Updated September 03, 2024 at 07:30 AM ET
Mostly, Natalie remembers feeling very, very alone.
At 24 years old, she was just out of college, struggling to pay bills and find a good job. And she was pregnant.
"I had kind of an on-again, off-again boyfriend, and I was taking birth control and we used condoms, so we thought there's not a really good chance of getting pregnant," she says. "But when you're young, sometimes your body has other ideas."
She asked NPR not to use her last name because she fears professional repercussions for telling her story publicly.
This was 2010. She was living in Missouri at her uncle's house, looking for a job where she could use her bachelor's degree in biology and chemistry — especially one that came with health benefits. She had been uninsured since her dad died when she was a teenager, and her mom wasn't around or able to offer her very much support.
In the meantime, she was working at a daycare center and made barely enough money to support herself.
"I remember the first $100 that I had in my savings account was huge — it took me six months," she says.
When she found out she was pregnant, she felt trapped.
"I was just thinking of the immediate future: What am I going to eat? Where am I going to live?" she says.
But it wasn't just Natalie's immediate future that was at stake — it was her long-term financial security, too.
Natalie's experience illustrates the profound economic consequences that an unplanned pregnancy can have on a woman's life. The decisions women make — and the options that are available to them — can have lasting effects on their finances, their families, and the economy as a whole. Those options have changed in sometimes unexpected ways since the Supreme Court struck down Roe v. Wade two years ago and allowed states to impose strict limits on abortion.
A taboo conversation
"I believe that eliminating the right of women to make decisions about when and whether to have children would have very damaging effects on the economy and would set women back decades," Treasury Secretary Janet Yellen told a Senate committee some weeks before Roe was overturned.
But a frank discussion of the economic side of abortion still strikes some people as taboo.
"It just feels callous to me," Sen. Tim Scott, R-S.C., told Yellen. "I think finding a way to have a debate around abortion and a meaning for the economic stability of our country, is harsh."
"This is not harsh," Yellen replied calmly. "This is the truth." She noted that access to legal abortion allows more women to join the workforce, finish their education and boost their earnings potential.
The single biggest decision
The most common reason women seek abortion is not having the economic resources to care for a child, according to data from the Turnaway Study. The landmark research project followed hundreds of women for years after they sought abortions and in some cases were turned away.
"We all understand — if we're parents, or know anybody who's a parent, or are paying any attention to parents — the ways in which having children impacts the economic lives of families," says Caitlin Myers, an economist at Middlebury College. "For women in particular, it's the single biggest economic decision most of them will make in their lifetimes."
Most women who seek an abortion are already low-income. Research shows that when these women are blocked from ending their pregnancy, they wind up worse off.
"We see increases in poverty, increases in the chance that your family falls below the federal poverty level, an immediate drop in full-time employment — which makes sense. It's really hard to work full-time with a baby," says Diana Greene Foster, who led the Turnaway Study.
Certainly, there are women who have children in the midst of financial difficulties who are relieved and happy with their decision. But in the study, women who were denied abortions were more likely to live in poverty, less likely to work full time, more likely to receive public assistance (though not enough to offset their lost income) and less likely to have additional children later in life.
In contrast, many women in the study who did have abortions went on to have children later, when their financial circumstances had improved.
A different kind of life
That spring in 2010, Natalie understood the stakes. Her uncle was helping her with groceries, but his rules for staying with him were that she not do drugs and not get pregnant. So her food and housing were on the line. She knew she didn't want to build a life with her boyfriend, "knowing that our relationship wasn't really healthy or stable."
"The other part of it was that I had grown up around a lot of women who did have children in their teens and 20s who were still dealing with the financial ramifications of that," she says. "They never got past those entry-level jobs, they were always very concerned about money — $100 in savings was kind of their perpetual life point."
Natalie wanted a different kind of life.
She felt that she couldn't talk to her family members or coworkers about abortion. She didn't know where to go or what it would be like.
"It was a hidden, secret Internet search," she says. "I spent a lot of time being afraid that they were going to find out."
Natalie ended up driving three hours to the nearest clinic for a medication abortion. She rented a cheap hotel and her boyfriend came with her and contributed $700 to help cover the expenses. "I put the rest on credit cards," she says.
New job, stable relationship, savings in the bank
A few months later, Natalie was on an entirely new path. She moved to a different state, found a job at a lab that used her science degree and broke up with her boyfriend.
