There are 34 days until the presidential election, and the stakes for reproductive healthcare could not be higher. Twenty-eight states across America have instituted abortion bans based on gestational limits, while another 13 have outlawed the procedure entirely. Below, Harper’s Bazaar is collecting the stories of those whose lives have been forever impacted by these restrictions. (Warning: This article includes sensitive content that may be upsetting to some readers, including mention of pregnancy loss.)
The clinics did not close one at a time but in droves. Within four months of the Supreme Court decision to overturn Roe v. Wade in June 2022, dozens had been forced to stop offering abortions and 26 had closed for good. By November 2023, Idaho had lost 22 percent of its practicing obstetricians. Almost one million women and girls live in that state. There are now only around 200 such doctors qualified to care for them. Experts anticipate a grim reconfiguring across the U.S.—a concentration of practitioners who are equipped to treat pregnant people in blue states, an exodus of trained doctors in red ones.
Top image: Barbara Kruger, Untitled (Your Body is a Battleground), 1989.
Photographic silkscreen on vinyl.
For women nationwide managing both wanted and unwanted pregnancies, the effect of Roe’s overturning has been devastating. It stands to get worse. This summer, the Supreme Court declined to rule on the merits of a case that asked the justices to consider whether emergency abortion care can be offered to patients whose health is in danger. In the meantime, in May, the Texas Supreme Court rejected a challenge to its abortion law and ruled against a group of women who had suffered serious pregnancy complications.
That same month, Louisiana moved to classify two FDA-approved abortion pills as “controlled dangerous substances,” further curtailing their administration in a state in which abortion was already illegal and the medications could be offered only in very limited circumstances. Now even possessing them without a valid prescription may be considered a crime, punishable with prison time.
This past February, fertility clinics across Alabama had to temporarily halt IVF services after the state’s supreme court ruled that frozen embryos were entitled to the same legal rights as children; treatments were imperiled statewide. Republicans in Congress have declined to help pass legislation that would federally protect IVF.
Since the dismantling of Roe in Dobbs v. Jackson Women’s Health Organization, a middle schooler had to leave her home state to access an abortion after a sexual assault, and another gave birth to a son born of rape. And those are just the stories we know. There are more that never make headlines.
EVELYN HOCKSTEIN/REUTERS/REDUX
Packages of mifepristone, medical abortion pills, at a clinic in Illinois.
Paperwork from a patient’s IVF treatment in Alabama, March 2024.
Women who live in states that have chosen to shore up abortion access—from Michigan to California—have, for the time being, been spared the effects of this new legal landscape. But millions of women now live with fewer constitutional rights than their mothers did, and countless lives have been upended. It is crucial that we listen to their stories, commit them to memory, and let them propel us to act.
Individual patients bear the brunt of abortion bans, and it’s individuals who seek to dismantle them. Last December, Kate Cox sued the state of Texas for the right to terminate her pregnancy after her daughter was diagnosed with a lethal fetal abnormality in utero. Doctors told her that her child would be stillborn or likely die within minutes, hours, or days. Continuing the pregnancy would have put Cox’s own health and future fertility at risk. With the courts slow-walking her case, she traveled to New Mexico for the procedure. She is now pregnant again—in Texas—and terrified.
In Indiana this April, the state appeals court ruled in favor of plaintiffs, several of them Jewish, who argued that the state’s onerous restrictions violate their rights to religious freedom. Even so, Indiana’s abortion ban stands while the lawsuit proceeds.
Protesters demonstrate in support of access to abortion outside the United States Supreme Court.
In all six states in which abortion rights have been put to a ballot vote since Dobbs, voters have chosen to protect them. Polls have shown that support for abortion in some or all cases has risen—among both Democrats and Republicans. Studies have shown that the number of actual abortions is up too, as patients with the financial means travel to states in which the procedure is legal and a growing number end their pregnancies at home using abortion pills.
