My stomach hurt as I desperately tried to think of something to say to the woman sitting in front of me:

“You know you love your son so much . . . I bet he would love another sibling!”

Annabelle* looked up at me, exasperated. I already knew her answer.

“I just can’t take care of another baby,” she moaned, almost crying.

As a counselor at the crisis pregnancy center where we were meeting, I was ashamed to admit I agreed with her.

New York prides itself on being “pro-choice,” and yet what choices does it actually offer pregnant women? Take a typical case that I see weekdays while doing sidewalk counseling. A young college-age girl finds out she is pregnant. If she lives in New York or another liberal state she has only one option, abortion. Where does she go to find one? Planned Parenthood, the recognizable chain brand, will offer her an abortion up to 24 weeks of gestation. Next is Parkmed NYC, an upscale neighborhood facility that is desperately trying to attract business; it’s open seven days a week and will perform abortions until 30 weeks. And then there are smaller facilities like Early Options, Eastside Gynecology, and Pure OBGYN, as well as scores of independent practitioners who would gladly take her money. Lenox Hill, Bellevue, Columbia, Mount Sinai, and New York Presbyterian are some of the many city hospitals that have expanded their abortion services since the Dobbs decision. If her work schedule doesn’t permit a visit to any of these facilities, she needn’t worry. Mayor Eric Adam’s has launched America’s first abortion-pill-by-mail dispensary to supply the meds to her—free of charge. The poor women of color I saw at the center did not have great insurance. But that’s okay! New York offers free abortions with or without insurance—taxpayers foot the bill.

“Okay, I understand,” I say, trying to fight back tears. “We need to see how far along you are to know what kind of procedure is right for you. Let’s schedule an ultrasound,” I calmly suggest. “What days are you free?”

We make an appointment for the following week, and I pray for a change of heart.

And yet . . . I understood where she was coming from. The “choice” to abort was so easy compared to what she would have to go through if she decided to keep her baby. But she came back the next week and to my utter surprise the ultrasound worked. She wanted to keep her baby. And yet there was no excitement in her voice.

“Okay, so you don’t want to go through with the abortion.”

“I changed my mind,” she said, wearily.

I just looked at her. She was poor but not poor enough. Which means she didn’t qualify for food stamps, WIC, or Section 8 housing. She was married and had a job, usually a plus, but their two incomes—low even when combined—put them out of reach for government assistance of any kind. She worked a 12-hour shift, six days a week, however her employer did not pay overtime, nor did he give her sufficient lunch breaks, or really any breaks at all. She was proficient in English but not to the extent needed to file a worker complaint. However, even if she were, that system is so backed up it probably wouldn’t have changed anything. She was legally here on an HB visa, and yet her legal status made it more difficult to access avenues of government support than if she were illegally here and a single mother. Still, her prospects were better than other mothers I had worked with. Women, for instance, who were homeless or leaving abusive situations with nothing except what they could carry.

Where can a woman go if she is homeless or about to lose housing while pregnant? In New York City there are only a handful of maternity homes. Sacred Heart, run by the Sisters of Life, provides housing for pregnant mothers only. Expect Hope also doesn’t take women with other children and has a strict requirement that they must participate in Bible studies and worship services in order to live there. Good Counsel, with one home in the Bronx and one on Staten Island, does take women with children, and the Missionaries of Charity in the Bronx provides temporary shelter for pregnant women. While New York City offers assistance to poor families or single women with young children, it has spent very little in targeted efforts to help pregnant mothers in need. There are no city-funded maternity homes.

In November New York is likely to pass the Equal Rights Amendment. This bill will solidify abortion on demand in state law and forbid any discrimination concerning pregnancy and pregnancy outcomes. This emphasis on non-discrimination would seem to imply that the state is bound to respect and support a woman’s decision to keep rather than abort her baby. Yet none of the marketing or talking points concerning the bill mention this, nor is there any suggestion that a state that pays for low-income women’s abortions should also pay to help low-income women become mothers. As a prolifer, I would love it if New York City was as ready to help vulnerable women choose life as it is to help them abort their unwanted babies.

For starters, the state needs to overhaul low-income maternity care. Many of the women who come to the center where I am a counselor tell horrifying stories about the subpar care they have received. Juliette* was six months pregnant with a baby she desperately wanted. When she went for a routine OBGYN checkup the doctor informed her the child’s head was shrunken. Immediately she was put on Cytotec to induce early labor and within a couple of hours she delivered a stillborn baby. She is still confused as to what exactly happened, what went wrong, and most importantly why the doctor didn’t catch this complication earlier or explain to her why her baby didn’t survive. She came to us pregnant again and scared. She wanted another child, and yet that experience traumatized her to the point where she was seeking an abortion rather than go through another potential late-term miscarriage. This is not an isolated incident. Substandard maternal healthcare disproportionately affects communities of color. A truly pro-choice state would ensure affordable and high-quality maternity care, especially in low income and vulnerable populations. New York has yet to do that.

A pro-choice state would also ensure access to housing, be it maternity homes or accessible waivers for women who are pregnant and facing a housing crisis. Good quality, affordable childcare, mental health counseling, and free or low-cost parenting classes offered in English and Spanish should be available. These are simple steps New York City could take if it were as committed to making the choice to have a baby as desirable as the choice to have an abortion.

A prolife friend and I joke that we would be Marxists if we weren’t Catholic. Jokes aside, it is true that neoliberalism has not only wreaked havoc on the working class but has also incentivized abortion. Without a strong social-safety net and welfare programs for people in need, the only option that really seems viable to most women is abortion. An authentically pro-choice administration that respected a “women’s right to choose” would honor her choice to keep a child and provide adequate services to help her bear and raise that baby. Sadly, that is not what we have in New York City.

*Names have been changed