When the media misrepresents maternal deaths, it can discourage other women from seeking the care they need
(Commonplace) After the Supreme Court overturned Roe v. Wade, everyone, pro-life and pro-choice alike, waited with quiet dread for the first body to fall. Not the steady, rainfall-like pitter-patter of over 1,600 deaths per day of children in the womb. The first real body. Not a puzzle of tiny limbs being reassembled in a products of conception lab, but a woman who had breathed and lived, and whose own heart would have kept on beating but for an abortion ban.
The wait was longer than most of us, myself included, expected. In the days after Dobbs, trigger bans caused clinics to flicker closed—open—closed as injunctions and stays were hashed out in state courts. Abortion doctors called patients each morning to clarify whether abortion was legal today. Abortion funds committed to paying for women’s flights, hotels, and medical bills so that abortion would keep on happening, just somewhere else.
There were odd attempts to conjure up victims. A JAMA paper pointed out that infant mortality went up compared to other states after Texas passed its heartbeat law. But this was because, as the paper pointed out, more children with congenital problems were being born in Texas. If they had been screened and aborted, as they might have been elsewhere, it would have counted as bettering infant health.
Texas also had an increase in abandoned babies, some of whom have been found in time to be saved, while others died. Again, these deaths were reported as the fault of abortion laws. The implication is that when the children die earlier, in the privacy of a clinic, it’s liberation, but when they die publicly and visibly, it’s a tragedy. These two strains of reporting argued that abortion laws were obstructing the right kinds of deaths.
It took until 2024 for The New Yorker to surface the first woman who potentially died because of an abortion ban. Writer Stephania Taladrid put the question starkly: “Did an Abortion Ban Cost a Young Texas Woman Her Life?” A close read of her reporting reveals the answer is no. Taladrid’s story was the first of what has become a genre of attempted abortion exposes featuring vulnerable women who face medical neglect that is cast as the fault of abortion laws.
Even when no abortion is sought, even when a baby has already died, abortion laws are blamed as the reason a paramedic dawdled in an emergency, a clinician failed to give a patient the information she needed, a doctor sent a septic woman home.
Writer Stephania Taladrid put the question starkly: “Did an Abortion Ban Cost a Young Texas Woman Her Life?” A close read of her reporting reveals the answer is no.
[Click here to subscribe to Pregnancy Help News!]
In some cases, misstatements about the law in abortion reporting put more women at risk. A woman reading these abortion death stories could be left to conclude that one doctor’s personal and severe negligence was in fact what her state requires of all doctors. This is false, and at least one woman appears to have died due to believing there was no hope in seeking care.
Start with the facts. Yenifer ‘Yeni’ Alvarez-Estrada Glick had a high-risk pregnancy. She lived a long drive from a hospital with a labor and delivery ward, and women in her community sometimes gave birth in the local ER. Glick had diabetes and hypertension, and she was overweight. She had a history of pulmonary edema. In her first trimester, she had some bleeding and difficulty breathing. She was uninsured. For a number of the doctors that Taladrid interviewed, this made Glick a clear candidate for a therapeutic abortion but for one other risk factor—she lived in Texas.
The boundaries of when a chronic condition could trigger a “life-of-the-mother” exemption are blurry. Every year, many women with conditions similar to Glick’s successfully deliver babies and make a full recovery. It’s hard to write a narrow exemption about possible complications that could emerge. Broader health exemptions include chronic conditions and, plausibly, all pregnancies. For example, Indiana’s law is expansive enough to allow abortion “to prevent any serious health risk,” and every pregnancy possible clears this bar.
As a woman who has had a previous C-section (and two subsequent vaginal births), I’m high-risk enough that the local birthing center won’t take me as a patient. A prior C-section means I have a higher risk of catastrophic hemorrhage than other mothers. About six in a thousand moms trying to give birth vaginally after a prior C-section will need a blood transfusion due to excessive bleeding. It’s a small chance of a serious complication. If it’s a serious enough risk for a birth center to decline the delivery, does it meet Indiana’s standard of a “serious health risk?”