With the elections in November, more states—including Florida, where a six-week ban is in effect, as well as South Dakota, Colorado, and Nevada—will put the question of abortion to voters. But it is of course the outcome of the presidential race that will have the most profound impact on the state—and states—of abortion in this nation. The winner could appoint at least two more justices to the Supreme Court if older justices retire, either cementing its far-right flank or upending it. The next president will perhaps be in a position to either sign or veto a national abortion ban. He or she will make America either safer for those who can bear children or more dangerous.
The fall of Roe has transformed not just what it means to be pregnant in the United States but the practice of medicine and the legal status of women. Here, patients, providers, and scholars in five states reflect on that seismic shift—and their uncertain future.
An ultrasound photo attachedto the chart of a patient at the AcaciaWomen’s Center in Phoenix, April2024, after the Arizona SupremeCourt voted to uphold an 1864 law banning abortion with no exceptions for rape or incest.
TEXASSAMANTHA CASIANO, 30
Samantha Casiano, 30, was born and raised in Texas, where she has lived all her life. She was pregnant with her fifth child when she and her husband learned that their daughter had anencephaly, a condition in which parts of a fetus’s brain and skull are missing. Her daughter Halo would survive only hours after birth.
The Travis County 459th District Court in Austin prior to an emergency hearing in Cox v. Texas, December 2023
WHEN I GOT PREGNANT with Halo, I already had four children, so it was not my first rodeo. But at 20 weeks, I went in fora scan and was told that my daughter had anencephaly and that the diagnosis was incompatible with life. I went through 20 weeks thinking, “We’re going to bring home a baby.” We were excited to find out the gender. And then we hear this.
I was at the appointment alone, and I didn’t even know what the condition was. My husband was at work, and I just thought maybe it was something that a surgery could fix. But then when I spoke to my OB, I learned exactly what it meant. It didn’t really, truly hit me until a caseworker came in and gave me a paper with funeral homes listed on it. It was a few days after Christmas. It was the kind of day you never forget.
I’ve lived in Texas all my life. My husband and I lived a block or two away from each other growing up, and then we moved together about an hour away from there. And it was like, one day you’re united with your state, and then the next day you feel like you’re stripped of your rights and left behind.
“I DON’T WANT any other CHILD of mine to ever have to go through this. My EGGS are more SECURE INSIDE of MY BODY than they ever will be out here in THIS STATE.”
After, I went to the lobby and I just started ugly crying. I called my husband, and he didn’t understand a word I was saying. He was like, “Calm down, breathe. What’s wrong?” When I told him, he couldn’t believe it. We started looking at options. I read more, and I was immediately scared. Was I going to go to jail for this?
And even after that, we looked at the prices, and I was like, “I can’t do this.” We had one vehicle, and this was a time-sensitive situation. We would have had to get a rental and find two sitters. I’m a document processor. He installs tile as a contractor. The amount of time we would have needed off work—it was not in the budget. I felt like I should have been able to have that support in my own hometown.
I remember I vomited. Even now, when I think about it, I get nauseous. To wake up every morning knowing that your daughter is going to die, having to plan a funeral before your child is even here? It’s just so cruel.
Kate Cox at the Capitol following the State of the Union, March 2024
My anxiety went through the roof. I had to start taking pills for depression. I became more antisocial. I couldn’t bear it when people tried to rub my belly.
The day I gave birth, I was working. I was in heavy pain, and I could feel her dropping. I lived next door to my brother-in-law, and I told him I might have to go to the hospital. He drove me, and then, as we pulled up to the hospital, my water broke. When I was put in a room to deliver, they told me my daughter was breech. They gave me more Pitocin, and they told me to push.
In the end, she was with us for four hours. They gave her morphine, and she basically suffocated. She was gasping for air the entire time. Eventually, her eyes started bleeding, and I couldn’t take it anymore. She was with her father from there, and she died in his arms. He had to go back to work later that day.
It was very traumatic. I felt like I was her life support, and I should have been given the right to release her from that, and I wasn’t. She was born on March 29. We buried her on April 7.
I will not be having any more children. I don’t want any other child of mine to ever have to go through this. My eggs are more secure inside of my body than they ever will be out here in this state.
