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Undue Burden: The Cost of Pregnancy in the U.S.

Undue Burden: The Cost of Pregnancy in the U.S.

The 50th anniversary of Roe v. Wade, the landmark legislation that legalized abortion in America, quietly came and went in January. What should have been a day to celebrate women’s rights was instead a day of sorrow, fear, and outrage.

Since Roe was overturned last April, half of the states in America have banned abortion, severely limited access to abortion or have anti-abortion legislation in progress. Although most of these laws target healthcare providers, lawyers are proposing legal strategies to criminally prosecute women who seek abortions, reminding us that these laws are moving in a frightening direction.

Protecting a woman’s control over her body was rooted in a combination of constitutional rights to privacy and opposition to laws that place a disproportionately “undue burden” on any group. Justice Amy Coney Barrett famously stated that the “undue burden” argument is less relevant because of adoptions and safe-haven laws that allow mothers to give up their babies without legal repercussions.

This claim is blind to the psychological and physical burden pregnancy places exclusively on women before the child is born.

It also ignores the very real financial burden of pregnancy that rarely enters the public discourse.

Childbirth in the USA is more expensive than any other country on Earth. The single biggest reason for seeking an abortion is financial. Women who seek abortions often cannot afford the cost of pregnancy and childbirth, let alone child rearing. Although costs vary widely by state, routine hospital deliveries without complications cost over $10,000 on average in the USA. If the delivery requires a Cesarean section (a third of all births), the price tag can easily double or triple.

Furthermore, there is the cost of additional medical care, childcare, lost wages, and lost employment if the mother develops complications related to pregnancy and requires ongoing medical intervention or bed rest. These costs are not remedied by safe-haven or adoption policies that only go into effect after the child is born.

To be sure, some of these women have health insurance that will cover some portion of the medical bills, as argued by Justice Alito. However, 43% of Americans are underinsured, meaning they do not have adequate coverage for major medical expenses. Over 2 million low-income Americans fall into the health insurance “coverage gap”, meaning they cannot afford healthcare but are not covered by Medicaid. Even with good insurance, deductibles and out-of-pocket costs could run into the thousands of dollars, and health insurance would not remedy lost wages and other non-medical expenses related to managing an unwanted pregnancy.

The mother could sue the biological father if he is not supporting her financially, but this would require researching and hiring a lawyer, taking time off work to gather and file paperwork, meeting with legal representatives, and fighting him in court. The burden of attempting any compensation is a high-cost, low-outcome endeavor. With only 44% of mothers receiving full child support once the baby is born, it would be even more challenging to get the father to pay prenatal medical costs when only the mother is receiving medical services or defaulting on bills. Only 1 state—Utah—requires biological fathers to pay 50% of pre-natal medical costs, but even this does not cover the slew of non-medical costs or risks to employment that coincide with pregnancy and childbirth.

These financial burdens only exacerbate the health and mental health burdens that disproportionately impact women and underage girls when they are forced to give birth. Pregnancy and childbirth carry significant health risks, including long-term medical complications and even death. Furthermore, most states with abortion bans do not allow provisions in the case of rape, incest or the sexual exploitation of a minor. Forcing a victim of rape, incest or pedophilia to carry a child to term and undergo the extreme physical and emotional trauma of childbirth further victimizes the woman or girl. According to the Rape, Abuse and Incest National Network (RAINN), a third of women who survive sexual assault contemplate suicide.

Once again, these burdens fall exclusively on the woman.

If the United States wants to continue to lead the way on women’s rights—indeed, human rights—we can’t turn a blind eye to the precarious and often injurious situation women are placed in when abortion rights are taken off the table.

View Comment (1)
  • Cogently written and filled with vital information. This is need-to-know information that is often missing in debates about abortion access in the mainstream news. The issue is not just the embryo, but also the security and safety of the mother, who often already has other children who count on her for their very existence and well-being. If the anti-abortion “pro-lifers” were truly, fully “pro-life,” they would acknowledge that the lives of the mother and her born children need protection as much as, if not more, than a fertilized egg does.

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