Even under Texas’s more restrictive health rule, plaintiffs argued that the exemption for “a serious risk of substantial impairment of a major bodily function” could apply to all pregnancies. The plaintiffs argued that fertility was a “major bodily function,” and that any undesired pregnancy carried a small but serious risk of hysterectomy or other damage for the reproductive system. An unwanted pregnancy now could limit the ability to have a wanted pregnancy later.
But for Glick, the legal questions of when a risk became serious or which bodily functions were major were irrelevant. She wanted to hold her baby.
She knew it was a struggle to stay well—she was uninsured, she couldn’t afford the rest she needed, she skipped doses of the medication she and her baby relied on so the side effects wouldn’t interfere with her work as a home health aide.
When Glick and her baby girl made it to 23 weeks, the point of periviability, she was in the hospital again because her blood pressure and pulmonary edema were dangerous for them both. Again The New Yorker‘s reporting raised the question of whether Glick should have been offered an abortion at this point. She could feel her baby moving, and had already named her Selene. She told her mother, if it came to a question of her life or the baby’s, she wanted her mother to save her daughter.
Elsewhere in America, Selene might have been delivered at this point, and she would have had a reasonable chance of survival. In hospitals that commit to improving their care for periviable babies, two in three babies born at 22 weeks pull through. However, less aggressive hospitals don’t habitually refer patients to the best care, and often deny that anyone could do more for a vulnerable child. When doctors don’t practice care, their ability to provide it degrades.
Glick was one of many mothers who wasn’t able to get the level of care she needed for her baby or for herself. Without insurance, Glick would have been an EMTALA (Emergency Medical Treatment and Active Labor Act) patient. EMTALA exists to prevent hospitals from turning away patients seeking emergency care. Under EMTALA, Glick needed to be screened, and could not be discharged until she was stable. But “stable” can simply mean that her blood pressure was back in the “safe” range at the time of discharge. Everyone, Glick included, understood she would not be stable for long.
At 31 weeks, Glick slipped into a medical crisis. The paramedics who came to meet her dawdled in her driveway. Her heart stopped beating by the time she got to the local ER. When the doctors delivered Selene by Caesarean, she was dead, too. Her baby shower had been scheduled for that weekend.
Almost every baby delivered at 29 weeks survives. If Glick had received continuous care, there is every reason to think, even with her comorbidities, doctors could have cared for both patients. Instead, both Glick and Selene died.
For Glick, her care was constrained by her poverty, her lack of insurance, and her distance from competent doctors. Even if no one raised abortion explicitly, her instructions to her mother made it clear she didn’t want to end her child’s life to improve her own prognosis. Framing her case as the fault of an abortion ban presumes that abortion is the escape clause for bad medical care.
Poverty and marginalization are the preexisting conditions that put a woman’s health at risk and make abortion “necessary.” For many women, these conditions aren’t easy to escape—it’s not a matter of diet or exercise or time. If this level of risk requires abortion, it implies that the social determinants of health make it impossible for poor women to carry safely to term. Abortion is the stopgap that is supposed to save their lives at the cost of their children’s.
Saying women who can’t receive adequate care should be counseled to abort is a brutal exile from hope. This isn’t “put on your own air mask before helping others.” It’s asking poor women to reconcile themselves to a much deeper impoverishment—only one air mask available, pick you or your baby.
Expecting poor women to rely on abortion to protect them from care deserts or underinsurance is oppression redistributed. They face unjust treatment from doctors. The proposed recourse is to destroy the child that exposed them to malpractice. The physical peril they might willingly endure is turned inward onto the child they carry. Abortion is not and cannot be seen as the solution to the way we fail vulnerable pregnant women.
Even if no one raised abortion explicitly, her instructions to her mother made it clear she didn’t want to end her child’s life to improve her own prognosis. Framing her case as the fault of an abortion ban presumes that abortion is the escape clause for bad medical care.
