We are in the final days before 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.
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.
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.
TEXAS
SAMANTHA 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.
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.
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.
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.
ALABAMA
MICHELE 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.
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.
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 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.
TENNESSEE
REBECCA MILNER, 44
Rebecca Milner, 44, lives in East Tennessee with her husband. After years of pursuing fertility treatments, she found out she was spontaneously pregnant in February 2023. At her 20-week ultrasound, she learned that she’d experienced preterm premature rupture of the membranes (PPROM). Without protective amniotic fluid, her daughter had failed to develop properly in the womb. Rebecca had to travel to Virginia for an abortion. She was later admitted to a hospital in Tennessee after contracting an infection following her delay in care.
I WAS BORN AND RAISED in Texas, in a suburb of Houston, and I got my graduate degrees in Virginia, so I lived in Virginia for school and then worked there for a little bit. In August 2016, my husband and I moved to Tennessee for my current job. We’ve lived here since then, and I love the community that we found here. I love the access to the outdoors, the hiking. We started trying to get pregnant in 2017, when we felt more settled.
We had postponed actively trying because we wanted to be really thoughtful and intentional about it. We wanted to wait for the “right time.” I know people say there’s no right time, but we wanted to feel like we were financially going to be okay. Long story short, we were trying for six years. We went through fertility treatments. For people who haven’t experienced it, it’s an emotional roller coaster of hormones—taking pills, going through injections, going through procedures, some of which don’t feel very dignified. I would say it’s not the way you want to conceive a baby with your partner out of love. And then time after time, you have the hope that this is going to be the time that works and then you have to deal with the emotional crash of it not happening.
I want to convey just how much we wanted a child.
Still, eventually, I had gotten to a point where I had kind of given up hope. I had turned a corner and was thinking that it wasn’t going to happen. Then the week of Valentine’s Day in 2023—just last year—I had scheduled a colonoscopy. In your forties, when you have a family history of this stuff, you get colonoscopies. I went through the whole prep, and I knew that I was also supposed to start my cycle, but I didn’t have any symptoms. So that morning, I took a pregnancy test even though I didn’t think it was possible that it would be positive, and I was just blown away. How is this happening? It was a total surprise. There’s this way that people talk about infertility. Like, “If you stop trying, that’s when you’re going to get pregnant!” And I don’t want my story to be one of those stories. I was in an incredibly sad, despairing place, trying to rethink my life without children. It’s not like you can just tell somebody who is in that situation flippantly, “Well, stop trying. Relax.”
At this point, I was 43 and the longer it took, the more I felt nervous about my age and about the increased risks. I had had a healthy amount of fear around what it would mean to even be a parent. And I can say that the moment I saw that test, all my fear went away. I only felt joy. It was just like a switch had been flipped.
At my first official appointment, they noticed that I had a small chorionic hemorrhage. It’s basically just a small internal bleed. They said that it was very common and that it wasn’t anything of concern. Usually, they resolve on their own, so everything seemed fine, and we were off to a good start. We did some initial testing, and everything came back fine there too. We were seeing the ultrasounds, hearing the heartbeat. It was so precious, being able to go through that together. We found out we were having a girl and after that we started to tell family. I had a trip already planned to Texas to see my parents, and my sister flew in. I was still like, “Is this real? Am I making this up?” My family was so excited. My sister doesn’t have children, and this was going to be the first grandchild for my parents. There was just a lot of celebration.
A few days before my 16-week appointment, I was in the shower in the evening, and I started to bleed. I just screamed, and I was screaming for my husband to come. We called the OB, and we were put in touch with the on-call doctor. And that person said because of where I was in my pregnancy, there wasn’t really anything that could be done. It wouldn’t benefit me to go into the emergency department, and I should just stay in bed and try to see my doctor in the morning.
I couldn’t sleep. I was just trying to tell myself to keep calm, even as I was cramping. And I just remember thinking, “This can’t be it. This can’t be the end.” We were just getting started. We had waited so long for her. They got me in right away the next morning, and we were just so relieved when everything looked okay. They didn’t see any fluid leaks. My cervix was closed. The subchorionic hemorrhage had gotten much bigger, but other than that, we were just incredibly relieved that things seemed to be okay. The next benchmark was getting to the 20-week scan, and we thought about having an interim appointment to go in and check. But the bleeding was getting better every day. I was spotting in the mornings, but I was told that that was normal during pregnancy. I just tried to take it easy.
At the 20-week scan, they told us that they were seeing something off with her head shape, but that they couldn’t totally tell what was happening because my fluid was low. They referred me to a high-risk OB. It was presented to us as, “You’ll have a consultation. We do this all the time. They’ll be able to give you more information.” I did not have a sense then that something was critically wrong.
We thought it would be about a week before we could be seen, but they called that evening and said they had an appointment the next morning. My husband was supposed to lead a meeting at work, so we thought, “Okay, I’ll go, and you have to go do your workday. I’ll get the information.”
At the appointment, I could just tell it wasn’t going well. I was seeing measurements on the screen that looked really bad. When the specialist came in, he said, “How are you?” And I said, “Well, to be honest, I’ve been sitting here looking at this screen and trying not to panic.” I think he figured out then he didn’t have to beat around the bush. He said, “I don’t think you’ve been adequately prepared for this appointment.”
