What Happens to Women When the State Decides

Here’s a headline for our sick times.

The Supreme Court is hearing a challenge to a federal law, the Emergency Medical Treatment and Active Labor Act, or EMTALA. This is the act passed in 1986 that requires hospitals that accept Medicare to screen and at least stabilize all emergency patients regardless of ability to pay. They can’t just ship uninsured people in unstable condition off to another hospital, in other words. The people who receive the treatment still get billed for it, but at least treatment is not denied.

“After Roe v. Wade was overruled in 2022, the Biden administration issued guidance clarifying that if a pregnant patient arrives at a hospital with an emergency condition that could only be stabilized with an abortion, the hospital is required to provide that care — regardless of state law,” Rolling Stone reports. But Idaho is challenging this, arguing that states — not the federal government or, heaven forbid, doctors — should decide what emergency treatment women are entitled to receive. The Idaho abortion ban does (in theory) allow for an abortion to save a woman’s life, but as with Texas the language is vague enough to leave doctors guessing as to how close to death a woman has to get before she can have an abortion. If they guess wrong as far as the state is concerned, doctors can face criminal charges, the end of their careers, and prision time.

A bunch of lower courts sided with the feds over Idaho, but on January 5 the Supreme Court lifted the lower court injunction, reinstating the ban until some vague future time when they hear arguments and issue a ruling, in which we assume the majority will still side with Idaho.

No rush, there, justices. It’s not like women are dying or anything. Oh, wait …  See also.

Earlier this week Dahlia Lithwick and Mark Joseph Stern wrote a piece for Slate headlined Republican Officials Openly Insult Women Nearly Killed by Abortion Bans. It begins,

For many years before S.B. 8 passed in Texas and was then swept into existence by the Supreme Court, and before Dobbs ushered in a more formal regime of forced childbirth six months later, the groups leading the charge against reproductive rights liked to claim that they loved pregnant women and only wanted them to be safe and cozy, stuffed chock-full of good advice and carted around through extra-wide hallways for safe, sterile procedures in operating rooms with only the best HVAC systems. Then Dobbs came down and within minutes it became manifestly clear that these advocates actually viewed pregnant people as the problem standing in the way of imaginary, healthy babies—and that states willing to privilege fetal life would go to any and all lengths to ensure that actual patients’ care, comfort, informed consent, and very survival would be subordinate.

As you probably know, one of the ways states were shutting down abortion clinics before Dobbs was to enact absurd “health and safety” building requirements for abortion clinics and only abortion clinics. Lithwick and Stern continue,

A recent filing by the office of Tennessee Attorney General Jonathan T. Skrmetti, a Republican, captures the dynamic all too well. Skrmetti has been fighting a lawsuit filed by a group of Tennessee women denied emergency abortions under the ultranarrow medical exception to that state’s ban. The women plaintiffs suffered an appalling range of trauma, including sepsis and hemorrhaging, because they could not terminate their pregnancies. The attorney general’s response to their complaint is a scathing, shockingly personal broadside against the victims of the ban. He accused them of attempting to draw “lines about which unborn lives are worth protecting” by imposing a medical exception “of their own liking.” He mocked them for asserting that ostensibly minor conditions like “sickle cell disease” might justify an abortion. And he insisted that the lead plaintiff, Nicole Blackmon, lacks standing, because she underwent sterilization after the state forced her to carry a nonviable pregnancy and deliver a stillborn baby. The attorney general viciously suggested that, if Blackmon really wanted to fight Tennessee’s ban, she could have tried for another doomed pregnancy.

Abortion bans are beloved by misogynists. The bans allow women-haters to pretend they ocupy a moral high ground as they abuse and belittle women on a grand scale. This is why there is no reasoning with, or compromising with, them. They will not rest until all abortions are banned, and if women suffer and die they don’t care. As Sarah Jones wrote in New York magazine, “Abortion bans aren’t meant to save lives but to empower the lawmakers who write them. They envision a world with themselves at the top, passing judgment on all those beneath them. A person is disposable because someone in power decides they are such.”

Back to Lithwick and Stern:

Texas Attorney General Ken Paxton and his staff have evinced similar hostility toward plaintiffs in the Lone Star State who brought a nearly identical suit. The lead plaintiff in that case, Amanda Zurawski, was denied an abortion for three agonizing days after her water broke in the second trimester, leading her to develop sepsis; she nearly died in the ICU, and may never be able to get pregnant again. Paxton’s response? Because she might now be infertile—as a direct result of Texas law— Zurawski lacks standing to sue. When the case went to trial, Texas’ lawyers asked profoundly insulting questions of the plaintiffs. “Did Attorney General Ken Paxton tell you you couldn’t get an abortion?” they pressed each woman after pressing them for invasive details about their failed pregnancies. One plaintiff vomited on the stand after recounting her horror story.

