Who Gets Care and Who Gets to Die?

America’s mothers are dying because we don't have access to reproductive care

This newsletter is usually sent on Wednesday, but I am dealing with the cold from hell. (Not covid.) Also, I have a book deadline, taxes, a child who turned 12, and spring break with no childcare. And between all of that and the caffeine and DayQuil, I had few coherent thoughts Tuesday. As my own boss, I had to give myself the day off. But on Wednesday, Iowa’s governor signed into law two bills specifically attacking trans kids in Iowa. Last week, my friend Molly Monk wrote an essay about queer joy in the face of bills like this. I hope you read it and remember what a vital and important part of our communities queer people are. And if you are watching this happen and feeling hopeless, donate to the Iowa Trans Mutual Aid fund. If you are a trans Iowan in need, the Trans Mutual Aid fund can help you find the healthcare and support you need. 

And one more thing: Reproductive rights are also LGBTQ rights. This is all intersectional. Okay, now onto the weekly newsletter…

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In February, Jessa Duggar Seewald, whose Christian conservative family rose to fame with the TLC show 19 Kids and Counting, announced she’d experienced a miscarriage and had to have a D&C, which stands for dilation and curettage. The procedure is a common one and involves scraping the lining of the uterus to remove fetal tissue. It’s used when a person has a miscarriage and the tissue is not expelled from the body. And it’s also a common abortion procedure.

Pro-choice critics were quick to point out that a member of the infamously anti-abortion family had benefited from a procedure that pro-life legislatures have been working to make illegal. 

The National Review wrote a righteous screed in defense of the Duggars, noting that the three states that ban D&cs have carve-outs that allow those procedures for miscarriages or when the life of the pregnant person is threatened. 

But the reality is doctors in states with abortion bans with health exceptions are refusing women life-saving care out of fear of violating the restrictive laws. 

Around the same time Seewald announced her miscarriage, The Guardian ran a story about doctors in Louisiana refusing to give treatment to a Black woman who was having a miscarriage, citing ambiguities in the law. In September, the New York Times ran a story in September about doctors in states like Arizona, Wisconsin, and Texas who are delaying necessary procedures or refusing to provide them even when the life of the pregnant person is at risk. 

Dr. Alison Haddock, an emergency physician in Houston and chair of the board of the American College of Emergency Physicians, told the Times, “We’re no longer basing our judgment on the clinical needs of the woman, we’re basing it on what we understand the legal situation to be.”

The realities of women’s lives have never been reflected in the laws. Even when Roe was the law of the land, the realities of finding and accessing abortion care (even when it’s classified as miscarriage care) has not been easy or accessible. 

This isn’t a hypothetical. Women are dying from restrictive laws that prevent them from accessing care. 

This month in Idaho, Bonner General Health hospital in Bonner County shut down its labor and delivery services because of the state’s restrictive abortion laws. A press release issued by the hospital placed the blame solely on the state’s abortion restrictions, noting:

“The Idaho Legislature continues to introduce and pass bills that criminalize physicians for medical care nationally recognized as the standard of care. Consequences for Idaho physicians providing the standard of care may include civil litigation and criminal prosecution, leading to jail time or fines.”

In Texas, a woman is being forced to carry a child with a deadly fetal anomaly to term despite the risks to her life.

When a child’s life is pitted against the mother’s, the mother always loses. In states with abortion bans, mothers are nearly three times more likely to die in childbirth. America, which has the highest maternal mortality rate of any high-income country, is watching that figure get worse. A report by the CDC found that the maternal mortality rate in 2021 was one of the worst in American history.

When outlets like Jezebel pointed out Seewald’s  apparent hypocrisy, she responded by calling the comparisons cruel, citing the difference between aborting a dead fetus and a wanted pregnancy. “To equate one with the other – and to a mother grieving the loss of her baby no less – is severely distasteful.” 

The author Becca Rea-Tucker, who writes the newsletter A Little Something Sweet, pointed out the incongruity of Seewald’s logic, noting, “What stands out to me from that screenshot is the way Seewald highlights her own real and human pain while dehumanizing others in the same breath. She says people have D&Cs for many reasons, but hatefully refuses to accept that all of those reasons are valid, not just the Duggar-approved ones.”

Another obvious issue, as many of the above examples show, is that abortion treatments can be necessary even for intended pregnancies. People who want to have babies sometimes have to have abortions.

Writing in her newsletter Commie Pinko Queer, Lisa Duggan notes of the cliché of right-wing sexual hypocrisy,“It’s not merely a matter of individual or even simple political hypocrisy. The deeper history shaping these scandals is the way that inequality has been sexualized…The charge of hypocrisy actually frames the crisis as personal or narrowly political rather than structural and historical.” 

The Duggars are an example of personal hypocrisy when it comes to reproductive rights. But this is really a story of systemic inequality. Even when Roe was enshrined in law, abortion access was still unequal. Women who were poor, lacked access to transportation, or lived in rural areas were often unable to obtain abortions. Lourdes Rivera from the Center for Reproductive Rights noted, “Since Roe, here in the U.S., the direction has been to block access to abortion—first with the Hyde Amendment saying that poor women could not use Medicaid benefits to cover access to abortion. And then states layer on restrictions, making it really difficult to access.”

Miscarriage can be devastating and Seewald is entitled to grieve, but women are dying because of restrictions on abortion — restrictions her family supports. It’s not cruel to point out that the freedom of people like the Duggars to get treatment for a miscarriage rests on the unfreedom of others. The real issue is not hypocrisy but inequality.