Recently, an old friend, mathematician David Rohrlich, urged his colleagues in the American Mathematical Society to refuse to hold meetings in any state that has implemented stringent anti-abortion legislation.  His reasoning is simple—the laws are so vaguely written and so far-reaching in their implications that they endanger the life and health of any woman unfortunate enough to suffer a pregnancy complication while attending a professional meeting in one of the misogynist red states. Pregnant women should not be forced to choose between missing a meeting that’s professionally important to them or else risking serious illness and death if they go to the meeting.

The reaction to Rohrlich’s proposal among mathematicians has been very positive, and there’s a good chance the Math Society will announce a boycott. If other professional societies can be persuaded to do likewise, the economic effect will put pressure on the red states to stop violating women’s human rights.

The new wave of anti-abortion measures has had an unsurprising effect on women’s ability to procure an abortion.  After all, the status of women’s reproductive rights in the red states was dire enough before the overturning of Roe v. Wade.  What seems to have blindsided some observers, however, are the calamitous consequences of the legislation for the health and safety of any woman whose pregnancy develops complications.

The U.S. is an extremely litigious as well as highly bureaucratic society.  The media are full of accounts of hospital administrators directing their medical staff to err on the side of caution when deciding what care they can give women whose pregnancies are in danger.  Hospital legal teams are apparently terrified that their physicians will be charged with abortion-related criminal offenses.  Obstetricians, gynecologists, and nurse-midwives are increasingly afraid to provide miscarriage treatment they would have unhesitatingly offered in previous times.  Instead, medical practitioners in the anti-woman states are delaying decisions about how to treat pregnancy complications, turning away pregnant women experiencing bleeding, cramping, or elevated blood pressure, and advising the affected women to seek care in a more woman-friendly state.

In the “A Little Bit Pregnant” chapter of Sex and Herbs and Birth Control I touch on the many ways that pregnancy is a process, not an absolute.  In most cultures and time periods a woman was not considered pregnant until she declared herself to be so; anything she did before that declaration to either support or discontinue her pregnancy was her own business.  Even now, medical authorities view pregnancy as an unfolding process, one that begins not with sperm meeting egg, but rather with secure implantation of the fertilized zygote in the uterine wall.

In like manner, the termination of pregnancy can be a complex process.  But the new laws of the red states are making the treatment of pregnancy complications hazardous, even life-threatening.  As any reputable obstetric professional will tell you, the procedures to deal with a failing pregnancy are indistinguishable from those used to cause an abortion.  And indeed, as journalist Kate Zernike notes, major medical societies as well as insurance providers “define abortion as any procedure that terminates a pregnancy—whether that pregnancy is wanted or unwanted, whether a woman is seeking the procedure to clean out her uterus after a miscarriage, or because of a dire fetal diagnosis, or to terminate a pregnancy she had not expected.”  

But the safest methods to terminate a morbid pregnancy, while giving the patient the best chance of carrying a pregnancy to term in the future, require that treatment begins before the fetal heartbeat has ceased.  Waiting for the cessation of fetal heartbeat, as the laws of several states now mandate, puts the woman at great risk of future harm.

As I mentioned above, health professionals in the anti-women states are delaying treatment or urging the affected women to travel to one of the states that puts a priority on maternal health.  Clearly, this option is not equally available to everyone.  The costs can be prohibitive and medical insurance often does not cover trips out-of-network.  As the president of the American Medical Association noted in an article in the New York Times, the post-Roe situation is causing “chaos.”  As Zernike succinctly puts it: “Women are being denied abortions for miscarriages and to end pregnancies that have little or no chance of survival or left to become sicker before they can have an abortion deemed to be lifesaving.” 

The risks of pregnancy complications in the U.S. are significantly higher than in other industrialized countries.  Reasons include a higher percentage of first pregnancies among older women, a large percentage of expectant women with high blood pressure, diabetes, and obesity, COVID-19 sequelae, and expensive or otherwise inaccessible pre-natal care options.  Cases of preeclampsia, stillbirth, ectopic pregnancy, and other morbid conditions are high and increasing.  Women experiencing these conditions often need abortion care sooner rather than later.  These issues are not going away, despite anti-women politicians’ attempts to sweep the consequences of their vicious policies under the rug.  

Among sources consulted:  Kate Zernike, “After Roe, a Debate About What the Word ‘Abortion’ Means,” New York Times, 10/18/2022; Ariana Eunjung Cha, “Pregnancy complications spiked during the pandemic,” Washington Post, 10/8/2022.  The New York Times also has a series of video interviews with health professionals and others that can be accessed online.