Women and poverty.
The proportion of women of childbearing age who are poor increased 45% between 1970 and 1991, (16) a period in which the number of female-headed households nearly doubled. (17) Today, a third of the nearly 59 million women aged 15--44 are either poor or have such low incomes that, while not officially classified as poor, they are on the brink of poverty (Figure 1; see page 10.) (18) Contrary to conventional belief, the majority of poor and low-income women are white and have small families. (19) Furthermore, fewer than a third of poor women are on welfare, (20) because many have no children (a general requirement for Aid to Families with Dependent Children--AFDC--the country's principal welfare program) and because income eligibility limits set by the states are below--often far below--the poverty line. (21) Because minority women are disproportionately poor, the public often perceives that most AFDC recipients are black; in fact, nearly half are white. (22)
The majority of AFDC recipients remain on welfare for less than two years at a time; (23) they marry, get a job or by some other means manage to increase their household income, or they lose their eligibility because their child reaches age 19 or leaves home.(24) But, by definition, poor and low-income women have few, if any, reserves to carry them through hard times, and any setback--the breakup of their marriage, the loss of a job, a childcare crisis or an unplanned birth--can, and often does, precipitate a return to welfare. (25)
For many lower income women, the ability to escape their disadvantaged circumstances, or to avoid poverty and welfare in the first place, may hinge on their ability to avoid giving birth when they are financially unable to support a child. Thirty-nine percent of new welfare "spells," for example, are the result of a first birth to an unmarried woman. (26) More than eight in ten of AFDC recipients aged 15--44 and nearly two-thirds of all women of reproductive age who are poor and low-income are unmarried.(27)
Most poor and low-income women try to prevent an unintended birth. While larger proportions of these women than those with higher incomes use no method of contraception when they have intercourse, the overwhelming majority of lower income women who are at risk of an unplanned pregnancy use contraceptives regularly.(28) However, they are less successful than higher income women in using their contraceptive method consistently and correctly.(29) As a result, while unintended pregnancies are common among women of all income levels in the United States, poor and low-income women are far more likely to experience an unplanned pregnancy than are more affluent women.(30)
Lack of Options
Women who are poor or on the edge of poverty often have no real choice in how they resolve an unintended pregnancy, because they cannot afford to pay for an abortion on their own and have no insurance coverage for abortion services. A third of poor women and more than a quarter of low-income women have no public or private health insurance (Figure 2).(31) Moreover, many who do have insurance do not have coverage for abortion.
About half of poor women, for example, have insurance through Medicaid,(32) but only 16 states and the District of Columbia currently pay for most abortions for Medicaid recipients.(33) Where Medicaid does not cover abortions, research has shown that at least 20%--and perhaps as many as 35%--of Medicaid-eligible women who would have abortions if the procedure were covered are unable to raise the money to pay for an abortion on their own and continue the pregnancy to a birth that would otherwise have been avoided.(34)
Their inability to obtain an abortion reflects the difficulty these women have not only in paying for the procedure itself, but also in covering the additional expenses frequently associated with getting to a clinic or other facility. About a quarter of poor and low-income women live in nonmetropolitan areas,(35) which have experienced a significant decline in abortion providers in recent years.(36) As a consequence, many women must travel long distances to obtain an abortion; such travel can entail child-care costs and even overnight accommodations in addition to transportation expenses. Furthermore, when women in nonmetropolitan areas do have access to a nearby provider, it is likely to be a hospital, whose fees will be considerably higher than those charged by specialized abortion clinics,(37) which operate almost exclusively in urban areas.
Women from diverse backgrounds experience poverty. At the same time, however, women in certain groups are more likely than others to be poor.
(14.) U.S. Bureau of the Census, 1993, Tables 4 and 5, pp. 6 and 10.
Women account for 63% of Americans 18 and over who are poor. Fifty-four percent of poor households are headed by an unmarried woman; 41% are headed by a married couple, and about 5% by an unmarried man.
(15.) AGI, 1994c.
(16.) AGI, 1994d; U.S. Bureau of the Census, 1971, Table 5, p.44.
In 1970, 11% of women aged 15-44 were poor; in 1992,16% were poor.
(17.) U.S. Bureau of the Census, 1993, Table 4, p.6. Between 1970 and 1991, the number of female-headed households increased 95%, from six million to 11.7 million. In 1970, female-headed families accounted for 37% of all poor families; in 1991, they accounted for 54% of poor households.
