Reproductive rights continue to weaken in the United States under the Trump administration, and pregnant people are dying. It’s nearly impossible to keep up with the news as states continue to change their laws to make it harder for pregnant people to access abortions, but here are some recent highlights:
Pregnant veterans
In early August, the Department of Veterans Affairs filed a proposed rule that would eliminate coverage for abortion services and counseling for pregnant veterans.
Soon after the overturning of Roe v. Wade, the Biden administration established an interim rule allowing the VA to offer a limited amount of abortion services. These services were available to veterans “irrespective of what laws or policies states may impose” only when the “life or health of the pregnant veteran would be endangered if the pregnancy were carried to term or the pregnancy is a result of an act of rape or incest.”
The proposed legislation aims to undo this rule, claiming it was a matter of federal overreach that would force taxpayers into paying for abortion services.
The Trump administration claims the proposed legislation would not prevent those whose lives are endangered — such as in the case of ectopic pregnancies, which are never viable and pose great health risks to the pregnant person — from receiving life-saving medical care. However, critics have noted the language of the bill is contradictory.
The bill states, “No state law prohibits treatment for ectopic pregnancies or miscarriages to save the life of a mother.”
However, the very next sentence says, “Claims in the prior administration’s rule that abortions throughout pregnancy are needed to save the lives of pregnant women are incorrect.”
Main entrance to the V.A. Medical Center in Kansas City with people waiting to be picked up. (Photo by: Michael Siluk/UCG/Universal Images Group via Getty Images)
Life-threatening conditions
Nonetheless, the death rate of pregnant people has risen in the U.S. since the overturning of Roe v. Wade. This is because doctors living in fear of being criminalized for completing abortion-related medical services are now delaying treatment for life-threatening conditions.
According to a ProPublica report from September 2024, “Women in serious danger have been turned away from emergency rooms and told that they needed to be in more peril before doctors could help.”
“Women in serious danger have been turned away from emergency rooms and told that they needed to be in more peril before doctors could help.”
In 2023, for instance, an Oklahoma woman with a cancerous molar pregnancy (which is never viable, and sometimes does not even contain a fetus) was told by emergency room doctors, “We cannot touch you unless you are crashing in front of us or your blood pressure goes so high that you are fixing to have a heart attack.”
So, rather than offering medical care that would prevent a patient’s condition from escalating to a more dangerous state, providers are now advising pregnant people to wait until they are gravely ill before even considering their case. For any other medical issue, providers never would ask patients to wait like this.
But under this political landscape, doctors feel extreme pressure to protect fetal life, often at the expense of the well-being and dignity of the pregnant person.
To give another example, earlier this year, the dead body of Adriana Smith, a woman in Georgia who was eight weeks pregnant at the time of her death, was kept on life support for months after the hospital informed her family they were “legally obligated to keep Smith on life support until the fetus was viable” due to Georgia’s fetal personhood laws. The law asserts that an embryo or fetus at any stage of development is considered a separate person from the pregnant person carrying it.
The baby, named “Chance,” was born after just 25 weeks in utero, weighing less than 2 pounds and in need of intense medical care.
Since the overturning of Roe v. Wade, many pregnant people have been asked to risk their lives or been revoked of dignity due to restrictive laws that prevent doctors from giving them proper medical care in a timely manner. Today, CDC data has shown that pregnant people who live in states that banned abortion are “nearly two times as likely to die during pregnancy, childbirth or soon after giving birth” compared to those living in states where abortion is accessible.
So it is, in fact, correct that sometimes abortions are required to save the lives of pregnant women. And more than half of female veterans of reproductive age live in states that ban abortion, so the newly proposed legislation almost certainly would pose health risks to any pregnant person who has served our country.
‘Separation procedures’
This false argument that abortions are never medically necessary has grown in popularity over recent years and is related to an ongoing effort by pro-life lawmakers and advocacy groups to promote the idea that abortions are always elective procedures received by people who do not want their healthy babies, therefore they are acts of murder — not medical care.
They instead promote “separation procedures” for inviable pregnancies, which they refer to as “maternal fetal separation” (c-sections that remove a fetus from a uterus). They claim these are different from and better than abortions because they would only occur when medically necessary.
However, the American College of Obstetricians and Gynecologists opposes the use of this term. On the group’s website, they explain “maternal-fetal separation” is not a unique procedure. It is simply a more palatable way to say “abortion.”
“This is a misleading term used to disguise the fact that a person needs or has had an abortion.”
