Today marks the 40th anniversary of the Supreme Court decision Roe v Wade on Jan. 22, 1973 which legalized abortion in the United States. For many Texan women, however, this right is still beyond their reach.

There are a number of barriers to access, which means – for a lot of women – the “choice” to have an abortion is a privilege they cannot exercise. For a legal procedure that one in three women will undergo before she is 45, there are a lot of hoops – some medically necessary, some political –  to jump through that most Texans don’t realize or think about until they, or someone they know, seeks an abortion. These barriers add to the stigma that surrounds a common, safe procedure that empowers women to control their lives and circumstances in the most basic way; it allows them to decide if or when they will have children.

Many anti-abortion activists have changed tactics and moved from trying to overturn Roe v. Wade to passing state laws that make it so onerous to obtain an abortion that clinics shut down and patients can no longer access legal medical services. 2012 saw a record number of abortion restrictions passed all over the country, and Gov. Rick Perry and some members of the Texas Legislature hope to revisit the issue in this legislative session.

Three years after Roe was decided, the Hyde Amendment was passed, which bans low-income Americans on Medicaid from using that coverage for abortion. It is the only medical procedure that has been banned from Medicaid, which covers a variety of other reproductive health options. This effectively created a separate, and not at all equal, class of women, placing legal abortion beyond their financial reach.

In 1992, Planned Parenthood v. Casey upheld the right to abortion, but also allowed states to enact extreme restriction on abortion. Texas has done just that.

To get an abortion in Texas, a woman must receive state directed counseling designed to discourage abortions. This counseling includes material that cites a thoroughly debunked connection between abortion and breast cancer. This pink, flowered pamphlet [PDF] seeks to dissuade women from having abortions. Physicians have no choice. They are legally required to provide this information, even though most doctors and other medical professional strenuously object to the state imposing itself into a medical conversation between a patient and healthcare provider. Failure to provide the information, however, can cost a doctor his or her medical license.

After enduring this process, a woman is basically given a “time out” and told she must think about it for 24 hours, as if no thought process had occurred before she consulted the doctor.

When you’re talking about low-income women, this also means that she has to take another (often unpaid) sick day, and if she is one of the 33% of women who lives in one of the 92% of Texas counties that don’t have an abortion provider, she is now looking at travel costs, childcare, hotel, gas or airfare. Recovery time, especially after a late-term abortion, adds to these costs.

The state also mandates that a patient must have an ultrasound procedure, and the provider must show and describe the image to the patient before an abortion is administered. This law is designed to make it even more difficult for a woman to carry through and exercise her legal right.

Access can be even more daunting when a patient is faced with a “look-alike clinic,” sometimes called a Crisis Pregnancy Center or CPC, which capitalizes on patients’ confusion to stop them from receiving abortion access. They often position themselves right next to legitimate clinics.

Low-income citizens have a number of barriers to accessing health care in general. They are less likely to have consistent paid days off, steady doctor appointments and access to contraceptives. Often, economic issues are the reason a woman might decide to have an abortion, but they also keep her from accessing that legal right. Patients pay an average of $350-$400 for a first-term abortion. By the time some low-income patients are able to address a pregnancy, they are often even further along in their pregnancy, raising the cost of an abortion even more.

A procedure that starts out cost prohibitive can then become beyond reach.

Last year, the Texas legislature defunded Planned Parenthood, even though the clinics receiving money did not perform abortions. This January, they chose to leave federal family planning money on the table to make sure Planned Parenthood would not be  part of the Women’s Health Program, despite the fact it is a health care provider for almost 50,000 low-income women in Texas. Somehow, Texas HHS officials are claiming that women actually have more options now.  This politicization will only add to the number of unplanned pregnancies and exacerbate the problems for women who have inadequate access to health care, including contraceptives

There are groups working to ease the unfair burden on lower-income Texans. The Lilith Fund is part of the National Network of Abortion Funds, which raises money to help low-income women close the gap to abortion access. We work with a network of clinics that can refer clients to us when they say they cannot afford a baby or an abortion. The Lilith Fund gives grants to help cover part of the cost and we work with patients to find other resources from yard sales to supportive family members.

We help all kinds of women: young, old, students, even professionals. What they have in common is a system that stigmatizes their decisions and actively works against them using legal health care options. We trust our patients, and know they deserve to make the same decisions about when and if to have a child as someone who has more means. We don’t believe that access to care should be based on income. We had nine clients call our hotline in December whose abortions were going to cost them $1000 or more. For many Texans, that’s an unbelievable amount of money to come up with, especially on a time limit.

Abortion funds are a pivotal piece of the puzzle that ensures economic and reproductive justice. On this 40th anniversary, we celebrate how far we’ve come, but we also recommit to our goal of true reproductive equity.

 Lilith Fund will be having a party tonight at The Esquire to celebrate the 40th Anniversary of the Roe v Wade decision and invites supporters to attend and learn more.

Lindsay Rodriguez is on the board of directors for the Lilith Fund for Reproductive Equity, an abortion fund that assists Texans in exercising their legal right to abortion by removing barriers to access. They can be found on twitter @LilithFund and on Facebook.