’re on the schedule,” my coworker P. says, her hand warm and gentle on my shoulder. “Four o’clock. The midwife can see you as soon as her last patient leaves.”

We have been working in parallel roles at the clinic for only a few months, but P. is like a lantern swinging in the dark for me; her long blond hair and big smile a warm glow cutting through the bleakness of the news cycles and all-hands-on-deck emergency meetings, her arms a respite on the increasingly frequent days when one of us would leave an exam room or rise from a desk chair, turn to the other person and offer, “Hug?”

Like me, P. feels things deeply; like me, she’s been raised to apologize early and often. Like me, she sometimes has to step away from our work, in our small city’s lone reproductive health clinic—to cry in a supply closet, or stretch her limbs in a hallway, or take some deep slow breaths alone in whatever darkened office she can find.

“Thank you, buddy,” I manage quietly, placing my shaky hand over hers. I know there is still one more favor I have to ask of her, my lovely friend who’s already moved mountains in order to squeeze me into our packed patient schedule. My medication abortion will cost me $555 up front. My bank account balances flash across the screen of my thousand-tabs-open mind. Personal checking:

$142.70.

Family checking: just barely enough for mortgage and groceries.

Family savings: recently depleted by payments to the medical providers and collections agencies still flooding my mailbox with their clear-plastic-windowed envelopes.

I need to get back to work, to make money, to pay for all the other life-and-death things that aren’t this abortion.

My husband’s old pickup truck is in the shop, accruing new charges every day on an itemized bill we haven’t seen yet, our kind but gruff mechanic up to his elbows, at this very moment, in its years of oil and grime. The station wagon needs four new tires, and soon, new brakes. The baby is growing too tall for his car seat, though its packaging had made us emphatic promises that it would “grow with” him when we bought it. Its capacity and height limits proving to be no match for our off-the-growth-charts Paul Bunyan of a child. His feet, clad in baby Crocs or rainbow grippy socks, or (more likely) chunky and grass-stained and bare, already dangle off the seat’s bottom edge. My medical insurance plan categorically denies any coverage of abortion care.

(Other gems excerpted from my PPO’s Explanation of Benefits include: Your newborn will be subject to their own cost-sharing for covered services beginning on their date of birth. And in the section explaining that I am responsible for 20 percent of the full cost of any prenatal care, the company bizarrely defines any and all pregnancy-related services as maternity care for mother and child, despite the fact that an embryo or fetus is — medically! prescriptively! — not a child, and despite the fact that many pregnant people (a) are not “mothers” in any sense of the word and (b) frequently need medical attention that is not “maternity care” . . . whatever that term even means.)

I burn with shame as I open my mouth and let the bird of what I hope will be my last Big Ask fly out, the beat of its wings my strained, embarrassed whisper.

“Any chance of funding, you think?”

P. laughs, “On our salary? Big chance, love.”

She sits down at her keyboard, takes a sip from her coffee mug, and — as she and I have both done countless times before — opens a new message to our clinic’s abortion-fund coordinators. We wait in silence for an answer, a percentage, a dollar amount.

OK, comes the response from one of the coordinators after a moment, let me see what we can do.

A few minutes later: We can cover it. One of the funds will give us $385, and we can use $170 from another fund. The patient won’t have to pay anything today.

My shoulders drop. I want to sob with relief, to grab P. and squeeze her delicate frame in a tight rough hug, to do a humiliating dance of some kind. But another patient is at the door. I need to get back to work, to make money, to pay for all the other life-and-death things that aren’t this abortion.

Abortion funds are autonomous collectives of people — sometimes paid staff, but far more often volunteers with unrelated full-time jobs, who squeeze this work into lunch breaks and late nights and weekends — who raise and distribute the money required to have an abortion. The cost of an abortion can vary wildly, depending on your geography, gestational age, provider, and other medical, legal, and logistical circumstances. The average cost of a surgical abortion at ten weeks was $508 in 2014, according to the Guttmacher Institute, with location- and circumstance-dependent price tags ranging from $75 to $2,500. A medication abortion at ten weeks or less cost an average of $535 that year, according to the same source, but what patients must pay for their care can range from $75 to $1,633 or more.

Abortion funds give someone $500 — or $750, or $2,000, or $443.68, or $20 — and in doing so they create whole futures, whole people, whole lives, whole worlds.

Funds are, by and large, local and independent, though they often collaborate with one another, across city and state lines, to get people their abortions. Increasingly, as draconian laws force patients to travel farther and farther from their lives and communities, to cover more and more ground in their journey to obtain their five pills or their ten-minute procedure from a clinic, multiple funds are partnering to provide one person or one family with the money and the practical support they need.

(Of course, there are some barriers that cannot be funded away—by cruel design. If people have no source of trusted childcare, no work leave, no freedom or documentation or safe way to travel, they are forced to stay pregnant and give birth against their will, no matter how much money can be raised and pledged for them.)

Abortion funds give someone $500 — or $750, or $2,000, or $443.68, or $20 — and in doing so they create whole futures, whole people, whole lives, whole worlds.

The funding that paid for my abortion came not from my government or my health insurance company or my employer. It came from people, like you and me, from individual human beings who make up a village of care.

This village, in paying for my abortion care, was paying for my son to have all the food and clothing and books he needs, for his health care and toys, for him to have a living mother in a healthy body, with capacity and joy to spare. They paid for me to avoid falling behind on my mortgage and student loan payments. They paid for my parents to receive flowers on their birthdays. They paid for my car to have its oil replaced and transport me safely to work. They paid for me to write these words to you.

From You or Someone You Love by Hannah Matthews. Copyright © 2023 by Hannah Matthews. Reprinted by permission of Atria Books, a Division of Simon & Schuster, Inc.

Hannah Matthews is a journalist, essayist, and abortion care worker. Her work has appeared in ELLE, Esquire, Teen Vogue, Catapult, McSweeney's, and many other publications, and her book You Or Someone You Love is forthcoming from Atria in 2023. Follow her on Twitter, subscribe to her newsletter of abortion love letters, or visit her website for more information.