Where abortion is outlawed, women receive substandard healthcare. Some are fighting back.
This story originally appeared on Jill.substack.com, a newsletter from journalist, lawyer and author Jill Filipovic.
Nearly a year since the Supreme Court overturned Roe v. Wade and pitched women across much of the U.S. back a century or so, reproductive health researchers have begun to paint a picture of just how damaging abortion bans have been. There are, of course, all of the women who want abortions but cannot get them, and are forced into undesired motherhood. And then there are all of the women who are pregnant and are treated as little more than brood mares for a fetus that now has a greater claim to life and to the woman’s body than the woman herself.
A new study from the University of California San Francisco details a few of these cases—and there are surely more that haven’t been reported. Here’s what they found:
- Women well into their wanted pregnancies who developed complications, but were refused care that would have been standard in a pro-choice state because their fetus still had a heartbeat.
- Women who were refused care and wound up with severe infections, and had to be admitted to the ICU.
- Women who saw their fertility compromised—who lost fallopian tubes or uteruses—because they were refused appropriate care.
- Women who were miscarrying and were sent home.
- Women who had fetuses with abnormalities incompatible with life, who were nonetheless forced to continue their pregnancies at unnecessary physical risk (not to mention great emotional pain) and give birth to babies that died.
Here’s one story from a physician:
“I meet her 2 days later in the ICU. She was admitted from the ER with severe sepsis … and bacteremia. Her fetus delivers; she is able to hold [the fetus]. We try every medical protocol we can find to help her placenta deliver; none are successful. She is now on 3 pressors and in [disseminated intravascular coagulopathy]. The anesthesiologist cries on the phone when discussing the case with me—if the patient needs to be intubated, no one thinks she will make it out of the OR. I do a D&C.”
Health workers are so scared of breaking the law that they cannot do their jobs. Many of these anti-abortion laws are written in such a way as to presume that any abortion is a crime; that the abortion was life-saving can be an affirmative defense for a doctor, but by the time you’re putting forward an affirmative defense, you’re in a courtroom. And many prominent abortion opponents claim that abortions are never necessary to save a pregnant woman’s life. So that is what doctors are up against: An anti-abortion movement that says abortions are never necessary, and that also penned the laws that criminalize abortion; these laws say that a doctor can defend herself in court by arguing that the abortion was life-saving, but they’re written by people who say abortions are never life-saving and are always murder. It’s a trap, and everyone knows it.
Health workers also know they are being surveilled and targeted. Not everyone who works in a hospital is pro-choice; what if a doctor gives a pregnant women accurate health information in front of an anti-abortion nurse who construes it as “aiding and abetting” abortion? What if an abusive partner or ex finds out? These laws turn the doctor-patient relationship, as well as relationships between health workers, adversarial and paranoid.
They also cause women unnecessary pain. From another physician:
“Anesthesiology colleagues refused to provide an epidural for pain. They believed that providing an epidural could be considered [a crime] under the new law. The patient received some IV morphine instead and delivered a few hours later but was very uncomfortable through the remainder of her labor.
“I will never forget this case because I overheard the primary provider say to a nurse that so much as offering a helping hand to a patient getting onto the gurney while in the throes of a miscarriage could be construed as ‘aiding and abetting an abortion.’ Best not to so much as touch the patient who is miscarrying. … A gross violation of common sense and the oath I took when I got into this profession to soothe my patients’ suffering.”
Pregnancy should not render women second-class citizens. But in abortion-hostile states, it does.
One bit of good news is that women are fighting back. Fifteen people—13 women denied abortions, plus two ob-gyns—are now suing the state of Texas over the state’s abortion ban. And their stories are horrifying:
Two plaintiffs, Kiersten Hogan and Elizabeth Weller, had their water break prematurely, but were both told to wait until they were sick enough to receive abortion care, according to a draft of the suit.
Hogan was allegedly told that if she tried to leave the hospital to seek care elsewhere she could be arrested for trying to kill her baby, according to a draft of the suit. She was kept in the hospital until she went into labor four days later in the hospital bathroom and delivered her son stillborn.
“I was told that if I tried to discharge myself or seek care elsewhere, that I could be arrested for trying to kill my child. I wanted this baby, so of course I stayed,” Hogan said at a press conference.
“When I needed to use the bathroom, I was accompanied and watched and made sure that I didn’t push,” Hogan said.
Hogan called the experience the most traumatic and heartbreaking experience of her life.
“At every turn, staff reminded me how alone I was and how unmarried I was. I was made to feel less than human,” Hogan said.
Weller had to wait until she developed an infection before a hospital approved her abortion despite her losing almost all her amniotic fluid, which a pregnancy is not viable without, according to a draft of the suit.
“My doctor told me that due to a new Texas law, my request for an abortion had been denied. Now, I was left with one of two options, each cruel and inhumane. I could either stay in a hospital to wait for my baby to die, at which point I could get the abortion I needed to protect my health, or I could go home and wait for either my daughter’s death or for an infection to develop that might cause my own demise,” Weller said at a press conference Monday.
“My baby would not survive and my life didn’t matter. And there was nothing I could do about it,” Weller said.
No woman should have to risk her own life, or compromise her own healthcare, because she is pregnant. Pregnancy should not render women second-class citizens. But in abortion-hostile states, it does.
There is no way to ban abortion and protect women’s health—this is one reason why feminists are almost universally pro-choice. Pregnancy is as messy and complex as any human body; no two bodies are alike, and pregnancy has long been one of the more dangerous things a woman can do.
We are lucky to live in a time when fewer women die in pregnancy and childbirth than in centuries past—and yet so, so many women in the U.S. still die in pregnancy and childbirth. Criminalizing abortion makes pregnancy more dangerous; it renders doctors impotent to treat pregnant women fully and appropriately. It is not convenient for abortion opponents, but the truth is that pregnancies go wrong, and sometimes they threaten women’s lives and our health. Even when everything goes right, pregnancies are tremendously stressful events on the body; they leave their mark, and they cause permanent changes (and often permanent injuries). It is unreasonable and unconscionable for the state to force this on women.
Everyone, including the abortion opponents who penned and passed these laws, understood that this would happen—that with abortion bans in place, women would be injured, that women would not receive a full range of healthcare, that women would die. None of this was a surprise. And for abortion opponents, it’s a tolerable cost.
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