Pregnant? The State Can Ignore Your Advance Directive

5.21.25

Click to skip ahead: Criminalizing Care connects the dots on the rise in post-Roe arrests. Conservative Cruelty notes that we’re still waiting to hear from the nation’s leading anti-abortion group on Adriana Smith, along with some troubling legal news about advance directives and pregnancy. In the States, news from Texas, New Hampshire, and more. All About Louisiana looks at anti-abortion legislation seeking to expand civil liability. Anti-Abortion Glossary reports on the latest around ‘coercion’. In the Nation, supporting Planned Parenthood and a new ruling on workplace protections for abortion patients.

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Criminalizing Care

If you missed yesterday’s breaking story, please read it below: A Texas woman, Mallori Patrice Strait, was jailed for nearly five months—charged with abuse of a corpse after miscarrying in a public restroom.

Texas Jailed a Miscarriage Patient for Five Months

Her case echoes prosecutions we’ve seen across the country—like Brittany Watts in Ohio and Selena Maria Chandler-Scott in Georgia. These are not just a handful of horrifying outliers. According to Pregnancy Justice, over 200 pregnancy-related arrests took place in just the first year after Roe fell.

And these cases all follow a pattern. Instead of arresting women on suspicion of abortion, law enforcement accuses them of ‘abuse of a corpse’ or ‘abandoning a dead body’—charges based on how they handled their miscarriages. This gives Republicans the cover they need to claim they don’t prosecute women for abortions, while punishing patients all the same.

And let’s be clear about who’s being targeted. It’s women of color—like Strait, Watts, and Chandler-Scott; and women who are low-income, unhoused, or young. In March, a Pennsylvania teenager was investigated for burying her fetus in her backyard. And in 2023, a 17-year-old in Nebraska was sentenced to 90 days in jail for doing the same.

And those are just the stories we know about.

Something else to keep in mind as more of these cases come to light: you’ll notice that many involve women later in pregnancy. That’s not just a consequence of fetal personhood—but ‘viability’ laws and standards that allow state interference at a certain point in pregnancy.

But our bodies don’t become less ours at 24 weeks. And fetal personhood is wrong at any point in pregnancy.

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If you are facing investigation or arrest over a pregnancy outcome—or just need information about pregnancy criminalization—go to Pregnancy Justice. You can also get free legal advice from If/When/How’s Repro Legal Helpline: 844-868-2812

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Conservative Cruelty

I’m tempted to post a countdown clock at this point: It’s been a full week since the country learned about Adriana Smith—and still, not a peep from the country’s most powerful anti-abortion organization, Susan B. Anthony Pro-Life America.

Smith, whose body is being kept on life-support in a Georgia hospital against her family’s wishes, was 9 weeks pregnant when she was declared brain dead. Doctors told Adriana’s family that the state’s 6-week ban prevents them from allowing her to pass away naturally and peacefully.

Some anti-abortion groups have issued statements—with most just trying to duck responsibility. But SBA? Silent. And that silence speaks volumes.

It’s not just that the organization is afraid of political backlash, though that’s certainly part of it. My guess is that SBA president Marjorie Dannenfelser hasn’t distanced herself from Adriana’s torment because she supports it. In fact, I’m willing to bet she agrees with Students for Life president Kristan Hawkins—one of the few anti-abortion leaders to say out loud that Adriana’s body should be used as an incubator.

She just doesn’t want to say it in public. Not with voters watching, anyway.

As Mary Ziegler writes at Slate today, the idea that conservatives didn’t see this coming is absurd:

“Adriana Smith’s case isn’t an oversight. It’s just one example of what fetal personhood means.”

There’s only so long SBA can stay quiet, because their absence is starting to be very noticeable.

Tick tock, Marjorie. ⏰⏰⏰⏰

In related news: I thought I was pretty well versed on all things pregnancy and abortion, but this news from Dr. Jennifer Lincoln truly shocked me: over 30 states have laws that override your advance directive if you’re pregnant.

An advance directive is supposed to be a binding legal document. It lays out your wishes for medical care—like whether or not you’d like to be kept on life support—if you become incapacitated. But Lincoln reports that in most states those wishes can be thrown out if you’re pregnant; and in nine states—Alabama, Indiana, Kansas, Michigan, Missouri, South Carolina, Texas, Utah, and Wisconsin—advance directives for pregnant people are automatically invalidated.

That’s not some small legal loophole! That’s the state declaring that your body no longer belongs to you.

