Conservatives Want to End 'Exceptions' for Women’s Lives

And they think no one will notice

Most of the time, I enjoy making political predictions. This one, however, makes my stomach turn: Conservatives want to do away with ‘exceptions’ for women’s lives. In fact, they’ve been laying the groundwork to eradicate the exception since Roe was overturned—though I didn’t fully piece together the move until recently, when I saw a leading anti-abortion activist refer to life-saving abortions as ‘elective.’

The short version is that they’ve been strategically redefining ‘abortion’ across law, culture and medicine, while pushing the false claim that abortion is never necessary to save a person’s life. The end game is legislation that bans abortion in all cases, mandating that doctors only end life-threatening pregnancies using c-sections or induced vaginal birth, no matter the risk to the pregnant person. 

I’ll explain in detail, but please know that like most anti-abortion strategies, this one is being rolled out quietly and incrementally. In the same way that Republicans won’t pass an outright ban on contraception—instead chipping away at access until birth control is impossible to get—the plan is to methodically eradicate the exception right under our noses. 

Because the idea of eliminating life-saving abortions is so radical—who would suggest such a thing?—there’s a real risk that Americans won’t notice until it’s too late. The unthinkable-ness of their extremism is protecting them. 

This is exactly why I publish Abortion, Every Day: The work I’ve done over the last year—tracking seemingly unrelated moves from anti-abortion organizations, lawmakers and lobbyists—makes what they’re doing clear. You just need to connect the dots. So let’s take a look back at some of the tactics I’ve told you about this year, and piece it all together.

Redefining ‘abortion’

Abortion is a medical intervention to end a pregnancy, for any reason. But since Roe was overturned, conservatives have been trying to redefine abortion as an intention. For instance, they claim that treatment for miscarriages and ectopic pregnancies aren’t really abortions—even if the medication or procedure is identical—because these pregnancies are presumably wanted.

In addition to dividing women into those who ‘deserve’ care and those who don’t, the goal is to divorce abortion from healthcare.

Even though this definition has no basis in medicine or reality, Republicans have embedded it in state laws and policies anyway—often after being lobbied by anti-abortion groups.

North Carolina’s abortion ban, for example, states that “an act is not an abortion” if doctors “remove an ectopic pregnancy” or “remove a dead, unborn child.” And earlier this year in South Dakota, the state’s Secretary of Health Melissa Magstadt released an ‘informational’ video where she said treatment for ectopic pregnancies and miscarriages “is not considered abortion” and that “intent plays a crucial role” in defining true abortions.

Please understand that they’re not codifying this lie for kicks. The more frequently these redefinitions appear in state laws, the easier it becomes for conservatives to argue in court that the false definition is rooted in the country’s history and tradition. All they need is a patchwork of state policies to point to and say, See? Abortion is defined as an intention!

Replacing ‘abortion’

Republicans aren’t just redefining abortion, they’re replacing it with the made-up medical term ‘maternal fetal separation.’ As absurd as it sounds, here’s Kristan Hawkins, president of the extremist group Students for Life, explaining:

“When you’re looking at a case where a woman’s life is at risk, where the physician believes that she can no longer safely carry her child in her womb, or she may lose her life—we wouldn’t consider that an abortion [but a] ‘maternal-fetal separation’.”

Some might ask, What does it matter what they call the procedure, so long as women get the care they need? Well, it matters because when Republicans started citing ‘separation procedures,’ they also began outlining the type of procedures they’d consider acceptable means of ‘separation.’ Namely, induction of vaginal birth and c-sections.

To be crystal clear: Republicans want women with life-threatening pregnancies—­even when they’re very early on—­to be forced into major abdominal surgery, or unnecessary and traumatic vaginal delivery, rather than get a ten-­minute abortion.

Why promote this horror? I wrote about this at length in my book and you can read background here as well, but the short version is that this is yet another way to divorce abortion from healthcare. Conservatives want to be able to claim that abortion is never necessary to save someone’s health or life; they think they can make that lie true by forcing women into c-sections and calling it ‘maternal fetal separation.’

That leads us to the next section, where it all comes together.

Claiming abortion is never medically necessary

The effort to redefine and replace “abortion” in legislation has always been about laying the groundwork for one central—and false—argument: that abortion is never medically necessary.

After all, if abortion is just the intentional ending of a pregnancy, and if women with life-threatening pregnancies can just be treated with ‘maternal fetal separations,’ then all abortions can be labeled elective. That’s the goal.

Sometimes, they say this outright. This summer, for example, I reported on a paper published by anti-abortion activists Ingrid Skop and James Studnicki. They argued that “there is no disease, illness or condition for which an induced abortion has been determined to be a standard of care” and claimed there is “no justification” for health- or life-saving abortions. Instead, they suggested women can simply be given ‘separation’ procedures—in other words, c-sections.

