Weaponizing the Law to Punish People for Miscarriage

A legal system that recognizes fetal personhood punishes people for their pregnancy outcomes and strips them of their rights in the name of protecting the fetus. One striking recent example comes from Texas, where the state Supreme Court recently ruled that Kate Cox could not have an emergency, life-saving abortion. And in October, an Ohio woman was charged with a felony after her miscarriage.

Miscarriage is normal. Subjecting people who have miscarriages to criminal punishment is needlessly cruel, counterproductive, and relies on a legal understanding that pregnant people are a lesser class of person.

‘I Don’t Want To Die’: Texas Patients Are Afraid to Get Pregnant

The fear of losing their lives is precisely what many pregnant Texas residents say they’ve experienced after four young women died in the state when they were unable to access medically necessary abortions.

Three died while doctors delayed their care for hours as they miscarried. Another, Tierra Walker, was 20 weeks pregnant and suffered from soaring blood pressure that had required multiple hospitalizations, yet was given no option for what would have been a lifesaving abortion by any of the 90 doctors who examined her.

She died in bed of preeclampsia, a serious, persistent high blood pressure disorder, and was found by her son on his 14th birthday.

Two of the dead women were also already moms, while another, Nevaeh Crain, was just 18 and expecting her first baby when she died of an infection while miscarrying. Crain had been sent home by two hospitals in the hours before her death, and a third delayed care while they waited to confirm that her fetus had no heartbeat.

These deaths and near-deaths have created an atmosphere where “100% of my patients are afraid” of experiencing complications in their pregnancies, said Dallas OB-GYN Dr. Austin Dennard. “It’s an extra stress to every stage of pregnancy. These laws are stealing the joy out of pregnancy.”

“Women are afraid to get pregnant in Texas. There is a pervasive unease with pregnancy. Women in their 40s with high-risk pregnancies are very afraid. Those pregnancies are fraught with difficulties,” she said.

After Years of Silence, Texas Medical Board Issues Training for Doctors on How to Legally Provide Abortions

For the first time since Texas criminalized abortion, the state’s medical regulator has instructed doctors on when they can legally terminate a pregnancy to protect the life of the patient—guidance physicians long sought as women died and doctors feared imprisonment for intervening.

The new training from the Texas Medical Board was released nearly five years after the state passed its strict abortion ban in 2021, threatening doctors with severe penalties. Pregnancy became far more dangerous in the state after the law took effect: Sepsis rates spiked for women suffering a pregnancy loss, as did emergency room visits in which miscarrying patients needed a blood transfusion; at least four women in the state died after they didn’t receive timely reproductive care. More than a hundred OB-GYNs said the state’s abortion ban was to blame.

The new medical training, which ProPublica obtained under a public records request, assures doctors they can now legally provide abortions, even when a patient’s life isn’t imminently in danger, and goes over nine example scenarios, including a patient’s water breaking before term and complications from an incomplete abortion. 

But medical and legal experts who reviewed the training said the case studies represent only the most straightforward situations doctors encounter. The complications that women face in pregnancy are varied, complex and impossible to capture in a brief presentation, many cautioned. One attorney called the training “the bare minimum.”

Tierra Walker’s Family Sues Ken Paxton and Doctors, Saying Texas Abortion Ban Caused Her Death

Tierra Walker was just 37 years old when her son JJ, 14, found her lying facedown and unresponsive on her bed. As he desperately called 911, he cried, “I need you, I need you,” and tried his best to bring her back to life with CPR, following the instructions of the emergency operator. It was too late. He lost his mother and best friend on his birthday.

Walker died at 20 weeks pregnant after multiple ER trips and hospitalizations. She had been examined by 90 doctors, including 21 OB-GYNs, during the previous months. Yet not one of those 90 medical experts Walker met with ever suggested that she do the only thing that could have definitively saved her life—undergo an abortion to end the pregnancy.

Tierra Walker’s family has filed a lawsuit against Texas Attorney General Ken Paxton, the University of Texas Health Science Center at San Antonio, several of Walker’s doctors and others, alleging the state’s abortion ban and her providers’ refusal to offer an abortion caused her death. The suit accuses Texas’ political and medical establishments of “deliberate indifference, discrimination, and medical mistreatment.”

Walker’s family says she repeatedly requested an abortion as her health deteriorated, but hospital staff focused on the fetus’s condition while disregarding the growing danger to Walker.