The stories that have followed Glick’s have continued to misrepresent on the law and the standards of care for pregnancy, miscarriage, and complications of abortion. Abortion advocates have put women at risk, and may have misled doctors by exaggerating their legal risk.
Across the country, not a single state sets penalties for a woman who procures an abortion or for a doctor who treats complications that follow from abortion after the baby has died. Not a single state prohibits the removal of a baby from the fallopian tube in an ectopic pregnancy to save a mother’s life.
However, formal reporting and informal anecdotes shared on social media have falsely indicated that women should not expect to receive care—leading at least one woman to stay at home, dying rather than seek the care she assumed was out of reach.
Across the country, not a single state sets penalties for a woman who procures an abortion or for a doctor who treats complications that follow from abortion after the baby has died. Not a single state prohibits the removal of a baby from the fallopian tube in an ectopic pregnancy to save a mother’s life.
In the initial days after Dobbs, there may have been legitimate confusion about new laws, some enacted via trigger, or simply written many years ago and never repealed. Hospital lawyers, accustomed to conservative guidance, may have been reluctant to endorse carve-outs that had not yet been tested in court. But enough time has passed that practitioners should know the law and be aware that other doctors have not been sued for providing miscarriage care.
In some cases, poor care was interpreted as universal policy, and misinformation spread virally on social media. Ryan Hamilton and his wife sought medical care in Texas when she began bleeding at 13 weeks. The first doctor they saw confirmed their child had died, and prescribed misoprostol to medically manage the miscarriage. She took the medicine, and then the second dose prescribed, but it didn’t appear to be helping.
When Hamilton got in touch with a doctor at the Surepoint Emergency Center where they’d been seen, the doctor he spoke to would not prescribe any more misoprostol, and Hamilton was left with the impression that Texas law was the reason why.
He went with his wife to a hospital he did not name, and the doctors there confirmed that the child had died, but said that the situation did not, in their estimation, require a dilation and curettage (D&C) to remove the baby’s body and placental tissue to complete the miscarriage. These doctors did feel comfortable prescribing more misoprostol. After taking the prescribed medicine, Hamilton’s wife began bleeding more and collapsed, unconscious, in their bathroom. He rushed her to the emergency room, and she was stabilized.
For Hamilton, this was proof that doctors were denying care at the cost of endangering women. But, reading his telling, two things are clear: First, he and his wife were treated in a brusque, uncompassionate way in a time of grief and crisis, and second, the law was not the problem.
As Hamilton tells it, doctors at both places confirmed that his child no longer had a heartbeat, and thus the Texas law on abortion was irrelevant to their care. Texas defines abortion as “the act of using or prescribing an instrument, a drug, a medicine, or any other substance, device, or means with the intent to cause the death of an unborn child of a woman known to be pregnant.” Elsewhere in the legal code, it specifically notes that an unborn child is “an individual living member of the homo sapiens species.” The moment the Hamilton baby died, the law ceased to be relevant to their care.
The Hamiltons’ doctors clearly knew that. Prescribing misoprostol was allowed because they understood they were not carrying out an abortion according to Texas law. There is no remotely plausible reading of the law that allows misoprostol to be prescribed once but not twice, nor one that would allow misoprostol but not a D&C. When Hamilton asked for more medication or medical intervention, it wasn’t the law that prevented him and his wife from receiving additional treatment. It was a mix of the doctors’ judgement and the limits of the places he sought care.
Tweet This: Maternal deaths misrepresented: Even when no abortion is sought, even when a baby has already died, abortion laws are blamed as the reason.
A first-trimester miscarriage might be addressed with medication, surgery, or neither. A doctor who prescribes misoprostol might want patients to wait longer to see if the miscarriage will progress, even if the patient would rather have it over with. For the bereaved parent, waiting for a miscarriage is hard—getting time off work means admitting you were pregnant. Going to work means risking bleeding in the office bathroom and losing the chance to recover your baby’s body for burial.