Just a few weeks ago, well-known anti-abortion activist Dr. John Bruchalski echoed that sentiment, calling life-saving abortions ‘elective.’ He said, “There are no advantages for a mother to end her pregnancy by an elective abortion, even in the most life-threatening circumstances.’” Again, the idea is that a standard abortion procedure isn’t necessary because women can be induced or forced into surgery.

This isn’t a fringe belief of random activists. Some of the country’s most prominent anti-abortion groups are on board. When the first post-Dobbs deaths were reported, for example, I noticed that major anti-abortion leaders responded by saying abortion bans allowed for life-saving care—but wouldn’t say the law allowed for life-saving abortions. Instead, they said bans allow doctors to “treat” patients or “intervene” to save lives, carefully sidestepping the word ‘abortion.’

That’s deliberate—and not just because they don’t believe abortion is medically necessary. The nation’s leading anti-abortion organizations will never say doctors can legally provide life-saving abortions because their ultimate goal is to eliminate that exception entirely.

If you’re skeptical, consider this: It wasn’t so long ago that Susan B. Anthony Pro-Life America (SBA-PLA) lobbied against an exception for women’s lives in Tennessee. When the state first passed its trigger ban, there was no exception for life-threatening pregnancies—just an affirmative defense mandate. That meant doctors had to break the law to provide a life-saving abortion and then defend it after the fact.

After facing political backlash, Republicans considered adding an exception for women’s lives, but SBA-PLA fought to keep it out. (There’s even audio of that lobbying effort.)

Meanwhile, we’re also in a moment when Republicans are fighting for the right to deny women life-saving abortions in hospital emergency rooms, and disbanding maternal mortality committees in order to hide the deaths of women killed by bans.

So are you really surprised?

How they’ll do it

You won’t see states passing laws explicitly banning life-saving abortions anytime soon. Republicans are too strategic for that. Instead, they’ll use the same incremental approach they’ve employed elsewhere—chipping away bit by bit. Most egregiously, I feel certain they’ll exploit women’s suffering and deaths to do it.

In fact, that tactic has already started: You might remember how anti-abortion legislators first started codifying their false definition of abortion after stories emerged of women being denied care. They claimed they were simply “clarifying” bans to address any confusion and ensure doctors knew they could treat women with ectopic pregnancies, miscarriages, or life-threatening conditions. Republicans framed these legislative tweaks as protections for women.

But let’s be clear: these people have no interest in protecting women. Their “clarifications” are a cover for the real end goal.

In the coming months, I expect we’ll see even more language about ‘maternal-fetal separation’ and legislative changes framed as efforts to ‘clarify’ abortion bans—especially as more stories of women dying come to light. I suspect they might even use a specific woman’s death as justification for tweaking a state ban.

At the same time, anti-abortion organizations will continue to normalize treating life-threatening pregnancies with c-sections and vaginal labor rather than traditional abortion procedures. Groups like the Charlotte Lozier Institute already explicitly recommend that emergency abortions “be done by labor induction or c-section,” falsely calling it “medically standard.” (It most certainly is not.)¹

Meanwhile, Republican leaders in anti-abortion states will offer “guidance” to doctors about how to legally treat women with life-threatening pregnancies, stressing ‘separation’ procedures. All of these same groups and legislators will also spread propaganda claiming that abortion procedures like D&Cs or abortion medications are far more dangerous than c-sections or vaginal labor.

Eventually, we’ll see a test case: a state where legislators pass a total abortion ban without exceptions. Because, they’ll say, abortion isn’t medically necessary anyway. As I noted earlier, when that case reaches the courts, conservative legal groups will point to years of legislation from multiple states as evidence that it’s “widely accepted” that abortion is simply an intention.

And while it’s true that this strategy is a slow and quiet one, it’s important to know that it’s already unfolding. Reports show that doctors are increasingly performing c-sections on women—even when it’s too early for a fetus to survive—out of fear of breaking the law.

In Louisiana, for example, doctors are performing more c-sections to avoid even the appearance of performing an abortion. And just today, ProPublica published yet another story of a woman killed by Texas’ abortion ban. Why? Because doctors were too afraid to perform a D&C.

They might not have explicitly banned life-saving abortions yet, but doctors are already too scared to perform them.

I know this is a lot—difficult to read and harder to process. I appreciate you sticking with me this far. I wish I had a better prediction, and I wish I didn’t feel so confident that this is their plan for the country. But I truly believe that the more we understand what they’re trying to do, the better prepared we’ll be to stop them.

1. The group also claims a c-­section is “a more appropriate method of separation” because it “shows greater respect for the human dignity of the fetus, even if she is too young or sick to survive.” Women’s dignity isn’t mentioned.