ALABAMAMICHELE BRATCHER GOODWIN, 54
Michele Bratcher Goodwin is a law professor at Georgetown University and the author of the 2020 book Policing the Womb. For decades, she has been researching and writing about the criminalization of pregnancy, particularly in Black and Brown women. She has been tracking the surveillance of pregnant people and efforts to legislate fetal personhood for more than 20 years. Alabama is the epicenter of that movement.
Michele Bratcher Goodwin testifies in front of the Senate Judiciary Committee at a hearing titled “The Assault on Reproductive Rights in a Post-Dobbs America,” April 2023
OVER 20 YEARS AGO, I started doing research on assisted reproductive technologies. And even before then, I had been taking note of the surveillance of Black women—and the surveillance and criminalization of their pregnancies in particular. I had noticed that there were people who worked in criminal justice who were ignoring women and ignoring Black and Brown women. And then there were people who were working in the space of feminist jurisprudence and women’s rights who unfortunately were looking just at white women.
I wrote in the Yale Law Journal in 2017 about an undocumented woman in Texas who was seeing her ob-gyn. Her husband had legal status, and her kids had legal status. She didn’t. She went to another branch of her doctor’s office, and a white woman there became suspicious of her [immigration status] and called the police. She was arrested in front of her kids. White women law scholars were not writing about that.
White legal scholars were not paying attention to Rennie Gibbs, who in 2007 was charged at 16 for “depraved heart murder” in Mississippi after having a stillbirth because she told her medical providers that she had used drugs. [Her daughter was delivered with her umbilical cord wrapped around her neck, but] Gibbs was treated as a pariah. I could go down the list of tragedies that were unfolding that were not registering on the radar of legal scholars who were doing feminist studies.
A scene from a rally in support of IVF in Montgomery, Alabama, February 2024
What we see now should not surprise us. Across the country, we have seen an increase in efforts to punish miscarriage. In Louisiana and South Carolina, there are lawmakers who have proposed the death penalty for women who have abortions, as well as others who facilitate an abortion.
In Alabama, where there are constitutional rights for embryos, I would argue that we could have seen a lot of this coming. The state supreme court said this years ago—that it saw no difference between a 12-year-old and a fetus and no difference between a viable fetus and a nonviable fetus.
How did Alabama get to that point? It started with the active encouragement of nurses and doctors to provide confidential patient information to prosecutors who could go after women [for using drugs while pregnant]. Alabama became a hot spot where hundreds of women were arrested and pressured into plea deals. That helped to lay the groundwork because these women were charged with endangering the lives of their children. Then, in 2018, Alabama became the first state to pass an amendment to its constitution that recognized fetal personhood.
“I think it’s HARD for people to FACE THE FACT that we are WELL-PRACTICED at INJUSTICE in our country.”
I think it’s hard for people to face the fact that we are well-practiced at injustice in our country. I wish it weren’t so. But we have centuries of history in which women have been denied citizenship, women have been denied the right to vote, women have been denied the opportunity to take out loans in their own name, women have been denied the opportunity to sit on juries, women have been denied the opportunity to have bank accounts. We’ve had centuries of legal marital rape, centuries of domestic violence, centuries of all these things, and for Black women it’s lasted even longer. We’ve had a more muscular history of in justice than liberation. And we don’t sit with that.
TENNESSEENICOLE BLACKMON, 32
Nicole Blackmon, 32, moved to Tennessee from Alabama after she losther teenage son, Daniel, to gun violence. A few months later, Nicole and her husband learned she was expecting. When she was told in her second trimester that her baby would not survive delivery, she became a victim of overlapping American crises. In a country where it’s easier for a person to buy a gun than receive basic health care, a woman can lose two children in a single year.
Activists protesting in downtown Nashville, June 24, 2022.
I LIVE IN NASHVILLE. I have been living here for two years now. Before that, I was in Mobile, Alabama. I grew up there and lived there most of my life. I moved to Nashville because I had just lost my 14-year-old son to gun violence. His name was Daniel, and he was known for his smile. He was at a friend’s house, and he got caught in the crossfire, just sitting on the porch. After that, for a fresh start, my husband and I decided to move.
