I remember the first time I heard the maxim “abortion is health care.” I thought it was promising, in terms of messaging, but ultimately a bit hyperbolic. That was before last June, when the Trumpified Supreme Court overturned Roe v. Wade, the landmark 1973 decision in which abortion was enshrined into law. The fallout from the right-wing majority eliminating a constitutional right to an abortion has profoundly hurt women, hamstrung doctors, and overwhelmed hospitals. “Because it’s such a pithy and memorable phrase people think it must not be true,” NARAL’s Angela Vasquez-Giroux told me, “but abortion is actually health care.”
This past weekend marked the 50th anniversary of Roe, which, instead of a time of celebration, was marred by marches—because the antiabortion movement remains determined to further erode Americans’ rights—and misery, as women across the country face far more restrictions than a year ago. At least 13 states have banned abortion since Roe was officially overturned. This loss of bodily autonomy on the federal level has created medical disasters for women all throughout the country.
For instance, Idaho woman Carmen Broesder said she was denied dilation and curettage, or D&C, despite the clear medical need. “Why should I get to death’s door to get help?” she asked in a series of TikTok videos. In some of these abortion desert states, doctors are afraid to perform D&C for miscarriages out of fear they will be prosecuted. Katrina Green, an emergency room physician in Nashville, told Bloomberg Law, “Where is the line where we can intervene? If we intervene too early, then a lawyer might come after us.” The internet is awash in stories of women unable to get treatment for ectopic pregnancies and miscarriages.
But the problem isn’t just with individual doctors unable or unwilling to treat women, but hospital systems are being challenged in new ways since the end of Roe. “There’s a panic happening all over the South now that we are seven months in. The first wave of people denied abortions are starting to get near a point of giving birth, and it will crash our hospitals down here once it happens,” said Robin Marty, operations director of the West Alabama Women’s Center and author of Handbook for a Post-Roe America. “In Alabama, we are seeing patients who have given up on trying to get abortions and are giving up even trying to find doctors to help them through their pregnancies. They are coming to us knowing we can offer prenatal care, and choosing to stay even though we can’t do deliveries, deciding it’s better to have prenatal care and take their chance on whoever is on duty at the hospital when they go into labor than risk not being able to find anyone at all. Right now we are still at the point where a lot of people could go to other states to get abortions.”
A hospital system stretched thin from three years of pandemic, alongside an epidemic of rural hospital closures, is a recipe for disaster for the American South when it comes to maternal fetal health. America already has “a maternal mortality rate several times higher than other high-income countries,” including nearly three times higher than France, the next country on the list, according to the Century Foundation. This tragic situation will surely only get worse in post-Roe America, especially for communities of color where the maternal mortality rate for Black women is nearly three times higher than white women, according to the CDC. In case you were wondering if American health care is racist.
Now doctors are even more worried about treating pregnant women. This post-Roe health care crisis “started cascading” in recent months as “the clinics filled, and the waits got longer,” Marty told me. “Now is a crisis, but six months from now? That will be the catastrophe.” Or as NARAL’s Vasquez-Giroux put it to me, “We all knew this would impact women who were seeking abortion care, but we weren’t prepared for how it would impact America as a whole. What it really underlines is that it’s actually not safe to be pregnant in America.”
Despite the damage to maternal fetal health and the underlying anxiety among doctors, Republican governors have seized on abortion as yet another culture war crusade. Abortion, like bullying trans kids and banning books, has become a way for Republican governors to prove their MAGA bona fides despite the fact that even Mr. MAGA himself, Donald Trump, seems to realize how unpopular the assault on abortion rights is with the public. After the GOP’s poor showing in the midterms, Trump “truthed” his frustration: “It was the ‘abortion issue’, poorly handled by many Republicans, especially those that firmly insisted on no exceptions, even in the case of rape, incest, or life of the mother, that lost large numbers of voters.” But somehow this has not permeated the party, with Virginia governor and red-vest-wearer Glenn Youngkin pushing for a 15-week ban in purple state Virginia.
Republicans find themselves in an intractable position. Banning abortion is unpopular even in red states like Kansas and Kentucky, as recent ballot initiatives demonstrated, and such severe restrictions are likely to find even less support the more people see videos and hear horror stories of women unable to get the medical care they need. But in order to appeal to the right-wing base, these Republicans will keep taking a hard line on abortion.
Ron DeSantis, for one, has suggested he’d support an abortion ban at around six weeks; Florida currently bans abortions after 15 weeks, though the law is being challenged in court. Speaking in Florida on Sunday, Vice President Kamala Harris used DeSantis’s words against him, “Can we truly be free if so-called leaders claim to be—I quote, ‘on the vanguard of freedom’ while they dare to restrict the rights of the American people and attack the very foundations of freedom?”
Not even a year since Roe was overturned, we’re seeing terrible reverberations, things women didn’t even know to worry about a year ago. Republicans thought they’d win over evangelicals but that group won’t ever be satisfied despite their wildly unpopular Supreme Court victory. (In June 2022, polling showed 6 in 10 Americans were pro-choice.) The theme for the latest “March for Life” was “Next Steps: marching forward into a post-Roe America.” If anything, the anti-choice crowd has become more emboldened, with former vice president Mike Pence agitating for a national ban since minutes after Roe was overturned. Clearly, the GOP’s “states’ rights” argument has always been a complete scam.
What’s become clear over the past seven months is that post-Roe America isn’t in the middle of an abortion crisis, it’s in the throes of a health care crisis. And it’s only going to get worse.