This is How They Kill Us

The rise of post-Roe c-sections

I remember the feeling of hands inside me. Pulling, tugging, moving things aside. My emergency c-section wasn’t painful, but that feeling of being invaded was somehow worse than physical hurt. For years, the thought of the surgery would send me into a PTSD panic, my knees literally buckling and vomit coming up the back of my throat. In my memory, my arms are tied down while I’m being cut—but I know that’s not true. It’s just my brain’s way of making the powerlessness of the moment seem tangible. 

Because I was so early in my pregnancy, just 28 weeks along, doctors had to cut me both horizontally and vertically, making it life-threatening for me to have a vaginal birth in the future and increasing my risk for uterine rupture. I didn’t know it then, but I would never have another child. 

So when I see anti-abortion groups blithely suggesting that women with life-threatening pregnancies should be forced into c-sections rather than easier, safer, and less traumatic abortions—it feels personal. Because I chose my medical nightmare; it was necessary to save both my life and my daughter’s. I can’t imagine the horror of going through such a thing unnecessarily, or at 16 weeks pregnant instead of 28. What if my tied-down arms weren’t a post-traumatic illusion, but a legal reality?

For nearly a year, I’ve been tracking this growing strategy: Some of the most powerful anti-abortion organizations in the country are using carefully-worded legislation and seemingly-credible clinical recommendations to codify medical atrocities—pushing doctors to force pregnant women into unnecessary labor and c-sections, even before fetal viability and sometimes even when a fetus has died.

Why would anyone do such a thing? The answer is as simple as it is awful: Anti-abortion groups and lawmakers want to prove that abortion is never necessary to save a person’s life. The problem is that they know pregnancy can be deadly, especially in the United States. Rather than admit abortion can be life-saving, their solution is to force doctors to end deadly pregnancies in any other way—even if it means torturing women in the process. 

Anti-abortion lawmakers and activists are so desperate to divorce abortion from health care, they’d prefer to see us dead than allow critically ill women to get care they disagree with. 

I mean that literally. This is how they kill us. With the sly shifting of medical standards and surreptitiously-placed legislative language. Because while these people are cruel, they’re certainly not stupid. Anti-abortion extremists know the only way to normalize medical torture is to move quietly and slowly. 

After all, dystopias aren’t created in a day. They’re built, law by law and talking point by talking point, through medical regulations, bureaucracy, and fear. From a Supreme Court ruling in Idaho to timid guidance from hospital administrators in Louisiana—anti-abortion groups don’t need to own up to their grim vision when they have others embedding the nightmare bit by bit. 

That’s not to say they haven’t been busy themselves. Using extremist groups with credible-sounding names—like American Association of Pro-Life OBGYNs or the Charlotte Lozier Institute—the anti-abortion movement has carefully disguised radical calls to hurt women as simple scientific recommendations.

They’ve inserted the nonsense term ‘maternal fetal separation’ into legislation, court cases and conservative talking points, removing ‘abortion’ in an attempt to further the lie that the procedure is never necessary. They've published papers and trotted out ‘experts’ who claim it’s “medically standard” to force women into c-sections or vaginal labor when their lives are at risk. Again, even when it’s too early for a fetus to survive.

Anti-abortion legislators have done their job too, passing laws that allow their state to define what conditions are life-threatening during pregnancy and the best course of action for doctors. They’ve written mandates that emergency terminations be performed in a way that “provides the best opportunity for the unborn child to survive.” If states must be forced to save women’s lives, it appears, they’ll make sure we suffer greatly for the trouble. 

It’s not a coincidence that reports coming out of anti-abortion states show a sharp rise in c-sections. With their license and freedom on the line, doctors and hospitals are falling in line. One Texas OBGYN who was directed to give a septic patient a hysterotomy told researchers, “The morbidity is going to be insane.”

To people who value fetuses above women, that’s a price they’re willing to pay. Indeed, all of this cruelty starts to make morbid sense when you understand that the broader anti-abortion goal goes beyond forced c-sections or redefining medical standards. They are trying to make Americans numb to women suffering and dying during pregnancy. They’re treating it as unpreventable—natural, even—so that voters don’t bat an eye when the maternal mortality numbers skyrocket. 

There’s a reason that Texas has put an anti-abortion extremist on its maternal mortality review board and Idaho has disbanded their committee altogether. Conservatives know what’s coming, and they’re determined to make sure it seems like business as usual to the rest of us.

My worry is that it’s working. After all, did you ever think that you’d watch the Supreme Court hear arguments about how many organs a person can lose before they’re given an abortion? It took less than two years from the demise of Roe for Republican leaders to oppose laws requiring hospitals to save women’s lives.

If women’s deaths are already normalized, what chance do we have of making our suffering seem urgent?

This summer, it will be 14 years since I had my emergency c-section. For as awful as the surgery was, I’m incredibly grateful for it: it gave me my life and my daughter. I get to look at Layla on her birthday next month and know that my pain was in service of something.

What I can’t bear to think about is all the women who will endure the same for nothing. Those whose lives will be forever and horrifically altered just so some extremist who will never meet or care about them can deliver a smiling talking point about abortions never being necessary.