Doctors’ concerns are focused elsewhere—on exactly what happened to Hamilton’s wife. Medication-managed miscarriages can be more painful, or bring on heavy bleeding that requires surgical intervention. So, too, can medication-induced abortion. When doctors don’t give a clear explanation of the tradeoffs and potential consequences, they fall short of the patient’s expectations of informed consent.
Doctors may not adequately warn patients about the pain, just as they often fail to do for IUD insertion. They may describe bleeding (“a heavy period”) in ways that fall far short of patients’ experiences. A woman who calls in because she is experiencing frightening bleeding may be surprised to hear from the nurse’s line that passing clots “up to the size of a lemon” is normal.
In my own experiences of miscarriages (unaugmented by medication or surgery), what I heard from doctors in the exam room about what to expect didn’t match what actually happened. When a woman calls in and is told everything is safe and fine, even when it’s wildly different than what she was told would happen, it’s disorienting and discouraging. When the nurse seems a little irritated a mother called in, even when it’s based on the very criteria she was told merited a call (“You filled a pad in an hour? That’s fine, just call back if it keeps going”), it can make her more reluctant to pick up the phone a second time. When seeking care, I’ve had three separate doctors scold me for crying while miscarrying.
Care is not just the provision of medical services. Holistic care requires building trust both through explaining what is happening and why, and reassuring patients that their care team doesn’t hold them in contempt for their suffering.
Incomplete answers made the Hamiltons’ experience harder than it needed to be. I have no doubt they were denied a D&C at the Surepoint Emergency Center, for the simple reason that Surepoint does not perform D&Cs for anyone. It does not perform surgeries, period. It’s a freestanding ER, unconnected to a hospital, that can’t admit patients for further care. Hamilton clarified on twitter that Surepoint simply told them, “If you want a D&C, you’ll have to go somewhere else.” Because they didn’t explain why they were saying no, Hamilton was left unsure whether anyone would offer them care.
I have no doubt they were denied a D&C at the Surepoint Emergency Center, for the simple reason that Surepoint does not perform D&Cs for anyone. It does not perform surgeries, period.
It’s worth highlighting stories of poor or confusing care to make sure doctors’ mistakes are not repeated, but it’s also essential to be clear about patients’ rights and recourses so a patient doesn’t conclude that there’s no point in seeking medical attention. The death of Candi Miller, in Georgia in 2022, was the result of misinformation around when and whether doctors would treat a woman who had an abortion.
Miller was 41 and had lupus, diabetes, and hypertension. She sought an abortion because she knew her chronic conditions meant any pregnancy would be a high-risk pregnancy. None of these conditions are incompatible with safe delivery given proper care, but Miller may have expected she wouldn’t receive it. She ordered abortion pills online, and took them. ProPublica’s reporting does not make it clear how far along in pregnancy Miller was, and, if she ordered pills online without speaking to a doctor, she may not have known either.
The bleeding and pain were more intense than she expected, but per her family, she did not want to see a doctor “due to the current legislation on pregnancies and abortions.” Alone, suffering, she took several kinds of painkillers—her autopsy revealed fentanyl among others in her system. It was broken trust that left her to die at home. A D&C is and was legal in Georgia to manage the consequences of abortion when the baby has died.
Exaggerated reporting of what the law allows or forbids doesn’t just endanger mothers like Candi Miller; it offers cover to doctors who offer subpar care to vulnerable mothers, and then hide their malpractice behind the false excuse of the law. In one final example, reporters Lizzie Presser and Kavitha Surana did an excellent job laying out the failures of care that led to the death of 18-year-old Nevaeh Crain and her baby, while drawing the wrong lessons.
Crain was sick on the day of her baby shower and, at six months pregnant, went to two ERs with strong signs of infection. The second ER diagnosed sepsis, and then discharged her—a horrific failure of care. No abortion law prevents a hospital from admitting a mother for continued monitoring and treatment for infection. No abortion law prevents delivering her viable six-month child, so that both mother and child can be treated separately.
