Red States are Killing Women Who Want to Be Moms

Watch Your Back: Looking Out for Women and Girls in America #3

Welcome back! I’m not a big trigger warning person, but this newsletter discusses some very serious pregnancy-related complications. Take care.

It’s no secret that the American right wants women to have more babies. At some point soon, I’ll write about all the fun reasons guys like JD Vance are so keen on pronatalism. (A totally wholesome passion shared by Putin, Orban, and—most famously—Hitler.)

Anti-abortion laws are one of the ways they plan to “encourage” women to have children. Abortion should not be used as a form of birth control, they say. (It’s not.) Abolishing abortion—and certain forms of contraception—will help America return to the good old days of heterosexual marriage and big families. (Days which sucked for everyone but were hellish for women. Just ask your grandma.)

So far, the right has managed to make abortion illegal in many states. But they haven’t succeeded in raising the birth rate. Instead, they’ve found their success stymied by a much higher law: the law of unintended consequences.

As we discussed last week, abortion rates have actually risen in almost every American state since Dobbs. With reduced access to clinics, women have turned to abortion pills, which are safe, effective and easy to send through the mail.

You’d think the right would be looking for ways to make it easier for women to have children, but instead they’ve managed to make pregnancy more dangerous than it has been since the advent of modern medicine.

We warned them that abortion bans would cause death and suffering. They chose not to listen. Now, in one of the great ironies of our time (and there are so many), it turns out the women suffering most are NOT those seeking abortions.

Far more often, the right’s victims are women who WANT to have children. And they are doing everything they can to sweep this inconvenient truth under the rug.

Anti-abortion laws are killing and traumatizing women who WANT TO BE PREGNANT.

After Texas banned almost all abortions in 2021 (a year ahead of Dobbs), the state saw maternal deaths shoot up 56% . These were not women “using abortion as birth control.” These were women who went to a hospital to have a baby—or to be treated for a pregnancy-related emergency—and did not come out again.

Across the country, women are being refused care for common pregnancy-related emergencies like miscarriages and ectopic pregnancies. Seven deaths have been directly tied to anti-abortion laws so far. (Ms. Magazine is keeping a running list.) More often, patients survive—but return home horribly traumatized by their experiences. Some bear physical scars that leave them unable to have children in the future.

WHY THE HELL IS THIS HAPPENING?

Let’s pause for a moment to acknowledge how much abortion has changed in the past few years. The image in people’s heads may be quite out of date.

Today, at least 63% of abortions are medication abortions. Women who are less than 10 weeks pregnant take two pills in the privacy of their own homes. They endure some cramping then expel tissue so small that it is usually invisible to the naked eye.

The remaining 37% are surgical abortions. Before the second trimester, this almost always involves vacuum aspiration and/or a simple procedure called a D&C (which is used for a wide variety of conditions).

93% percent of abortions take place in the first trimester (before 13 weeks). Almost all of what the right calls “elective” abortions take place at home, in a private doctor’s office, or at a clinic.

Now that we’ve got those facts out of the way, let me be clear:

No woman in America goes to a f**king HOSPITAL when she wants an abortion. And yet that’s where women are being denied care.

Women who go to hospitals with pregnancy-related emergencies are women who WANT to have a baby but have been told one of the following:

1. Their fetus has severe medical abnormalities

2. Their fetus cannot survive outside the womb

3. Their fetus has already died

4. They are sick and need treatment that may threaten their pregnancy.

Let’s set the fourth aside for the moment. The first three are far more common.

Many of these terrible discoveries are made after fetal testing (usually done weeks 15-20). The procedure for removing a fetus that is dead, dying, or possesses severe medical abnormalities is an ABORTION.

The day a woman finds out her fetus won’t survive is likely the worst day of her life. But if she lives in a state like Texas, she’s about to have a whole heap of trauma dumped on that injury. She will be informed—often to her great surprise—that the hospital can’t do anything until HER life is at risk.

Keep in mind, there’s nothing that can be done to save the fetus. There is no reason whatsoever that the mother’s life needs to be put in greater jeopardy. And no one knows what “at risk” really means. The laws are purposely left vague to keep doctors and hospitals scared shitless. If a doctor acts sooner than the state deems fit, they can be jailed for 99 years. Legally, a doctor is helpless to act until their patient is at death’s door.

So a woman who WANTS A BABY but faces a pregnancy-related complication in a red state may:

• Be sent home carrying a dead fetus and told to wait for a “natural” miscarriage

• End up hemorrhaging so badly she almost bleeds out in the bathtub

• Be sent to the hospital parking lot to wait in her car until she’s sick enough

• Be forced to carry a non-viable fetus to term

• Die of sepsis or lose her uterus

There are stories so awful they will sear themselves into your memory and forever fuel your nightmares. Here’s one I came across in New York Magazine just this morning:

[W]hen Kiersten Hogan was 19 weeks pregnant, her water broke. According to the complaint she later joined against the state [of Texas], Hogan was detained against her will in the hospital: She was told that as long as a fetal heartbeat was detectable, she would be kept there, on bedrest, until she either began contractions or became sick enough to qualify for an abortion. She said hospital employees told her “that if she tried to leave the hospital it would be used as evidence that she was trying to kill her baby; that if she tried to do anything to end her pregnancy, criminal charges could be brought against her.” Four days into her hospital detention, Hogan had a stillbirth in the bathroom.

