Dr. Constance Williams Chapman, OB/GYN, performs a postnatal checkup with Katie Pike, 27, and her son Kai, in Monticello, Arkansas.
Photo: Jahi Chikwendiu/The Washington Post/Getty Images
Most abortion opponents profess a deep concern for the well-being of women. An interest in their emotional state, or their physical health, perhaps even the welfare of the children a pregnant woman may already have at home. It is possible to love the fetus as much as the woman who carries it, these activists insist. Live Action, which was founded by the prominent abortion opponent Lila Rose in 2003, sells a “Love Them Both” T-shirt for the low price of $24.99. Crisis pregnancy centers across the country sometimes offer free diapers or car seats while they peddle lies to women in need. But that paltry alternative to a robust safety net leaves many women — and children — behind, as a new story from the Washington Post shows. Though abortion opponents say they embrace women and their needs, the policies they promote create a nightmare world that many women cannot escape.
The Post followed the story of Sa’Ryiah Lincoln, a 15-year-old Arkansas girl pregnant with her first child. Lincoln had already picked out a name for her child by the time she discovered blood in her underwear, a frightening medical emergency. When EMTs arrived, however, she learned that her local hospital no longer delivered babies, and she would have to travel by ambulance another half-hour to a larger facility. One of Lincoln’s doulas, Hajime White, told the Post that “anything could have happened” on such a long trip to the hospital. In some ways, Lincoln was lucky. The second hospital stabilized her, and she gave birth to her son a few months later.
The danger in which Lincoln found herself is not so unusual for Arkansas, which prohibits abortion with an inadequate exception for the life of the mother. The state can also be a dangerous place to give birth, especially in its southeast timber country. “Arkansas already has one of the nation’s worst maternal-mortality rates, and mothers in this area die at a rate exceeding the state average,” the Post reports, adding, “Ninety-two percent of recent maternal deaths were preventable, a state review committee found.” Anti-abortion rhetoric may embrace women, but in practice, anti-abortion states value them very little indeed.
Medicaid covers 44 percent of all births in Arkansas, and the state ends postpartum coverage two months after birth for many recipients, according to a previous Pulitzer Center report on the state’s maternal-health crisis. In 2023, after the Supreme Court overturned Roe v. Wade, the federal government offered states the ability to extend Medicaid coverage a full 12 months after birth. “Arkansas was one of only three states to decline,” the Center observes. “It’s a tragedy,” Dr. Zenobia Harris of the Arkansas Birthing Project told the Center. “Two months after the baby’s born, they don’t have coverage anymore. If people have undiagnosed hypertension or diabetes and they’re not getting care, they’re more likely to die.” The Post reports that Governor Sarah Huckabee Sanders said that the state’s existing coverage rules were extensive enough — but the women and girls of Arkansas are struggling.
State representative Aaron Pilkington, a Republican and abortion opponent, told the Post, “If we really say to the world we’re pro-life, we need to put our money where our mouth is and make sure these women are treated and have the care they need.” Pilkington proposed legislation in 2022 that would have extended Medicaid coverage for postpartum women, but it didn’t pass. “We’re on our own,” said White, who was Lincoln’s doula, to the Post. “We’re the main ones who are actually dying out here, and no one really understands.”
That’s due in part to the state’s anti-abortion laws, which likely deter obstetricians from practicing in the state. Abortion opponents like Pilkington can’t have it all: The right to terminate a pregnancy is linked inextricably to the broader right to determine one’s own reproductive fate. Abortion care is one aspect of a comprehensive reproductive-health regimen, and when states heavily restrict access to abortion, women’s health suffers overall.
As one recent analysis in Rewire News Group notes that since the end of Roe, physician “residency programs in states where abortion is banned or restricted have received fewer applicants,” a trend that has continued for the second year in a row. States such as Arkansas, with the most restrictive abortion bans, saw the biggest decrease in applications. “While almost all residency positions are filled due to a shortage of training positions, states with reproductive-health-care restrictions may have a harder time attracting candidates of choice,” Kendal Orgera, the lead research analyst for the Association of American Colleges’ Research and Action Institute told Rewire. “Because about half of trainees stay to practice in that state, this may have long-term implications for the ability to serve patients across communities in some states.”
The Post’s Arkansas story also makes a powerful case for reproductive justice. The SisterSong collective, a leading voice for reproductive justice founded by women of color in 1997, defines that framework “as the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.” No state guarantees health care or safe housing, which is a colossal national failure, but the situation is often particularly dire in states that ban abortion. Though women may give birth, just as abortion opponents wish, they will often do so in the most difficult circumstances, scrambling for a living while balancing skyrocketing child-care costs. They may even die in the process. There’s no way to solve this crisis without a public safety net — or without the right to a full range of reproductive health-care services. Women need both.
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