By the following year, "I had my own apartment for the first time, I had health insurance, I had a few thousand dollars in savings," she says. "I didn't have a family social safety net in place like other people — like, you can move in with your parents. That wasn't an option for me, so it was really important to me to build up those savings."
She met the man who would become her husband through friends in Iowa, her new home state. They tried for years to start a family, with no luck. "We saved up for two or three years and threw our entire savings into one round of [in vitro fertilization]," she says. It cost $20,000. The cycle did not work, and they decided not to try again.
Then, a big surprise. Natalie got pregnant out of the blue in 2019, shocking herself and her doctor.
Baby River was born just as the COVID-19 pandemic was taking hold. Natalie had no idea how she was going to keep up with her job as a data scientist and her newborn since the pandemic sharply limited access to outside childcare. One option would have been to drop out of the workforce.
Natalie was lucky — her boss made a lot of changes so she could continue working and taking care of her baby.
"They shifted my schedule," she says, so she would work four ten-hour days per week. She's glad she was able to weather those first years as a parent and still hold on to the job she worked so hard to get.
The economic story
When abortion became legal decades ago, access to that option — along with effective contraception — dramatically increased women's ability to work outside the home.
"It enabled many women to finish school," Yellen told that Senate committee in 2022. "That increased their earning potential. It allowed women to plan and balance their families and careers. And research also shows that it had a favorable impact on the well-being and earnings of children."
The share of women aged 25 to 54 in the workforce has jumped from 51% in 1972 — the year before Roe v. Wade — to 78% today.
"That is one of the biggest economic stories of the 20th century," says Myers, the economist.
When the Supreme Court struck down Roe, there were fears that a half-century of economic gains for women might be reversed.
So far, though, the economic fallout has been limited — not because access to abortion doesn't matter, but because women are finding workarounds.
In the two years since the Dobbs decision, 14 states have outlawed abortion and six more have imposed strict limits. Despite that, the number of abortions actually increased. Tens of thousands of women have crossed state lines, often traveling long distances, to visit clinics where abortion is still legal. Others turned to newly accessible online clinics, receiving medical abortion pills through the mail.
"It's just been a humongous transformation of what abortion access looks like in this country," Greene Foster says. "And probably to the chagrin of people who are opposed to abortion, those bans did not have the effect that they anticipated," at least on the national level.
A different picture for low-income women
Certainly, some low-income women living in states with abortion bans have been unable to travel for abortions and have given birth to children they would not have, if abortion had remained available close by. In Texas, for instance, researchers at the University of Houston estimate that 16,000 additional babies were born in the year after a 6-week ban took effect. (The infant mortality rate in Texas also increased during that time.)
"Some folks, they just haven't left the state ever," says Jenice Fountain, CEO of the Yellowhammer Fund, a reproductive justice organization based in Alabama.
"Your everyday person and community, especially the low-income community in Birmingham, isn't following this bill to know what's legal, how to navigate [access to abortion] or anything like that."
She says in Alabama, there are absolutely more people having children because of the abortion ban, and those people have to navigate access to prenatal care, safe birth, and childcare.
Politically, it's unclear what national changes might still come on reproductive rights. Access to abortion remains fragile, Myers says, even after the Supreme Court rejected a challenge to medication abortions in June on technical grounds. Access to contraception, in vitro fertilization, paid maternity care, and other issues affecting women's participation in the workforce are live political issues as well.
Myers suspects abortion opponents will continue to seek limits on interstate travel, telemedicine and laws that allow doctors to ship abortion pills through the mail.
"There's no way this is over," she says.
Looking back at her younger self
Natalie is now 39. She has a healthy four-year-old, a stable marriage, and a job as a data scientist. She wonders if any of that would have been possible if she had continued that first pregnancy 2010.
"I spend a lot of time thinking about that abortion, especially in the last year or so," she says.
In Iowa, where Natalie lives, a six-week abortion ban recently took effect. Even with fundraising by abortion rights supporters around the country, the logistics and expenses of traveling out of state for an abortion can be daunting.
"I was right at the line — financially — with being able to deal with it or not, and now if I was in the same situation, there's no way I could afford an abortion," Natalie says.
She's grateful she is able to provide stability and a loving home for her child, born ten years after her abortion. "I'm in a place, now, where not only can I provide medical care for myself and food for myself and housing for myself and have relatively stable employment, I can provide all of those things for my daughter," she says.
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