I hope this goes without saying, but no one should ever be held captive in a hospital and forced to give birth to a stillborn baby in a bathroom. That’s a f**king human rights violation.

These stories are hard to stomach. But we cannot turn away. At some point this weekend, I will summon my courage and force myself to watch the new documentary Zurawski v Texas, which follows three women denied abortion care while facing life-threatening pregnancy complications. I hope you’ll join me. It’s streaming for free on multiple platforms.

These cases covered in the documentary have received nation-wide attention. And yet, I still hear women say . . .

“IT WON’T HAPPEN TO ME”

There are red state women out there—republican and democrat—who believe they (or their daughters and nieces) are safe from anti-abortion laws. They’re married. Family-oriented. They want kids—tons of them!

I take no pleasure in saying this: YOU ARE THE ONES THEY’RE KILLING.

I’ve heard affluent types say, “I’ll just fly to a state where I can get care.” Think again, sister. Sepsis from an untreated miscarriage will kill you in a matter of hours. Even a plane ride will be out of the question. You will be stuck just like everyone else.

Just the other day someone told me, “I’ll make sure I have a good doctor.” A lot of right wingers seem to believe that women are suffering and dying because of bad doctors, not bad laws. And yet they can’t point to any malpractice cases. You know why? Women are dying in red states because doctors are following the laws.

“Well if the laws need to be fixed, let’s fix them!” some tell me. And yet every time fixes are proposed, the same activists emerge from the woodwork to defeat them. The Biden administration even tried to force Texas hospitals “to perform abortions if needed to stabilize a patient's emergency medical condition.” And the United States SUPREME COURT stepped in to let Texas keep killing women.

You’d think the right would worry about the bad PR, if nothing else. Here they are telling women to have more children—then letting them die when something goes wrong. But they have no intention of changing their policies. Instead . . .

WHEN WOMEN DIE, RED STATES COVER IT UP

Pregnant women keep dying, so at least two red states have simply stopped reporting maternal mortality rates. The Texas Maternal Mortality Committee, likely upset by that terrible leap in maternal mortality I mentioned earlier, recently decided not to issue any reports for the two full years following the Dobbs decision. Georgia fired an entire maternal health panel after word got out that two deaths had been directly linked to the state’s anti-abortion laws.

BUT THERE’S MORE

Women in red states are in danger whether they’re pregnant or not.

The unintended consequences of abortion bans keep piling up. And the victims never seem to be the women the right wants to punish.

The New Yorker ran an excellent story this week about the exodus of ob-gyns from Texas. These doctors don’t want to face the kind of soul-destroying situations described earlier in this newsletter. And who can blame them? Other states with anti-abortion laws are seeing doctors flee as well. In fact, the March of Dimes reported that 35% of American counties are "maternity care deserts” without any doctors, nurses, midwives or medical centers specializing in maternity care. (Their map below.) As I know from personal experience, pregnancy is f**king dangerous. Many complications demand immediate treatment. You may not have time to drive to the next county. If I had lived in one of the red squares on this map when I needed an emergency c-section, I might not be around today.

But it’s not just maternity care givers who are leaving. Doctors and nurses who specialize in other types of women’s health care are also fleeing red states. On Threads, I recently offered the example of breast cancer radiologists. (Which Texas is currently losing in droves.) No doctor wants to tell a woman who’s 6 weeks pregnant and has just been diagnosed with cancer that she’ll have to wait 7+ months for treatment. So they’re getting the hell out of Dodge. And that means the women of anti-abortion states may soon find doctors of all sorts hard to come by.

I’ve also heard that medical schools in anti-abortion states are being forced to tell prospective students that they will not be receiving training necessary to practice medicine in other states. So they’re starting to avoid states with abortion bans. Fewer doctors means worse care for everyone.

BUT NONE OF THIS WILL KEEP THE RIGHT FROM “ENCOURAGING” WOMEN TO HAVE CHILDREN

I really meant to talk about contraception in this newsletter, but I’ve reached my word limit. NEXT WEEK we’ll discuss what Project 2025 has in store for Plan B, IUDs, pills and more. But if you like having your contraception covered by insurance, you should probably go ahead and ask your boss whether they think you should have access to birth control. Because they may soon be the ones making those decisions for you. How silly of you to think it was your call!

SO WHAT ARE WE GOING TO DO ABOUT REPRODUCTIVE RIGHTS THIS WEEK?

1. Watch Zurawski v Texas

2. Make sure your loved ones know the risks involved in being pregnant in a red state

3. When trying to talk sense to people, make it clear how the issues will affect their lives. Assume they don’t care about other people or the greater good. Because if there’s one thing I learned from the last election, it’s that most people don’t.

4. I know it’s early, but we need to start thinking about the 2026 elections. Getting the House back is the first step toward turning this shitshow around.