The New Anti-Choice Plan for Life Exceptions

Activists want health & life exceptions to dictate “equal care” for women and embryos

Since Roe was overturned, Republicans have been struggling with how to win over voters on abortion. Study after study shows that Americans  overwhelmingly oppose abortion bans, especially those without exceptions. Even in the reddest of states, people want to see abortion access for sexual assault victims protected, along with women’s health and lives. 

And with horror stories from anti-choice states rolling in at record speed—from sobbing cancer patients and raped children being denied care to women going into sepsis—conservatives have realized that they need a new message and tweaked legislation. And they need it fast. 

Extremist anti-abortion groups that carefully crafted deliberately vague health and life exceptions aren’t exactly eager to undo all their hard work; but they also know that public opinion is against them, and they need to at least appear to give a shit about women’s lives. 

That’s where ‘equal care’ comes in. Anti-abortion groups are increasingly using this term in response to criticisms about women’s health and lives being endangered—with some pushing it as a policy answer. The legislative director for ProLife Wisconsin, for example, told NPR this week, “We would like to tighten up that vague and undefined 'life of the mother' language, and essentially replace it with an equal care language requirement requiring equal care for mother and child.” Leaders of major anti-abortion organizations like Americans United for Life and the American Association of Prolife OB/GYNs have also advocated for the standard, as has the March for Life. 

Their claim is that this change would somehow help women and clear up confusion for doctors struggling to give adequate care under abortion bans. The truth, of course, is that such a policy would make doctors’ jobs even harder and women’s lives more at risk. 

I’ll give you an example: My own. When I was 28 weeks pregnant with my daughter, Layla, I developed severe preeclampsia—dangerously high blood pressure during pregnancy which can be fatal. The only way to resolve the condition is to not be pregnant. Still, the hope was that I would be stable enough to carry Layla for as long as possible. I was admitted to the hospital to be monitored, put on an IV drip of magnesium to help prevent seizures, and given a shot of steroids to speed up the development of Layla’s lungs. 

I remember doctors telling me I would be spending the rest of my pregnancy in the hospital; when I expressed incredulity that I would need to be there for months, they replied that I would be lucky to last a week. 

Two days later, I developed HELLP syndrome—a deadly complication of severe preeclampsia that breaks down your red blood cells and destroys your liver. (Without treatment it has a 24% mortality rate.) Watchful waiting was now out of the question: I needed an emergency cesarean section, even though Layla wasn’t due for another three months. I begged the doctors to wait, to allow her to have more time to grow. My father even pulled my OBGYN aside and asked what would happen if they were to hold off—she answered that a best case scenario would be a liver transplant. We knew what the worst case scenario was. 

And so when I first read about the concept of “equal care,” I immediately thought of my own experience and how it might have been different under such a policy. Obviously my physicians were already taking Layla’s health and life into account—but I was the primary patient. If my doctors were bound by a law that said otherwise, would they have considered that liver transplant in order to give Layla a few more days to develop? Would they have had a meeting with their legal team instead of springing into action to give me a c-section? How much permanent harm to my organs would have been considered an acceptable tradeoff?

All of which is to say: An ‘equal care’ standard would put women in even more danger than they already are—and not just in cases where doctors are considering abortion. There was never any doubt that my daughter was going to be delivered and treated, for example, but when she came into the world was determined by the risk to my health and life. A policy like this would completely change the way that OBGYNs treat women who have complications later in pregnancy—putting doctors in the position of having to decide how much permanent damage to a woman’s health is legally allowable in order to give fetuses more time in utero. 

The conservative push for ‘equal care’ has nothing to do with clarifying the exceptions to their horrific abortion bans. It’s not about protecting women’s health and lives, or helping doctors. (In fact they’re working hard to preemptively blame doctors for the inevitable deaths that their laws will cause.) This is about using a moment when people are scared and angry to push ever-more radical standards into legislation—policies that will continue to trump the rights of a pregnancy over the rights of a person. It’s a sly strategy they hope will fool voters into believing that they care about women, even as they cause us incalculable harm. And there’s nothing ‘equal’ about that.