This thoughtful piece on RH Reality Check points out that women’s economic situations often affect their reproductive choices, providing an illustrative example of how actual reproductive freedom is dependent on a variety conditions  including the physical location of services, social context, knowledge of services, and ability to pay.  These stories prove the importance of public funding for reproductive health services to ensure that all people have the actual, not just nominal, ability to make decisions about their reproductive lives.

From “The Economic Crisis: A Generation of Reproductive Health “Horror Stories” by Carole Joffe:

…But as we enter a new era, with the end of the Bush presidency coinciding with the worst economic crisis since the Great Depression,  I see different types of reproductive horror stories emerging. These stories transcend the abortion divide. They speak squarely to the economic devastation facing Americans across the political spectrum, and how this crisis impacts people’s reproductive lives.  Three recent items in the news serve as examples.

The first is the story of Starla Darling, a pregnant Ohio woman, who was informed she would soon lose her job and her health insurance.  She rushed to a hospital, requested a medication to induce labor, and had an emergency Caesarean section, two days before her health insurance expired. Not only was Darling upset about having a C-section birth — “I was forced into something I did not want to do” — her insurance company refused to pay for the birth.   Now this unemployed woman, two months behind on her rent, is facing medical bills of more than $17,000.

The second story, from the Wall Street Journal, concerns the increase in women seeking to donate eggs or serve as surrogate mothers, a rise attributed to economic hard times.  “Whenever the employment rate is down, we get more calls,” said an said a spokeswoman for an agency in Chicago, who reported a 30% rise in calls. “We’re even getting men offering up their wives.”

One of the most high profile recent cases of women using their eggs and uteruses to cope with economic difficulties came to light in a much-discussed New York Times magazine story of a Times writer who hired a middle-class woman, from a two-earner household, as a surrogate mother. The story revealed that the woman who served as a surrogate was doing so to help pay for her daughter’s college tuition. The daughter in turn was contributing to her college costs by selling her eggs.

These stories are particularly striking to me because in each case, the economic crisis is driving women to do things with their bodies that they otherwise would not do (a phenomenon, of course, that always rises in economic hard times).  True, some women prefer elective C-sections to vaginal birth, but Starla Darling clearly was not one of them.  With egg selling and surrogacy, the motivations are always a little murky — is it altruism and/or a desire for financial compensation? — but the current spike in inquiries is making clear that many women are now drawn to this option because of the latter, and that seems the case with the mother-daughter pair mentioned above.

Via here.