After the fall of Roe, pregnancy feels like a crime

After+the+fall+of+Roe%2C+pregnancy+feels+like+a+crime

Imagine being eight months pregnant and waking up in the middle of the night with a shooting pain in your stomach.

Worried that you might lose your pregnancy, you rush to the emergency room, where you are told that no one will care for you there because they fear they could be accused of participating in an abortion. The staff will tell you to drive to another hospital, but that will take hours and by then it may be too late.

Such frightening experiences are becoming increasingly common in the wake of the 2022 Supreme Court decision Dobbs v. Jackson Women’s Health decision, because doctors and other medical personnel, fearful of the far-reaching consequences of state abortion bans, simply refuse to treat pregnant people.

It’s part of what some reproductive health activists see as a troubling move from a ban on abortion to a climate of mistrust of all pregnant patients. “In fact, people are increasingly afraid of becoming pregnant,” said Elizabeth Ling, senior helpline advisor at reproductive justice legal group If/When/How.

The fall of Roo has created a widening net of criminalization that can ensnare doctors, nurses and pregnant people alike, with devastating consequences for patients’ health, experts say.

The number of complaints from pregnant women leaving the emergency department doubled in the following months Dobbs, the Associated Press reported earlier this year. Concerns about such treatment, combined with stories from people like Kate Cox, who was denied an abortion despite the risks her pregnancy posed to her health, have made some Americans fearful of becoming pregnant: in a recent poll, 34 said percent of women ages 18 to 39: They or someone they knew had “decided not to get pregnant because of concerns about dealing with pregnancy-related medical emergencies.”

Such studies, together with emergency room data and calls to helplines, reveal the feeling that in a post-Dobbs In America, any pregnancy can be dangerous – for patients, for doctors, or for both. “The fact that people see the condition of pregnancy as something that makes them vulnerable to state violence is just so heartbreaking,” Ling said.

Americans are prosecuted after a miscarriage

The Dobbs This decision has created an environment in which people who experience miscarriage are treated as criminals or crimes waiting to happen, advocates say — or sometimes both.

In October 2023, an Ohio woman named Brittany Watts visited a hospital, 21 weeks pregnant and bleeding. Doctors determined that her waters had broken prematurely and that her fetus would not survive, but as her pregnancy neared the point where Ohio bans abortions, a hospital ethics committee kept her waiting eight hours while they discussed what to do. She eventually returned home, suffered a miscarriage, attempted to dispose of the fetal remains herself, and was charged with abuse of a corpse.

The charges were eventually dropped, but experts say her case is part of a larger pattern. “There is hyper-surveillance, hyper-policing and hyper-interrogation” of pregnant people in America, says Michele Goodwin, professor of constitutional law and global health policy at Georgetown and author of Policing the womb: Invisible women and the criminalization of motherhood.

This supervision is not entirely new, say advocates and scientists. Black pregnant women in particular have been the target of suspicion for generations, stereotyped as drug users or “welfare queens” and even arrested when they tried to seek maternity care, Goodwin said. “There are cases where black women have been dragged out of hospitals, literally in shackles and chains,” Goodwin said.

Black women and other women and girls of color are also disproportionately targeted for arrest or investigation after miscarriages or stillbirths. In 1999, Regina McKnight, a 22-year-old black woman in South Carolina, became the first person to be prosecuted for murder after experiencing a stillbirth, according to Capital B. She was sentenced to 12 years in prison for endangering her pregnancy. drug use, but her conviction was ultimately overturned.

But now the atmosphere of criminalization around pregnancy is spreading “to larger and larger groups of people,” said Karen Thompson, legal director of the group Pregnancy Justice, which tracks the criminalization of pregnant people.

Black advocates have long warned that while the criminalization of pregnancy might affect Black and brown women today, “tomorrow it will affect everyone,” Goodwin said. “Dobbs took us into the future.”

Dobbs makes doctors afraid to treat pregnant patients

In the morning of post-Dobbs America, doctors and hospital staff now fear criminal prosecution if they are found to have performed an abortion in violation of their state’s bans. These bans have exceptions to save the life, or sometimes the health, of the pregnant person, but the exceptions are often extremely limited or unclear, forcing medical professionals to choose between refusing to treat a seriously ill patient and losing their license or going to prison. go to prison. .

“The way states write their statutes disrespects the physician’s medical judgment,” said Sara Rosenbaum, professor emerita of health law and policy at George Washington University. “It has had a profound chilling effect on emergency room care as doctors and hospitals are in panic mode.”

That chilling effect causes some doctors to not only refuse to perform abortions but also to provide any care to pregnant people in crisis, for fear that their care will be scrutinized in a restrictive and uncertain legal environment. A week after the Dobbs According to a federal investigation into ER visits, a woman arrived at Falls Community Hospital in Marlin, Texas, nine months pregnant and in labor. The doctor on duty refused to treat her and instead sent her to another hospital in Waco, the AP reported. The outcome of her pregnancy – and the impact on her health of delayed maternal care – are unknown.

In another case, a pregnant woman arrived at a North Carolina hospital complaining of stomach pain. The staff told her they couldn’t do an ultrasound and she ended up giving birth in a car on the way to another facility 45 minutes away, the AP reported. The child did not survive.

“We’re talking about a level of bizarreness that is in high regard The Handmaid’s Tale,” said Rosenbaum.

The Emergency Medical Treatment and Labor Act (EMTALA) requires all hospitals that accept Medicare to stabilize the medical conditions of anyone arriving at the emergency room, including pregnant people. But the medical interventions allowed under the state’s new abortion laws are often less than what EMTALA requires, Rosenbaum said.

Meanwhile, the Supreme Court will decide in the coming days on a case that could undermine EMTALA, giving hospitals even more leeway to turn away pregnant patients. “I don’t think it’s an understatement to say that the loss of EMTALA, or even the weakening of EMTALA, puts the lives of pregnant people at risk,” Ling said.

Even people who are not yet pregnant feel the broadening effects Dobbs. The If/When/How helpline has received calls from people who want to get pregnant but are terrified that “they could experience an unexpected loss like a miscarriage, and yet somehow be punished for experiencing that loss,” Ling said.

In recent months, she’s heard herself say the words, “It’s not a crime to be pregnant,” she told Vox. And yet it increasingly feels that way.

This story originally appeared in Explained todayVox’s daily newsletter. Register here for future editions.

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Swati Sharma