Lincoln has a map on her Substack, and I’ll be digging more into this. But it’s a gut-wrenching reminder: Pregnant people in this country are treated like second-class citizens—when we’re treated like people at all.

In the States

Don’t be fooled by today’s headlines about Texas. The state legislature advanced Senate Bill 31 this afternoon—the legislation Republicans claim will clarify (🚩) the state’s abortion ban and protect doctors who provide life-saving care. But despite GOP talking points (and far too many credulous headlines), the truth is a lot darker.

Abortion, Every Day first reported on SB 31 back in March, warning that it was a Trojan Horse—a bill designed to bring back a 1925 abortion ban that could be used to prosecute abortion funds, helpers, and even patients. AED’s reporting created a domino effect of coverage that put pressure on lawmakers to amend the bill and walk that plan back.

Their original plans foiled, Republicans have since shifted their attention to another bill—SB 2880—where they’re still trying to revive that century-old ban. And SB 31? Still a big problem!

The bill allows Texas Republicans to pretend that they’ve ‘softened’ their stance and offered legal clarity to doctors, even though it doesn’t actually expand exceptions. What’s more, the bill requires doctors to take a continuing education course about the state’s abortion ban—designed and taught by an organization hand-picked by Texas Republicans.

Translation: anti-abortion activists will be teaching doctors when and how they’re allowed to save a woman’s life.

How do I know? Because we’ve seen this before! When South Dakota Republicans passed a similar requirement, the state teamed up with the extremist American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) to create their ‘educational’ materials for doctors.

This is an organization that insists abortion is never medically necessary—and recommends c-sections for women with life-threatening pregnancies rather than safer, faster, less painful abortions. So maybe not the best folks to be giving medical advice!

Per usual, Texas is a testing ground for what anti-abortion groups want nationally. These so-called ‘Med Ed’ bills—which are becoming a trend—let lawmakers pretend they’re working with doctors to clarify care, when what they’re really doing is establishing a terrifying new norm: that the government gets to dictate when and how doctors treat their patients in medical emergencies.

So no, I won’t be celebrating SB 31. And I wish more headlines and publications were asking tougher questions.

Meanwhile, New Hampshire Republicans are pushing legislation that would create a formal citizen-led process for banning books in public schools. Good times!

Right now, New Hampshire school boards have oversight of book complaints; under HB 324, parents (or any individual) could file a challenge against a book, and the school would have to respond within 10 days. There would even be an appeal process if the person who brought the challenge doesn’t like the school’s answer.

Bill sponsor Rep. Glenn Cordelli said the legislation “is about making sure that our children, your children, have books that are age appropriate.” In a moment when conservatives are attacking books or lessons that even mention LGBTQ people, we know what ‘age appropriate’ is code for.

Finally, The Mercury News has a profile of Anna Nusslock, the California woman suing a Catholic hospital who denied her miscarriage treatment. Nusslock was just 15-weeks pregnancy when her water broke: there was no chance for her twin fetuses’ survival and she was more at risk the longer she stayed pregnant. But because there were still audible fetal heart tones, Providence St. Joseph Hospital refused to give her care.

Her story is just wrenching—it’s also a reminder that these bans and policies can impact you no matter where you live. Learn more about how Catholic hospitals’ anti-abortion policies hurt and kill women in AED’s past coverage.

Quick hits:

• Wisconsin Democrats are trying to expand access to contraception;

• A new study shows an increase in North Carolina’s out-of-state abortion patients;

• Where New Jersey gubernatorial candidates stand on abortion rights;

• And more on the parental consent fight in Florida.

All About Louisiana

Yup, Louisiana needed its own section today. Abortion is already completely banned in the state, but Republicans there aren’t done. They’re pushing even more restrictive and punitive laws—all in an effort to terrify anyone thinking about getting out-of-state care or ordering abortion pills.

Like their conservative counterparts across the country, Louisiana Republicans are furious that pregnant people have found ways to access abortion despite the state ban. So they’re working overtime to shut all of that down.

Their latest move? House Bill 575, legislation that would dramatically expand civil liability around abortion. It would allow patients, the fetus’s father, and even grandparents to sue anyone who “performs, causes, aids, or abets an abortion.”

Yes, really.

Bill sponsor Rep. Lauren Ventrella calls it the “Justice for Victims of Abortion Drug Dealers Act,” a title that had me rolling my eyes so hard I’m pretty sure I sprained something. Under this legislation, plaintiffs could sue for at least $100,000, plus damages for emotional distress and attorney fees.