(18.) AGI, 1994d.
(19.) AGI, 1994d; AGI, 1994a.
(20.) AGI, 1994d.
(21.) National Governors' Association, 1994, Table 3. Nationwide, the average income ceiling for a single woman with two children to qualify for AFDC is $5,231--just 42% of the federal poverty level.
(22.) AGI, 1994d.
Forty-seven percent of recipients are white, 38% are black and 15% are Hispanic.
(23.) U.S. House of Representatives, 1994, Table 10-31, p.410.
Twenty-nine percent of welfare "spells" end when a female household head marries; 25% end when the female household head's earnings increase; 11% when the woman no longer has a child eligible for benefits; 12% when the household head has some other increase in income, perhaps by moving to a program such as Social Security Disability or Supplementary Security Income; and 23% for a variety of other reasons.
(24.) Bane and Ellwood, 1994, Table 2.8, p.57.
(25.) Bane and Ellwood, 1994, p. 54.
(26.) Bane and Ellwood, 1994, Table 2.7, p. 54. Unmarried women include those who are single, divorced, separated or widowed. Forty-two percent of welfare "spells" are the result of a marital breakup, with the wife becoming a head of household; 7% are caused by a decline in the female household head's earnings; and 12%, by declines in earnings of other family members or by other changes in the family.
(27.) AGI, 1994d.
(28.) AGI, 1994a.
(29.) Jones and Forrest, 1992, Table 4, p.17.
(30.) AGI, 1994e; AGI, 1994f; Henshaw, 1992, Table 1,p.86.
(31.) AGI, 1994d.
(32.) AGI, 1994d.
(33.) American Political Network, 1994; Kolbert, 1994. Alaska, California, Connecticut, Hawaii, Idaho, Maryland, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina, Oregon, Vermont, Washington and West Virginia paid for abortions as of Nov. 30, 1994.
(34.) Trussell et al., 1980, p.127; CDC, 1980.
(35.) AGI, 1994d.
Twenty-two percent of poor women and 26% of low-income women live in nonmetropolitan areas, as do 18% of higher income women.
(36.) Henshaw and Van Vort, 1994, p. 106.
(37.) AGI, 1994g; Henshaw, 1991, p. 249.
Alan Guttmacher Institute (AGI), Abortions and the Poor: Private Morality, Public Responsibility, New York, 1979.
-----, "Title X Family Planning Clinic Network," unpublished memorandum, New York, Sept. 16, 1992.
-----, "Even as Politics Improve, Challenges Facing Family Planning Providers Mount," Washington Memo, Jan. 12,1993, pp. 3-4.
-----, tabulations of data from the 1988 National Survey of Family Growth, 1994a.
-----, tabulations of data from the 1987 AGI Survey of Reasons Women Have Abortions, 1994b.
-----, unpublished findings from focus groups conducted with poor women in Atlanta and Philadelphia, Apr.20 and May 12, 1994c.
-----, tabulations of data from the March 1992 Current Population Survey, 1994d.
-----, tabulations of data from the 1987 AGI Abortion Patient Survey, 1994e.
-----, tabulations of data from the 1988 National Maternal and Infant Health Survey, 1994f.
-----, tabulations of data from the 1993 AGI Abortion Provider Survey, 1994g.
-----, data from a special tabulation of the 1990 U.S. Census, 1994h.
-----, Sex and America's Teenagers, New York, 1994i.
Althaus, F.A., and S.K. Henshaw, "The Effect of Mandatory Delay Laws on Abortion Patients and Providers," Family Planning Perspectives, 26:228-231,233,1994.
American Political Network, Inc., "New Mexico: Dept. 'Greatly' Expands State Abortion Funding," The Abortion Report, Nov.29, 1994.
Bachrach, CA., K.S. Stolley and K.A. London, "Relinquishment of Premarital Births: Evidence from National Survey Data," Family Planning Perspectives, 24:2732,1992.
Bane, M.J., and D.T. Ellwood, Welfare Realities: From Rhetoric to Reform, Harvard University Press, Cambridge, Mass., 1994.
Bennett, W.J., and P. Wehner, "End Welfare for Single Women Having Children," USA Today, Feb. 1,1994.
Center for Reproductive Law and Policy, "Federal Court Blocks Pennsylvania Medicaid Restrictions," Reproductive Freedom News, Sept.23, 1994.
