I work in Baltimore, a place where economic hardship is a palpable force of nature. Although I take care of women who were raped, or have fetal anomalies or severe medical diagnoses, many of the most compelling stories I hear are from my patients who seek abortion out of economic necessity.

I remember a patient I took care of a couple weeks ago. As I was doing her procedure, she shared her story. She was the child of a teenage single mother and grew up in poverty. Her mother actually had a stroke while she was pregnant with her – and then went on to have three more children, a total of six.

She told me about how as a child, she had to act as both a sister and a mother to her younger siblings because of her mother’s disability. This helped her to realize how important it is to have a parent present and to be allowed to have a childhood, a rarity in her community.

She told me she was having this procedure to be able to parent her existing two children and finish getting through school while holding a job so she could provide for them. She had this choice because Medicaid paid for her abortion. The concept that if she lived 40 miles south in DC that choice would be taken away from her and those opportunities taken away from her children is unacceptable.