The ongoing recession has cost millions of Americans their jobs, but for some it's hitting even closer to home. Planned parenthood and other family planning clinics are seeing more patients in their waiting rooms. These clinics generally serve young women between the ages of 18 and 24. But now, older clients—and many without insurance—are coming in. Some are looking for help supporting the children they have. Others are afraid of raising a child they say they can't afford.

Family planning centers and clinics where abortions are performed see firsthand the effects of the economy on women in all age groups and income levels. Some noticed greater numbers seeking help in January.

"It's a time when families are looking at family size and how much they can provide," says Nancy Boothe of the Feminist Women's Health Center in Atlanta, who also saw an increase.

Some people are calling the clinic to see if they can get free birth control. They include middle-class clients who have decided to forego preventive heath care because they just can't afford it. Even older women are finding they are without insurance, perhaps for the first time. Others ask questions about abortion. "We've seen some people who said that they didn't really think that they would ever be making this decision, but recognize that this is a time when they have to think about taking care of the families that they have."

Boothe says. She says the number of abortions has not increased at the Atlanta facility, but Planned Parenthood of Illinois says it performed the highest number of abortions ever at its clinics in January. "I think it's understandable that people who face an unintended pregnancy are weighing their decision about what they want to do about it," says chief executive Steve Trombley. "And I think anybody listening to this interview understands that it's a very different decision today than it was a year ago to expand your family and to have a child."

He says the clinics are critical providers in smaller Illinois communities, including Peoria, Champaign and Decatur, where the economic slowdown has resulted in thousands of job cuts. "We all heard a month ago about the layoffs from Caterpillar, for example," Trombley says. So we have whole communities where people are suddenly being closed off from access to health care, and they rely on the social safety net that we're a part of."

Many women are reluctant to talk about their situations. Some are frightened, others embarrassed. As the recession drags on, two very different scenarios are emerging. Some are concerned that more women who face an unplanned pregnancy in this economy will end up choosing abortion. But there's also fear that women will put off their decision until the second or third trimester, when the cost is even higher—and the procedure is more difficult.