The doctor spent an hour with me. He explained that there was no amniotic fluid and likely when I’d had the bleed, I had had a rupture in my amniotic sac. I had been leaking fluid ever since. She had already been small for her gestational age and because of my fluid levels, she wasn’t able to develop her lungs. Her skull shape was abnormal because she was basically getting squished without the protection of fluid. He said there was nothing he could do or anyone could do and that I had three options. One was to basically monitor things at home—monitor any bleeding or fluid and especially monitor my temperature because I was at very high risk of infection. One option was what they call expectant management, which is when they keep you on IV fluids and antibiotics in the hopes that they can prevent infection and keep you pregnant long enough for the baby to develop. You’re hospitalized the entire time. But that kind of intervention wouldn’t increase her chances of survival. The doctor was telling me at this point that a 5% chance of survival would be generous.
Meanwhile, I’m trying my best to get all this information and understand all these medical terms and all these statistics so that I can relay it to my husband, all while processing this growing devastation. It’s sinking in that she isn’t to survive this, and that these options that he’s giving me are also incredibly risky to my health.
And then he said that my third option would be to terminate the pregnancy. The law in Tennessee had already been amended to protect the “life of the mother,” but even though the doctor was telling me about the risks of carrying this pregnancy and maybe going septic or hemorrhaging, my case didn’t qualify. I wasn’t in enough danger yet. I asked him, “What would you have done a year ago? Before Roe v. Wade was overturned?” And he said, “I would’ve offered to induce you today.”
After an hour, I had gotten to the point where I had asked as much as I could think of and I had to leave. I had to walk out the door and go face this new reality. And then I had to sit in my car and think about having to have this conversation with the love of my life to tell him this news about our baby. I sat in my car and bawled and groaned. I went home and I just waited. When he was done with his meeting, I said, “You need to come home.” And he asked me essentially, “Is she still alive?” And I said, “She is, but it’s really bad.”
I explained everything to him. And then we realized the clock was ticking. I couldn’t terminate in Tennessee. At 20 weeks, I couldn’t go to North Carolina, which is one of our neighboring states. And I’ve been told that at any point I could develop a deadly infection or go into labor and spontaneously deliver this baby on the kitchen floor. And now we have Friday—one business day before a weekend—to try and contact people, make appointments, figure out travel, all while grappling with the way it feels like the world is ending and we have to start to say goodbye to her.
We started making calls. We had friends who had been through something similar in Virginia, and they were able to connect us to their provider. I want to stress that we had the capacity to call people and to ask questions. We had people we know who live near this hospital and who would let us stay with them for a few days. We were able to afford the procedure that we had to pay upfront and out of pocket for. We could afford to drive four hours to get there. We had each other, and we could grieve together. We had jobs where we could take time off to be able to do this. There are so many people who don’t have these kinds of resources. There are multiple ways that our systems make this hard for people. It’s not just about this one decision—whether or not people should have access to abortion or at what point they should have access. It’s all these other elements that are unique to everybody’s situation. Everybody should be able to get through this the best way they can.
It was by the end of the day on Monday that everything came together. The hospital that we were going to in Virginia had us scheduled. And they also made us an appointment with a really excellent specialist before so that we could get a second opinion before the procedure, which was really important to me. And then we had leave and get on the road for what I called the worst road trip ever.
I hadn’t really taken any pictures during my pregnancy, and we decided that we wanted to take a few before going into the hospital. We just wanted to have these last few moments. When we got there, the doctor was amazing. She was clear. She took her time with us and made sure to answer all our questions and let me talk it through and say it out loud.
I remember she said then, “Even if this baby could be delivered, there aren’t even machines small enough to hook her up to sustain her life. There’s not even the technology.” She clearly laid out that this situation was a death sentence. I needed to hear it multiple times for it to sink in. And then at the end of the appointment, she reached out and held my arm. And it was the first time that I started to hear that she was scared for me. It was like, “She’s trying to convey the risk to me so that I can go forward with this abortion.” There are a lot of people that I feel grateful who provide care that people need to get through this. And she is one of them.
The next day, we went in for the procedure. There was a lot of bleeding and immediately when I got back to the house where we were staying, I started to bleed more. It was just like, “Who should have to deal with this?” That was Wednesday and Thursday, and then Friday, we were driving back to Tennessee. We stopped at a rest stop on the way back, and I noticed that I felt like I had chills and was starting to feel feverish. I just could tell I felt off. They had told us to watch my temperature closely. By that evening, I was getting warmer and warmer. I had a fever of 102. We went to the emergency department and stayed there. The doctor came into the room and shook my hand and he said, “I don’t even need to take your temperature. I can feel how hot you are.” They admitted me, and finally a nurse practitioner told me that I was being admitted to be treated for sepsis.
It was horrible. And my husband was experiencing all of it too—the loss of our daughter, being terrified that he was going to lose me, helping me deal with my grief. And meanwhile, we’re having to have these conversations about what to do with our baby’s remains. The emotional and physical whiplash is beyond what I can describe.
There’s no way to know when the infection started. The OB I spoke to believed it had started before I had the abortion. We think maybe if I had been able to get care earlier, I could have avoided it. I’m 44. It’s extremely unlikely that I’m going to have any other spontaneous pregnancy. So what now? I feel I have to make sense of something that doesn’t make any sense, and for me that means advocacy.
There’s so much misinformation about abortion. People are wanting to draw these arbitrary lines—not after 15 weeks or not after 16 weeks. I was 21 weeks. Tragedies don’t stop occurring after 15 or 16 weeks. Whatever someone’s reason is for pursuing an abortion, that should be their choice. It’s between them and their medical providers and whoever they want to consult. I could never have imagined, nor would I want to have imagined, what happened to my daughter. I love my daughter. I want her here. But that wasn’t reality.
I want people to know these laws didn’t protect me, and they didn’t protect my daughter.
NICOLE 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.
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.
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.
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.
INDIANA
CAITLIN 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.
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.
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.
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.
FLORIDA
KELLY 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.
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.
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.”
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.
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.”