“For months, Ms. Walker had been asking for termination of her pregnancy—even though this was a wanted pregnancy—because she did not think she would survive the pregnancy,” the lawsuit alleges. “Tragically, she was right.”

Dobbs Has Triggered Widespread Discrimination in Non-Reproductive Healthcare

In the years since Roe was overturned, physicians across a wide range of medical specialties have described how abortion bans are undermining their ability to follow evidence-based standards of care. Dermatologists, oncologists, neurologists, cardiologists and others told Physicians for Human Rights (PHR) that they are regularly forced to alter treatment plans, delay urgent care or avoid prescribing the most effective medications simply because those treatments could harm a pregnancy. These constraints are creating a chilling effect that reaches far beyond reproductive health and into the everyday practice of medicine.

As PHR’s Michele Heisler and Payal Shah explained, abortion bans are also fueling discriminatory care. Reproductive-age women are routinely denied the best available treatments, while men with the same conditions face no such barriers. Even within the group of reproductive-age women, clinicians are making decisions based on subjective judgments about a patient’s “contraceptive reliability”—a practice that opens the door to bias and disproportionately harms marginalized patients.

This two-tiered system of care is not hypothetical: It is already shaping medical decision-making in ban states, with dangerous consequences for patients’ health and lives.

‘Worse Than War’: A Texas Couple Was Forced to Flee the State for Essential Care—Twice

Hollie Cunningham’s family suffered incredible loss during two pregnancies. The mother of two was forced to flee Texas to get the care she needed, as she explains below in an interview with Courier Texas writer Bonnie Fuller.

“I didn’t really know about Texas’ abortion bans. I had always figured that if something were to go wrong with my pregnancy, my doctor would be able to do what she needed to take care of me.

The U.S. Built Wealth Off Enslaved Women and Girls: Michele Goodwin on the History of Reproductive Injustice

Goodwin, an expert in constitutional law and health policy, uncovers the reproductive health rights stories embedded in American history—and what they tell us about the future of our fight for reproductive freedom.

Listen to the second episode Ms. podcast, Looking Back, Moving Forward—”Inside the Feminist Fight to Reclaim Our Reproductive Freedom (with Renee Bracey Sherman, Michele Goodwin, Angie Jean-Marie and Amy Merrill, Susan Frietsche, and Gov. Maura Healey)”—on Spotify, Apple Podcasts or wherever you get your podcasts.

An Open Letter to Rep. Kat Cammack From a Medical Doctor: It’s Abortion Bans That Make Doctors Afraid to Act, Not ‘the Radical Left’

No woman may escape the cruelty of the nebulous and varying restrictions on reproductive healthcare in the post-Roe world—as Rep. Kat Cammack (R-Fla.) discovered in May 2024 when faced with a life-threatening ectopic pregnancy shortly after Florida’s six-week abortion ban took effect. Concerned by the lack of clarity in the wording of the law on the limits of intervention in pregnant patients, doctors reportedly delayed administering intramuscular methotrexate to terminate the pregnancy, out of fear of prosecution.

I’m a doctor. In this chaotic landscape, where reproductive healthcare policy and medical reality appear woefully divorced, my colleagues and I don’t know what misstep could land us in senseless litigation or with felony charges.

Rep. Cammack, your voice and your story have power. I hope you use them to reintroduce nuance and common sense to the discussion on women’s lives. There are many of us who will extend a hand across the aisle and work together with you to right some of the senseless wrongs. 

Texas’ SB 31 Could Loosen the State’s Abortion Ban in Life-Threatening Cases. Doctors Say It’s Still Not Enough.

Will a new bill in Texas stop the shocking number of deaths of pregnant women in the Lone Star State? That’s the hope of both Democratic and Republican supporters of SB 31, also known as the Life of the Mother Act. The bill is headed to the desk of Gov. Greg Abbott for signature and there is a strong expectation that he will sign it.

The goal of SB 31, which gathered broad bipartisan support, is to finally respond to the pressure to provide clarity about legal medical exceptions, allowing Texas doctors to perform lifesaving abortions and D&C (dilation and curettage) procedures on pregnant and miscarrying women in need of medical care. Supporters say they believe SB 31 will save the lives of pregnant women—yet many doctors still report uncertainty, and reproductive freedom advocates say the bill does not go far enough to address the loss of bodily autonomy suffered by women in the state.