Access to Pregnancy and Parenting Support Services: Women’s Views and Experiences from the 2024 KFF Women’s Health Survey

Following the overturning of Roe v. Wade on June 24, 2022, there has been an increased focus and recognition of the importance of pregnancy and parenting support services for people across the country, especially for those living in states where abortion is banned or severely restricted. Prior research has found that overall states with restrictive abortion laws have fewer policies and programs that provide medical and social support for families and children. The 2024 KFF Women’s Health Survey asked reproductive age (18 to 49) women in the U.S. to rate how easy or difficult they feel it is to access a range of services that are important to the health of women and families. This analysis focuses on women with children ages 5 and under because they likely have more recent firsthand experience with many of these services important to pregnant people and parents, including maternity care, Medicaid coverage, food stamps, contraceptive services, and affordable childcare. A consistent pattern throughout this analysis is that a higher share of women with young children report difficulties in getting access to pregnancy-related services and parenting supports in states that ban or restrict abortion.

KEY FINDINGS:

Maternity Care: Even before the Dobbs decision, there were concerns about closures of hospitals and maternity wards as well as workforce shortages, with current estimates finding that over 5 million reproductive age women live in counties with no or few obstetric providers. Since the fall of Roe, some initial studies have showed that fewer medical students are applying for residency positions in states where abortion is banned and there have been anecdotal reports of OBGYN providers leaving states where abortion is banned, potentially exacerbating longstanding workforce shortages. Nationally, the KFF survey finds that over a quarter (28%) of women of reproductive age with young children say it is very or somewhat difficult to get maternity care in their state (Figure 1). In states where abortion is banned or restricted to the first 6 weeks of pregnancy, one in three (34%) women with young children say it is difficult for women in their states to get maternity services, higher than those who live in states that allow abortions up to 24 weeks or later (23%).

Medicaid: For women with low incomes, Medicaid is an important source of coverage and covers 4 in 10 births in the country. A third of women with young children (32%) say that it is very or somewhat difficult for women in their state to get Medicaid coverage (Figure 2).

Four in 10 women living in states where abortion is banned or restricted to early in pregnancy (41%) say it is difficult for women in their state to get Medicaid compared to less than one in four women (23%) in states where abortion is generally available. Of the ten states that have not adopted the ACA Medicaid expansion, seven also ban abortion or have 6-week gestational limits.

Food Stamps: Nationally, four in 10 women with young children say it is difficult for women in their state to get food stamps (Figure 3). Food stamps, also known as the Supplemental Nutrition Assistance Program (SNAP), provide financial support for groceries to individuals with low incomes who meet their states’ income and resource requirements. Average monthly SNAP household benefits ranged from $183 to $457 in 2019, varying by state. Yet, half (48%) of women with young children living in states where abortion is banned or with early gestational limits say it is difficult to get food stamps compared to three in ten women living in states where abortion is generally available.

Contraceptive Services: One in eight (13%) women with young children say it is difficult for women in their state to obtain contraceptive services (Figure 4). In states where abortion is banned or restricted to early in pregnancy, one in five (19%) women with young children say it is difficult to obtain contraceptive services, double the share (9%) of women who live in states where abortion is generally available. Research conducted following the Dobbs decision reveals a decline in the number of oral contraceptive and emergency contraceptive pills dispensed in pharmacies in states with abortion bans.

Child Care: Nationally, a large majority (72%) of women with young children say that affordable child care is difficult to obtain in their state, standing out as a big challenge for families irrespective of state abortion policy (Figure 5). Median yearly child care costs for one child range from $5,357 to $17,171, and costs are even higher for infant care and vary by state. The issue has gained traction during this year’s Presidential campaign and remains a challenge for most parents of young children regardless of where they live.