Centers for Disease Control (CDC), "Effects of Restricting Federal Funds for Abortion--Texas," Morbidity and Mortality Weekly Report, 29:253255, 1980.
Chapin, J., American College of Obstetricians and Gynecologists, personal communication to J.D. Forrest, June 23, 1993.
CHOICE, "An Unacceptable Burden: The Effects of Pennsylvania's Restrictions on Medical Assistance-Funded Abortions," Philadelphia, Sept. 10, 1993.
C.K v. Shalala, "Brief in Support of Plaintiffs' Motion for Preliminary Injunction," Docket No. 935354 (NHP), Civil Action, (D.N.J., Apr.26, 1994).
CNN/USA Today/Gallup Poll, "The New Republican Mandate," Nov. 28-29,1994.
Congressional Quarterly, "House GOP Offers Descriptions of Bills to Enact 'Contract'," Nov. 19, 1994, pp. 3366-3379.
Crepps, J., Center for Reproductive Law and Policy, "Status of Funding for Abortion for Pregnant Women Eligible for Medicaid through Expanded Eligibility," memorandum to P. Donovan, Nov. 7, 1994.
Daley, D., and R.B. Gold, "Public Funding for Contraceptive, Sterilization and Abortion Services, Fiscal Year 1992," Family Planning Perspectives, 25:244-251,1993.
Donovan, P., "The People Vote on Abortion Funding: Colorado and Washington," Family Planning Perspectives, 17:155-159, 1985.
-----, "Family Planning Clinics: Facing Higher Costs and Sicker Ptients, "Family Planning Perspectives, 23:198-203, 1991.
-----, Our Daughters' Decisions: The Conflict in State Law on Abortion and Other Issues, AGI, New York, 1992.
-----, "The Restoration of Abortion Services at Cook County Hospital," Family Planning Perspectives, 25:227-231, 1993.
Forrest, J.D., "Timing of Reproductive Life Stages," Obstetrics and Gynecology, 82:105-111, 1993.
-----, "Epidemiology of Unintended Pregnancy and Contraceptive Use," American Journal of Obstetrics and Gynecology, 170:1485-1489, 1994.
-----, and S. Singh, "Public Sector Savings Resulting from Expenditures for Contraceptive Services," Family Planning Perspectives, 22:6-15, 1990.
Forste, R., L. Tedrow and K. Tanfer, "Sterilization Among Currently Married Men in the United States, 1991," paper presented at the annual meeting of the Population Association of America, Miami, May 5-7, 1994.
Frost, J.J., "The Availability and Accessibility of the Contraceptive Implant from Family Planning Agencies in the United States, 1991-1992," Family Planning Perspectives, 26:4-10, 1994.
Gold, R.B., "After the Hyde Amendment: Public Funding for Abortion in FY 1978," Family Planning Perspectives, 12:131-134,1980.
-----, AGI, unpublished memorandum to J. Rosoff, Mar. 7, 1994.
Hadley, K., Minnesota Housing Finance, personal communication to P. Donovan, June 30,1994.
Harlap, S., K. Kost and J.D. Forrest, Preventing Pregnancy, Protecting Health, AGI, New York, 1991.
Harris, L., "A Survey of Public Attitudes Toward Planned Parenthood and the Supreme Court Decision in Rust v. Sullivan," Louis Harris and Associates, June 1991, Study 912043.
Harris v. McRae, 448 U.S. 297(1980).
Henshaw, S.K., "The Accessibility of Abortion Services in the United States," Family Planning Perspectives, 23:246-252,263,1991.
-----, "Abortion Trends in 1987 and 1988: Age and Race," Family Planning Perspectives, 24:85-86, 96,1992.
-----, and J. Silverman, "The Characteristics and Prior Contraceptive Use of U.S. Abortion Patients," Family Planning Perspectives, 20:158-168,1988.
-----, and A. Torres, "Family Planning Agencies: Services, Policies and Funding," Family Planning Perspectives, 26:52-59,82, 1994.
-----, and J. Van Vort, "Abortion Services in the United States, 1991 and 1992," Family Planning Perspectives, 26:100-106, 112, 1994.
-----, and L.S. Wallisch, "The Medicaid Cutoff and Abortion Services for the Poor," Family Planning Perspectives, 16:170-180,1984.