These arguments are echoed by red-state attorneys general around the country, like Idaho’s Raúl Labrador, who proclaimed that women forced to carry dangerous, nonviable pregnancies merely “disagree with the legitimate policy choices made by the Idaho legislature.” (Should an Idaho resident suffering excruciating pain from a failing pregnancy drive to the statehouse rather than the emergency room? Labrador seems to think so.) Critically, these lawyers and politicians and activists are gaslighting their real victims. During a hearing over Zurawski’s case at the Texas Supreme Court, Beth Klusmann of the Texas attorney general’s office shifted the blame onto doctors: “If a woman is bleeding,” Klusmann said, “if she has amniotic fluid running down her legs—then the problem is not with the law. It is with the doctors.”

Elements of the abortion criminalization movement for years have claimed there is no actual medical reason ever to get an abortion, and I take it a lot of politicians are refusing to let go of this myth. And that’s because their contempt for women cannot be satiated if they have to show them some consideration and compassion.

Do read all of the Lithwick and Stern piece. Slate usually lets you read a few things for free before they put up the paywall, and if you hit the paywall open it in a private or incognito window. I don’t subscribe and I could read it. This is a powerfully written statement of the box these women-hating politicians have put women into. Women are nothing but incubators to them. The concludion:

If you have opted to move through the political landscape under the view that flawed persons are disposable and potential persons are flawless, the benefit of the doubt will always be afforded to the unblemished, someday rosy-cheeked soul that resides inside of the actual living human with the actual uterus. Indeed, the very instant that the hypothetical perfect babe becomes a real-life, in-the-world girl, a future pregnant woman is also birthed, and she will begin a long journey toward putative moral decay: potential miscarriage, poverty, health challenges, and other ostensible infirmities that will make her too flawed to be trusted to make judgments about her own future pregnancy. The tie will always go to the fetus, perfect in its secret unknown-ness. The mother will never be able to show that she wanted the pregnancy enough, took good enough care, made every correct predictive decision. And as such, the state will happily dismiss her interests as not only irrelevant, but self-serving, greedy, and dishonest. That it’s being said aloud in courtrooms, in pleadings, and in affidavits should not surprise anyone.

The pregnant woman has always been the fallen and the damned. Now, according to red states, it’s acceptable—necessary, even—to ensure that she knows this, from the very moment of conception until the moment she loses the power to make any choices about how she gives birth. Even if she dies, she was forever that which stood in the way of flawless, purest life.

And the Sarah Jones piece at New York magazine is worth reading also, although you have to be more persistent to get through the New York paywall sometimes. This looks at a Texas woman, Yeniifer Alvarez-Estrada Glick, who was murdered by the state of Texas. She suffered from serious health complications through most of her life that went untreated because Texas is one of the worst states in the nation about paying for health care for the poor. Texas still has, as it has had for many years, the highest rate of uninsured people in the nation. When Glick became pregnant her body simply couldn’t sustain the pregnancy. She sought medical help several times, and the Texas health care system pretty much just ignored her, until the day she died before the paramedics could revive her. Doctors reviewing her records have said that if she had received an abortion when she first presented with a clearly disasterous pregnancy, she probably would be alive now. Sarah Jones concludes,

Women, having sinned, cannot be sinned against. Perhaps they got pregnant when they shouldn’t have, or did something to make a pregnancy go south. Maybe Alvarez should’ve worked harder, and pulled herself out of poverty with nothing but personal grit at her disposal. The fault is hers, and hers alone, to these lawmakers. A fetus, though, has yet to fail and thus deserves salvation.

This makes for cruel policy. When it is put into practice, both woman and fetus can die. Alvarez is buried with her daughter Selene, who was delivered by emergency C-section but did not survive her mother’s demise. Abortion bans aren’t meant to save lives but to empower the lawmakers who write them. They envision a world with themselves at the top, passing judgment on all those beneath them. A person is disposable because someone in power decides they are such. Alvarez’s death was preventable, but in its own way, inevitable. There will be more like her as long as conservatives get their way.

I’ve been saying for years (see this post I wrote in 2006, for example) that the difference between the so-called “pro-life” and “pro-choice” opinions isn’t whether one perceives a fetus as a human being, but whether one perceives a woman as a human being.

