The ongoing recession has cost millions of Americans their jobs, but for some it's hitting even closer to home. Planned Parenthood and other family planning clinics are seeing more patients in their waiting rooms.
These clinics generally serve young women between the ages of 18 and 24. But now, older clients — and many without insurance — are coming in. Some are looking for help supporting the children they have. Others are afraid of raising a child they say they can't afford.
Family planning centers and clinics where abortions are performed see firsthand the effects of the economy on women in all age groups and income levels. Some noticed greater numbers seeking help in January.
"It's a time when families are looking at family size and how much they can provide," says Nancy Boothe of the Feminist Women's Health Center in Atlanta, who also saw an increase.
Questions About Free Birth Control, Abortion
Some people are calling the clinic to see if they can get free birth control. They include middle-class clients who have decided to forego preventive heath care because they just can't afford it. Even older women are finding they are without insurance, perhaps for the first time. Others ask questions about abortion.
"We've seen some people who said that they didn't really think that they would ever be making this decision, but recognize that this is a time when they have to think about taking care of the families that they have," Boothe says.
She says the number of abortions has not increased at the Atlanta facility, but Planned Parenthood of Illinois says it performed the highest number of abortions ever at its clinics in January.
"I think it's understandable that people who face an unintended pregnancy are weighing their decision about what they want to do about it," says chief executive Steve Trombley. "And I think anybody listening to this interview understands that it's a very different decision today than it was a year ago to expand your family and to have a child."
He says the clinics are critical providers in smaller Illinois communities, including Peoria, Champaign and Decatur, where the economic slowdown has resulted in thousands of job cuts.
"We all heard a month ago about the layoffs from Caterpillar, for example," Trombley says. "So we have whole communities where people are suddenly being closed off from access to health care, and they rely on the social safety net that we're a part of."
Many women are reluctant to talk about their situations. Some are frightened, others embarrassed.
Trouble Finding Money
Providers say the increased cost of contraceptives is part of the problem leading to unplanned pregnancies. Women pay up to $60 for a single month's supply of birth control pills. As a result, many can't afford them. Transportation is also an issue, especially in rural areas, according to Susan Wicklund, a doctor and owner of the Mountain Country Women's Clinic in Livingston, Mont.
"One of the biggest hurdles that women are having ... is trying to find money for gas, trying to find transportation, in some way, shape or form to get here," Wicklund says.
In 41 states, there are funds that help women pay the cost of transportation, abortion, child care and even counseling. The National Network of Abortion Funds helps raise money to pay these costs. The executive director says there is a greater need now for funding to pay for abortions.
Calls to the group's affiliates jumped by at least 50 percent in January from last fall's numbers. Part of the issue is that Medicaid covers the cost of abortion in just 15 states, leaving poor women with few options.
At Cobb Pregnancy Services in the Atlanta suburbs, three young women, one visibly pregnant, wait to see a nurse. This nonprofit center has also seen a small increase in people seeking free pregnancy tests and ultrasounds. Most pregnancy centers do not refer for abortions, but instead encourage women to keep their babies.
Director Lori Parker says more clients now say they or their partner have lost a job and that as a result, many need just basic help.
"We actually will put formula and food out in our reception room for those very people, which is kind of a unique situation," Parker says.
Because her staff has recently seen more people who say they have no money or no way to get diapers for their children, she says the center "very liberally gives those things out to them, because we want those babies taken care of."
As the recession drags on, two very different scenarios are emerging. Some are concerned that more women who face an unplanned pregnancy in this economy will end up choosing abortion. But there's also fear that women will put off their decision until the second or third trimester, when the cost is even higher — and the procedure is more difficult.