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The ongoing recession has caused millions of Americans their jobs, and for some it's hitting even closer to home. Planned Parenthood and other family planning clinics are seeing more and more people in their waiting rooms. Generally these clinics serve young women between 18 and 24, but now older clients and many without insurance are coming in.

While some are looking for help supporting the children they have, others are afraid to raise a child they know that in this downturn, they can't afford.

NPR's Kathy Lohr reports.

KATHY LOHR: Family planning centers and clinics where abortions are performed say they see firsthand the effects of the economy on women in all age groups and income levels. Some noticed increasing numbers seeking help in January, including Nancy Boothe with the Feminist Women's Health Center in Atlanta.

Ms. NANCY BOOTHE (Feminist Women's Health Center): Certainly, it's a time when families are looking at family size and how much they can provide.

LOHR: Some are calling to see if they can get free birth control. They include middle class clients who have decided to forego preventive health care because they just can't afford it. Even older women are finding they are without insurance, perhaps for the first time. And Boothe says others ask questions about abortion.

Ms. BOOTHE: 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.

LOHR: The number of abortions has not increased at this facility, but Planned Parenthood in Illinois says it performed the highest number of abortions ever at its clinics in January. Steve Trombley is the CEO.

Mr. STEVE TROMBLEY (CEO, Planned Parenthood): And I think it's understandable that people who face an unintended pregnancy are weighing their decision about what they want to do about it. And I think anybody listening to this interview understands that it's a very different decision today than it was even a year ago to expand your family and to have a child.

LOHR: Trombley says the clinics are critical providers in smaller communities, including Peoria, Champaign and Decatur, Illinois, where the economic slowdown has resulted in thousands of job cuts.

Mr. TROMBLEY: You know, we all heard a month ago about the layoff from Caterpillar, for example, 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.

LOHR: Many women are reluctant to talk about their situations. Some are frightened, others embarrassed. Part of the problem leading to unplanned pregnancies, according to providers, is the increased cost of contraceptives. 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, doctor and owner of the Mountain Country Women's Clinic in Montana.

Dr. SUSAN WICKLUND (Mountain Country Women's Clinic): One of the biggest hurdles that women are having, who - have real difficult economic times right now trying to find money for gas, trying to find transportation, in some way, shape or form to get here.

LOHR: In 41 states, there are funds that help women pay the cost of transportation, abortion, child care and even counseling. The executive director of the National Network of Abortion Funds, whose members raise money to pay these costs, 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 over 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.

(Soundbite of clinic)

Unidentified Woman #1: All right, we're going to go right back here. It'll be just a few minutes.

Unidentified Woman #2: Thank you (unintelligible).

LOHR: Three young women, one visibly pregnant, wait to see a nurse at Cobb Pregnancy Services in the Atlanta suburbs. This nonprofit center has also seen a small increase in people seeking free 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 many need just basic help.

Ms. LORI PARKER (Cobb Pregnancy Services): We actually will put formula and food out in our reception room for those very people, which is kind of a unique situation. We seem to see more people that come in and they just say they have no means. They have no money, no way to get the diapers for their children, no way to get the milk. And so we're really very liberal - liberally give those things out to them, because we want those babies taken care of.

LOHR: As the recession drags on, two very different scenarios are emerging. Some are concerned more women facing an unplanned pregnancy in this economy will end up choosing abortion. Others fear women will put off their decision until the second or third trimester, when the cost is even higher — and the procedure more difficult.

Kathy Lohr, NPR News, Atlanta.

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