They write: “This is a misleading term used to disguise the fact that a person needs or has had an abortion or to imply that there is a medical intervention that is an alternative to abortion. This phrase is also used by abortion opponents to justify or to mandate performing medical procedures that carry more risk for the patient, such as cesarean deliveries or inductions of labor, rather than abortion. Using this phrase creates confusion, prevents the public from understanding that abortion is a necessary and lifesaving procedure, potentially complicates the gathering of critical data related to maternal health, and further stigmatizes abortion.”
In other words, this is an effort to make abortion seem like an extreme and unnecessary procedure, rather than a method of lifesaving care.
Lab staff use a microscope stand and articulated hand controls to extract cells from 1-7 day old embryos, shown on the monitor at right, that are then checked for viability at the Aspire Houston Fertility Institute in vitro fertilization lab Feb. 27, 2024, in Houston. (AP Photo/Michael Wyke)
Attacks on IVF
Akin to this anti-abortion rhetoric is the recent attack from far right activists on In Vitro Fertilization, a treatment for infertility in which eggs are fertilized by sperm in a medical lab, then placed in the uterus to develop.
There are numerous medical reasons why a person may go through a series of IVF procedures.
For instance, a person seeking to get pregnant may have an ovulation disorder making it difficult for natural fertilization to occur. Some patients also have their eggs or fertilized eggs frozen for later use, such as people who are about to start cancer treatment, which can impact fertility long-term.
However, some anti-IVF activists are promoting something called “restorative reproductive medicine,” or RRM for short.
Like “maternal fetal separation,” RRM sounds like scientific, medical lingo, but it is not. Rather, it refers to a theory growing in popularity that the reason some people struggle with infertility is because there are underlying causes that can be resolved with holistic methods, such as changing your diet or balancing your hormones.
In a series of essays published by the Heritage Foundation, many writers denounce the use of pharmaceutical treatments for reproductive health issues in favor of natural methods, such as logging your menstrual cycle or planning intercourse based on visible biomarkers (like the excretion of cervical mucus). Many of the authors oppose IVF because they believe it does not identify or cure the “root causes” of infertility, which they think can be resolved by these holistic practices.
But deeper within the argument against IVF is not the health and well-being of pregnant people. It is about fetal personhood and the belief that life begins at conception.
If a person freezes their fertilized eggs and does not use each one, is it “pro-life” to discard some of them? As the push to criminalize abortion becomes increasingly more intense, rhetoric attacking the morality of IVF serves to solidify this ideological stance.
Source: Center for Reproductive Rights
Reproductive rights by state
Adding to the current confusion, reproductive rights look different across the states. Currently, there are no states that ban IVF, but a decision made by the Alabama Supreme Court last year has paved the way for shaky access.
Typically, legislation regarding fetal personhood makes exceptions for IVF, but last February, the Alabama court ruled that fertilized embryos have the same rights to legal protection as all children, which would pave the way for legal action to be taken against IVF health care providers.
The case is based on a 2020 incident involving a hospital patient who entered an unlocked door to the fertility clinic that housed embryos. The patient picked up a case storing three different couples’ embryos and dropped them because it was cold, destroying them. A trial court judge ruled that the embryos “are not people or children,” but the Supreme Court overruled this decision.
While the future of IVF is unknown, there are plenty of states that have criminalized abortion. According to The Center for Reproductive Rights: Since the overturning of Roe v. Wade, abortion has become illegal in 12 states, with very few exceptions in some places. This means anyone who attempts to have an abortion in Texas, Oklahoma, Arkansas, Mississippi, Louisiana, Alabama, Tennessee, Kentucky, West Virginia, Indiana, South Dakota or Idaho can be criminalized for having an abortion.
Abortion laws are “hostile” in 11 states, which means pregnant people in those states have very limited access to abortion. In most cases, there is a short window during pregnancy where abortion is legal, or sometimes just exceptions for life-threatening medical conditions.
In Florida, Georgia, South Carolina and Iowa, abortions must take place within six weeks of conception. In North Carolina and Nebraska, the limit is 12 weeks, and in Utah it is 18 weeks. And in Wyoming and South Dakota, lawmakers argue they can enforce a total abortion ban.
Abortion rights are available but not protected in New Mexico, Virginia, New Hampshire and the U.S. territory, Puerto Rico.
And in the rest of the states, abortion rights are protected. In some of these states, lawmakers have attempted or are attempting to expand protections to access, in light of the lack of federal protections for the procedure.
Mallory Challis
Mallory Challis is a master of divinity student at Wake Forest University School of Divinity. She is a former Clemons Fellow with BNG.