My patient, who I’ll call Jill, told me she was going to die if she stayed pregnant. She wasn’t being dramatic. Jill had almost died in her previous pregnancies.

As I went through each of her problems with her, my patient could clearly describe important details. By the time we reached her fifth significant health problem, I knew we could not safely provide her abortion in our clinic. This had never happened to me. Every sick patient I had seen before could still safely have her abortion in our clinic. But the woman sitting in front of me was different. Every patient is unique; every situation is different. It is my job to take care of each individual patient.

I told Jill she needed her abortion at the hospital where I worked instead, where her abortion could be done with an anesthesiologist monitoring her heart. She started to cry. It had taken her two months to scrape together the money for today’s abortion. We called the hospital where I worked to see how much the abortion would cost there. It would cost eight months of Jill’s salary. Her medical conditions were not life-threatening at that moment, but she could suddenly die in the next two months. And so it seemed unlikely that her Medicaid would pay for the abortion. She left the clinic crying, telling me she would have to self-manage her abortion because she didn’t want to die.

I think about her every day. I think about her two young children. I think about how we could have helped her if Medicaid paid for abortion without exceptions. I don’t know what happened to her. Had Medicaid covered her, I would have been able to care for her.