Jones, E.F., et al., "Unintended Pregnancy, Contraceptive Practice and Family Planning Services in Developed Countries," Family Planning Perspectives, 20:53-67,1988.
-----, and J.D. Forrest, "Contraceptive Failure Rates Based on the 1988 NSFG," Family Planning Perspectives, 24:12-19, 1992.
Kolbert, K., Center for Reproductive Law and Policy, personal communication to P. Donovan, July 20, 1994.
Kost, K.L. and J.D. Forrest, "Intention Status of U.S. Births in 1988: Differences by Mothers' Socioeconomic and Demographic Characteristics," forthcoming, Family Planning Perspectives, January/February 1995.
Maherv. Roe, 432 U.S. 464 (1977).
Minnesota Department of Human Services, "A Market Basket Evaluation of the AFDC Standard of Need: A Report to the 1991 Legislature," St. Paul, Dec. 15,1990.
Moore, K.A., "Facts At a Glance," Child Trends, Washington, D.C., Dec. 1993.
Mosher, W.D., "Contraceptive Practice in the United States, 1982-1988," Family Planning Perspectives, 22:198-205,1990.
Murray, C., "The Coming White Underclass," Wall Street Journal, Oct. 29,1993.
National Governors' Association, "State Coverage of Pregnant Women and Children--July 1994," MCH Update, Washington, D.C., Aug. 1994.
National Network of Abortion Funds, "Summary of Fund Profiles," Hadley, Mass., May 7, 1994.
New York Times, "The Harm in Family Welfare Caps," June 9, 1994.
Omnibus Budget Reconciliation Act (OBRA) of 1987.
Omnibus Budget Reconciliation Act (OBRA) of 1989.
Richard Day Research, Inc., "The Chicago Metro Survey: Attitudes Toward Abortion and Family Issues," Sept. 22-Oct. 2,1994.
Silverman, J., A. Torres and J.D. Forrest, "Barriers to Contraceptive Services," Family Planning Perspectives, 19:94-102,1987.
Standard of Need Advisory Committee, "Report to the Commissioner of Human Services," N.J., Oct. 1990.
Tietze, C., and S.K. Henshaw, Induced Abortion. A World Review, 1986, AGI, New York, 1986.
Torres, A., and J.D. Forrest, "Why Do Women Have Abortions?" Family Planning Perspectives, 20:169-176, 1988.
-----, et al., "Public Benefits and Costs of Government Funding for Abortion," Family Planning Perspectives, 18:111-118,1986.
Trussell, J., etal., "The Impact of Restricting Medicaid Financing for Abortion," Family Planning Perspectives, 12:120-130,1980.
U.S. Bureau of the Census, "Characteristics of the Low-Income Population, 1970," Current Population Reports, Series P-60, No. 81, 1971.
-----,"Poverty in the United States: 1992," Current Population Reports, Series P-60, No. 185,1993.
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-----,"Annual Update of the HHS Poverty Guide-lines," Federal Register, 59:6277-6278, 1994.
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U.S. House of Representatives, Overview of Entitlement Programs: 1994 Green Book, Washington, D.C., July 15,1994.
FIGURE 1 Income A third of American women of childbearing age are poor or low-income. Women aged 15-44, 1992: 58,680,000 Higher income (67%) Poor (16%) Low-income (18%) Source: The Alan Guttmacher Institute (AGI), tabulations of data from the March 1992 Current Population Survey, 1994. Note: In this and subsequent figiures and tables, percentages may not add to 100% due to rounding. Note: Table made from pie chart FIGURE 2. Insurance Poor and low-income women are much less likely than higher income women to have any health insurance. Most poor women who do have insurance rely on Medicaid. Women aged 15-44, 1992: 58,680,000 PERCENTAGEBY INSURANCES STATUS Medicaid Other Insurance No insurance Poor 48 18 34 Low-income 13 59 28 Higher income 2 89 9 Source: AGI, tabulations of data from the March 1992 Current Population Survey, 1994. Note: The survey asked women if they had been covered by Medicaid at any point in 1991; some of the women who reported they were covered by Medicaid may have had an increase in income at a later point in that year and therefore were no longer covered. Note: Table made from bar graph
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|Publication:||The Politics of Blame: Family Planning, Abortion and the Poor|
|Article Type:||Topic Overview|
|Date:||Jan 1, 1995|
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