After completing these initial steps, she sits in the waiting room, listening for her name to be called. She describes what happens after that: “They take your blood pressure and your temp. And then if everything is okay, you wait and get your finger pricked to test for your iron and your protein and stuff…Usually, it be during my time of the month that my iron really goes down.” Lately, the iron pills she has tried haven’t been working. This terrifies her, because “donating” is the bedrock of the family’s finances right now. The phlebotomist in charge of the finger pricking has told her that “if the iron pills don’t help, [it means] I could be, like, anemic.” Anemics are barred from donating.

Today, like other days, she’s nervous—what will happen if she is not allowed to give plasma? The family desperately needs the $30. They’re now nearly three months behind on the rent. Once she passes all the tests, she proceeds to the back room, where she’s directed to a recliner. Today she has brought along a Nicholas Sparks novel she checked out of the library. “I always bring a book with me,” she says.

A technician feels around for her vein with a plastic-gloved finger, rubs on some iodine with a Q-tip, positions an IV, and inserts a needle. For the usual donor, the procedure takes about 45 minutes, but for her it takes well over an hour, as she is just over the minimum weight of 110 pounds. “I get tired. Especially if my iron’s down, I get, like, really tired,” she says. The ritual takes roughly three hours, door to door. Even so, the payoff is relatively good: $10 an hour. As long as her iron, blood pressure, and temperature are okay, she’ll donate as often as she is legally allowed.

Later, she says the procedure makes her squeamish. “I can’t ever look at it. I never look at it when they do it. They do it right here,” she says, pointing to the obvious indentation at the crease in her arm, which looks somewhat like a drug track line. Many among the extreme poor bear these small scars from repeated plasma donations.

* * *

Before welfare died in 1996, a family of three couldn’t live solely on the $360 or so the program provided on average. Just prior to welfare reform, it took roughly $875 to meet such a family’s monthly expenses, but families could generally get only about three-fifths of that from the combination of cash welfare and food stamps.

To make matters worse, when a mother secured a job, she would lose about a dollar in welfare benefits for every dollar she earned. Often, she couldn’t afford to rely only on earnings from work in the formal economy. Work paid only a little more than welfare but cost a lot more in terms of added expenses for transportation, child care, health care, and the like. It was more expensive to go to work than stay on the welfare rolls.