Ventrella wants voters to think this is about stopping shady out-of-state doctors—the so-called “abortion drug dealers.” But many of those blue state providers are protected by shield laws. In reality, her bill would most likely impact Louisiana doctors providing legal emergency care.

Here’s how it could play out: A pregnant woman shows up at the hospital after her water breaks far too early. To prevent infection and sepsis, her doctor performs a (legal) abortion. But her mother-in-law, who’s there in the room, decides the doctor acted too soon—and convinces herself that a healthy baby could have been born if they’d just waited. (It’s not medically sound, but since when has that stopped anyone?)

Under this bill, that mother-in-law could sue the doctor.

Even if the court ultimately sides with the doctor, she’s now been through months or years of legal hell. And the next time she’s treating a miscarrying patient, maybe she hesitates—delaying care for fear of being sued again, putting her patient at risk.

It’s especially dangerous because HB 575 removes malpractice protections for providers. So now doctors are expected to make split-second medical decisions during emergencies with a legal target on their backs.

The bill is headed to a state Senate committee next, so I’ll keep you posted. In the meantime, take action against the legislation here, and listen to the latest episode of the Seriously?! podcast with Michelle Erenberg and Ellie Schilling of Lift Louisiana to learn more:

Anti-Abortion Glossary

Another wackadoo bill is making its way through the Louisiana legislature—and it’s a perfect example of one of the anti-abortion movement’s favorite buzzwords: coercion.

Last month, I flagged HB 425, which would expand the state’s definition of ‘coerced’ abortion—most notably around “extortion.”

Rep. Josh Carlson’s bill is so broad that a parent who refuses to pay for college for their pregnant teen—or a roommate who wants to end a lease with their pregnant friend—could be guilty of ‘coercion.’

I can’t stress enough how much conservatives love this word. They started to float it in earnest back in 2023, when leading anti-abortion activists identified the term as the GOP’s most promising talking point because “no one is openly in favor of coerced abortions.”

Since then, we’ve seen it everywhere—especially when Republicans are doing something shitty. Louisiana Republicans arresting a mom for helping her teen daughter get an abortion? We’re stopping coercion! Passing restrictions to delay abortion care in Michigan? We’re just making sure no one was coerced!

Montana lawmakers used it as an excuse when they were pushing a bill to charge women who got out-of-state abortions with ‘trafficking’ their own fetus. New FDA chief Marty Makary dropped the word when talking about potential restrictions on mifepristone. And anti-abortion activists even used it to argue against emergency abortions in hospitals—claiming the Biden administration was somehow coercing doctors by requiring them to save women’s lives.

All of which is to say: the anti-abortion movement thinks this term is their ticket out of voter backlash. It sounds compassionate. It polls well. And it just so happens to give cover to some of the cruelest laws in the country.

So if you’re working on abortion rights messaging, take note: coercion is the word we’ll be up against.

In the Nation

I really hate this news: A federal judge has struck down a provision of the Pregnant Workers Fairness Act (PWFA) that requires employers to make “reasonable accommodations” for workers who have abortions. U.S. District Judge David Joseph ruled that the Equal Employment Opportunity Commission (EEOC) overstepped its authority when it included abortion as a pregnancy-related condition deserving of workplace protections.

Now, let’s be clear here: The EEOC’s guidance only applied to businesses with more than 15 employees, it didn’t require employers to pay for an abortion—or to even give employees paid time off! In reality, the regulation was about ensuring workers can take time off for abortion appointments and recovery without fear of losing their jobs.

But asking employers to be decent human beings is a step too far for Republicans, who want the legal right to discriminate against abortion patients.

And while conservative leaders have insisted that workers who need ‘medically necessary’ abortions can still have paid time off—how exactly will that work? Are employees going to be required to prove to their boss that they’re sick enough to need an abortion?

Honestly, fuck these guys.

Finally, I was one of over 250 people who signed a letter in support of Planned Parenthood today—published as a full-page ad in The New York Times. As you all know well, Republicans are trying to shut down the reproductive health organization, and attack the country’s most vulnerable communities in the process. This week, don’t forget to ask your member of Congress to step up and fight for Planned Parenthood. Read the full list of supporters here.

Quick hits:

• NPR on why abortion clinics are closing, even in pro-choice states;

• Mother Jones on the increasing violence against abortion providers and clinics;

• And in international news, The Guardian on why abortion rights are getting more perilous in the UK.