A “life-of-the-mother” exemption would apply in the case of pre-viable sepsis, but it’s wholly irrelevant when the baby can be delivered. A doctor who offered to kill a child to treat sepsis at six months gestation would be as wholly out of line as one who offered abortion, not early delivery, as the treatment for preeclampsia.
But Crain wasn’t offered the standard of medical care. She was sent home, where her baby, Lillian, died, and where she got sicker. When Crain’s mother took her back to the hospital that had refused to admit her, the OB on duty confirmed the child had died. At this stage of development, the death would have been recorded as a stillbirth. The doctors, despite having a record of her baby’s death, didn’t treat Crain and dilly-dallied for various reasons, including waiting for an ultrasound.
There is no interpretation of the law that could justify this neglect. If the doctors were genuinely in doubt as to whether Crain’s baby was still alive, she should’ve been rushed into surgery to save her and her baby while it might still be possible. When my first daughter presented much less frightening symptoms of distress, it took less than 20 minutes from when my midwife said she thought the baby had to come out now till I was flying through the halls into an OR. The doctor’s slowness showed that either he knew the baby was dead, or he didn’t care if the baby would die. And, in the meantime, he treated Crain with just as much callousness.
There is no interpretation of the law that could justify this neglect. If the doctors were genuinely in doubt as to whether Crain’s baby was still alive, she should’ve been rushed into surgery to save her and her baby while it might still be possible.
One of the doctors who discharged Crain had previously been sued in 2002 for improperly neglecting a woman with an ectopic pregnancy. When Shiketa Walker came into the office with pain, bleeding, and an empty uterus on ultrasound, Dr. William Hawkins told the nurse to send her home. She sought out a second doctor, who diagnosed her with “constipation” and sent her home. She died when her ectopic pregnancy ruptured. This was long before Texas had abortion bans of any kind, and Walker was not seeking an abortion. She died because she had two neglectful doctors.
Hawkins went on to miss other infections, harming other patients, and the Texas medical board placed him under restrictions in 2015. The board noted three patients had filed malpractice claims against him, and three additional patients had settled. Crain’s family was not able to sue because their daughter’s poor care had happened while she was in the emergency room, not as an inpatient. Texas puts an impossible barrier in front of ER malpractice victims. It’s not enough to show their doctor departed radically from the standard of care—the doctor’s actions must be “willful and wanton.” In other words, it’s enough that Dr. Hawkins didn’t actively intend to kill Crain.
ProPublica successfully surfaced a Texas law that puts vulnerable women at risk—but it isn’t the abortion ban. Women in the ER need to be able to hold their doctors to the standard of care. Elsewhere, abortion advocates have sued to argue that EMTALA requires that hospitals provide abortions to stabilize women. What is actually needed is greater scrutiny of patient dumping, in defiance of EMTALA, where uninsured pregnant women are not admitted for the continuous monitoring that women like Glick and Crain needed.
This should be a natural point of collaboration for pro-life and pro-choice women. Doctors shouldn’t be able to hide behind abortion laws to cover for poor care. Abortion isn’t a solution to the vulnerability of poor or undocumented women who hope to hold their child, but fear their doctors. These women’s preventable deaths should provoke a medical reckoning. A doctor should safeguard a woman and her child together, not pit them against each other.
A core part of the pro-choice claim is that pregnancy makes women vulnerable in a way that men cannot be. In order to be equal, women must be able to escape this vulnerability, even if it means ending the life of a child in the womb. The stories of Glick, Hamilton, Miller, and Crain show how incomplete this approach to justice is. Women and children deserve real care—both during the unique challenges of pregnancy and for the whole of their lives. Abortion isn’t an escape hatch for systemic injustice; it’s a further violation.
Editor's note: Leah Sargeant runs Other Feminisms, a substack community, and is the author of Building the Benedict Option and The Dignity of Dependence. This article was published by Commonplace and is reprinted with permission.