We had been trying to have more children, but we weren’t having any luck. Then, after losing my son that same year, we found out I was pregnant. I suffer from a condition called pseudotumor cerebri, which causes swelling in the skull. It affects your eyesight, and it gives you bad migraines. I’ve been on medication for it, but you have to stop once you find out you’re pregnant. I went off of it even though it caused me a lot of pain.
When we moved, I did find a great doctor. But when I went in at 15 weeks, that’s when I found out the baby was having issues. On that ultrasound, we saw that the organs were outside of the stomach. It was horrible. We had a follow-up appointment, and we found out that it was more severe. I was told at that point that the baby would not survive delivery.
“I was PREGNANT and CARRYING a CHILD who I knew was NOT GOING to SURVIVE.”
We were crushed. I did not know much about the laws at the time. But when I asked the doctors about our next step, that’s when I found out.
I wanted to have an abortion. But my doctor said, “We can’t help you. We don’t offer that anymore.” I spoke with my husband about it. We didn’t have the kind of money to just up and go to a different state for the procedure, so I was forced to go through the pregnancy.
It was the most terrifying time I have ever experienced in my life. I was pregnant and carrying a child who I knew was not going to survive. I was grieving the loss of my son. And at the same time, I was not on my medication. I was in so much pain.
My husband was scared for me, not knowing if I was even going to make it through. I remember my mom telling me she was so scared that she was going to lose me.
A Tennessee mother testifies in support of reproductive freedom at a Senate Budget Committee hearing, February 2024.
My water broke when I was seven months pregnant. I was at home. I woke up that morning and realized what had happened, and part of me was relieved because I was like, “I made it to this day.”
I was in labor for 32 hours. I felt the baby moving inside my stomach the whole time, and it was painful. I asked the nurse and the doctors to put a sheet between me and the baby so that when I did give birth, I wouldn’t see. After just losing one son, I didn’t want to see my child like that. I just wanted to have a different memory.
At the hospital, they gave me a remembrance box. They cremated the baby and gave me the ashes, and they gave me blue hearts, so we assumed the baby was a boy. We named him Ethan. It means strong. I decided to get my tubes removed three months after I had the baby. I just couldn’t risk being pregnant in Tennessee again. Now I won’t be able to celebrate graduations. I won’t be able to see myself as a grandmother. I’m a mother who lost two kids in one year. If the law had been different and I was able to have that abortion, I could have let my body heal. I wouldn’t have been traumatized the way I was.
INDIANACAITLIN BERNARD, 40
Caitlin Bernard is an obstetrician-gynecologist at Indiana University Health and an abortion-rights activist. In post-Roe America, Bernard became one of the most famous abortion providers in the country after she spoke out about the legal abortion she provided to a 10-year-old girl who had been raped. The girl lived in Ohio and was three days past the six-week termination limit in that state. She was not the youngest patient Bernard has treated.
Caitlin Bernard with congresswomen on Capitol Hill, March 2024.
IT’S INCREDIBLY HARD to provide comprehensive reproductive health care under a severe abortion ban. The patients that we take care of now have to be incredibly sick in order to receive treatment. The vast majority of people we see aren’t that sick, and that’s a hard conversation to have.
“The FALL of ROE was just THE BEGINNING.”
We know that for many people, the challenges to access care out of state are insurmountable. We see a lot of minors, and that can be particularly difficult because they often face much greater challenges to access abortion out of state. We see a lot of people who are refugees or immigrants. And we also see a lot of people who are moms. They have children who they need to take care of, or they need to be able to support their family through working and they can’t risk more pregnancy complications and an even more severe outcome like maternal mortality.
And because of the way that our law is written, I can’t provide care for them because they’re not currently at death’s door. It’s devastating to have to say, “I know that you could have severe complications in this pregnancy, but I can’t do anything to prevent them.” It feels incredibly harmful to my patients. And it’s incredibly traumatic for physicians and providers as well.
While I can’t talk specifically about any one case, I can say that I think certainly we as physicians feel obligated to speak out when we’re seeing human-rights violations, which is what’s happening. People understand that we’re banning abortion, but they don’t understand the specifics of these laws. They don’t understand that there is no exception for rape in many of these abortion bans. And that pregnancy, even in very young people, might not necessarily be considered a life-threatening condition.
Protesters demonstrate in support of access to abortion outside the United States Supreme Court.
Every time we see a patient, we as doctors have to think,“Does this meet an exception?” And if it falls in a gray area, which it often does, we have to ask, “What is the risk to me if I make a decision that, yes, this risk is high enough that they qualify? What if a prosecutor disagrees with me? Am I going to lose my license? Am I going to go to jail?” These are felony-level penalties. It’s an ever-present concern, unfortunately.
A lot of people don’t like politics. Maybe they don’t understand it or they think it’s distasteful to discuss or they don’t feel that anything about our political system represents them. But I think it’s incredibly important to understand that there is a very real and very present danger. The fall of Roe was just the beginning.
FLORIDAKELLY FLYNN, 47
Kelly Flynn is the president and CEO of A Woman’s Choice. She owns five abortion clinics across Florida, North Carolina, and Virginia and has navigated a sharp influx in patients since Roe was overturned. After Florida’s six-week abortion ban went into effect in May, her clinic in Jacksonville became a logistical nerve center, directing patients north. Floridians will vote on a ballot initiative in November that would legalize abortion up until viability. It will need support from 60 percent of voters in order to pass.
Kelly Flynn, president and CEO of A Woman’s Choice, a network of abortion clinics, in Jacksonville, Florida, April 2024
I STARTED WORKING in abortion medicine when I was 19, after I had my own abortion. I had helped another patient calm her nerves, and the clinic offered me a job. Literally, while I was having my abortion, they said, “Do you want a job?”
I was in college, but I started working there two weeks later. The work found me, and I never looked back. By the time I was 25, I had moved to Florida to operate one of the clinics. That was in 2002. I acquired clinics in Raleigh, Greensboro, and Charlotte in 2008, 2015, and 2016. And we just opened in Danville, Virginia.
I’m 47 now; I had my abortion at 19. There were regulations, but nothing like what they are now. It’s become much harder to provide access over the last 10 years. We’ve had to get very involved in advocacy in multiple states. We shouldn’t have to. It’s just chaos.
A protester at a rally against Florida’s abortion ban in Orlando, April 2024
We’ve had a lot of people over the last few months come forward and show their support, which is nice, but we also feel helpless. Why are we being set back 50 years after what we’ve worked so hard for? What’s next? Are we not going to be allowed to vote? Women have tried so hard to climb the corporate ladder and become equal, and I feel like the message, especially in Florida, is just “Hey, put your apron on, make some babies.”
“Don’t let SOCIETY tell you that what you’re doing is WRONG. Walk out of this CLINIC with your full SENSE of INDEPENDENCE and START OVER.”
Prior to [Florida’s six-week abortion ban], we were seeing patients from Florida, Louisiana, Texas, Mississippi, Alabama, Georgia, and South Carolina. Patients are still scrambling to come in, but we often have to refer them north. It’s had a huge impact on our staff too. People come in, and they’re six weeks and one day, and we have to turn them away. Or we have to send them away for care we know they could get here.
One girl took a bus from Florida to one of our clinics in North Carolina. It was a 96-hour round trip because she had to give her 72-hour consent, get back on the bus, come back to Florida, go back to North Carolina, get her abortion, and then come back to Florida.
A scene from a pro-abortion rally in West Palm Beach, Florida, June 2024
The staff and me—we are normal. We have families. I make dinner every night. I have a kid. I will soon have two stepchildren. My job is just a lot more stressful than your average nine-to-five. Sometimes I’m like, “Gosh, I’m just going to go work at Target.” But I’m too young to retire and too stubborn to quit, so I’m going to keep fighting for as long as I can. The best part about my job is giving patients permission to say that this is okay. We tell them,“Don’t let society tell you that what you’re doing is wrong. Walk out of this clinic with your full sense of independence and start over.”
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Publish date : 2024-10-01 12:22:00
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