15 thoughts on “What Happens to Women When the State Decides

  1. "the difference between the so-called “pro-life” and “pro-choice” opinions isn’t whether one perceives a fetus as a human being, but whether one perceives a woman as a human being"

    Brilliant, that about sums it up! You should get that to the Biden campaign, they could use that bit of wisdom this campaign season!

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  2. What are these people thinking? This is so barbaric and politically counterproductive for Republicans. I've only been this staggered and perplexed by reliable accounts of lynchings and the brutal and sadistic murders of black people in the Deep South.  It's so irrational that you have to analyze based on primal drives, not political ones. I want to toss out a few concepts.

    Incel

    1.a member of an online community of young men who consider themselves unable to attract women sexually, typically associated with views that are hostile toward women and men who are sexually active:

    How did this situation evolve? In the 50s and into the 60s women tended not to work and if they did, they seldom got anything close to parity in pay for doing the same work as men. The game was rigged so that women had to trade sex for security with the social blessing of marriage. Women who attended college (usually women's colleges in that era) knew they were being groomed to be "better" breeding stock for sons from the most wealthy families. But exiting the 70's and into the 80's women filled more slots in the workplace and women graduating from college more frequently exercised the option to compete with men out of college in the workplace. They often did not get equality in pay but they often got close enough to be independent of marriage as a financial requirement. 

    According to Pew: among adults ages 25 to 34: 46% of women in this age group have at least a bachelor’s degree, compared with 36% of men. In other words, man are no longer able to control women by strangling financial opportunity outside of dependance on a man.

    Now crank this into the equation. In the last fifteen years, there's been a seismic shift in attitudes about non-traditional sexual roles. Gay males have been fighting for acceptance and equality for decades but the revolution through movies and TV introduced positive characters who were not straight. When campaigning for president in 2008, Obama could not openly support gay marriage. Now it's the law of the land with overwhelming support and acceptance. Somewhere in the post 2000 decades, the academic system taught kids to be who they are, sexually, and accept people who hear the beat of a different drummer. 

    What's this got to do with abortion? Everything! With the advent of birth control (which is also under attack and a legislative target) and access to elective abortion in the first half of a pregnancy, they were sexually liberated in relationships outside of marriage. (Taylor Swift drives wingnuts crazy by being sexy as hell AND being in control of her relationships – she's opened and closed romances, seemingly on HER terms. And she's encouraging her fans to exercise their political muscle.) 

    During the Trump debacle in DC, women in the area, (DC, MD, and VA) who had dating profiles openly rejected MAGA men from approaching them. This seemed to be in large numbers. I don't have stats. But men who feel entitled to women but have repugnant personal habits and beliefs are getting rejected. It's just not uncommon for a young woman to decide (and I have two daughters in this category) that they can find a good woman to share love if they don't have a good man. Can you see how this shifts the numbers?  Straight guys have to be on their game if they want a social life with the opposite sex. IMO, it's harder for a young man than it's ever been in the US because women are reaching parity. 

    So how does abortion (coupled with restricting birth control) fit in? They want women to be nervous about sex outside of marriage (where birth control would be available) because delivery of the baby would be mandatory. Sex (for women) would be about procreation, not pleasure between consenting adults. Fatalities are necessary to frighten women out of a lifestyle of freedom and control. (Control over their bodies and freedom to pass on a bad relationship.)

    The genie is out of the bottle. Corporate employers welcome women – women don't have equal representation at the very top but there's no way business can (or wants to) eliminate women from the workforce or adopt a pay sturcture which is discriminatory enough to turn back the clock to the 1950s. Men with Neanderthal attitudes vastly outnumber women who want a caveman. This whole thing is doomed to fail – the good news is that "woke" people of both genders are turning out in elections. 

    Disclaimer: I know that any sweeping generality (like this comment) will frequently fail in individual cases. Some people don't see any further than the tragedy that an abortion is. Nobody celebrates an abortion – it's a medical necessity or the lesser of two evils. A difficult choice under any circumstances but as Maha suggested, it's HER choice. An important source of information is her doctor, never her congressman. 

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    • Contempt for women isn't really new, though. It's always been baked into the Patriarchy. Before Roe v. Wade a lot of states had the same kind of draconian no-exceptions-for-rape laws they have now. The difference was, as I understand it, is that it generally wasn't so difficult for a woman experiencing life-threatening pregnancy complications to get a "therapeutic" abortion. 

      • Agreed. The only thing that's new is that women are financially and socially less dependent on a bad relationship.

    • Reflecting a bit more, I can remember when stand-up comedians on the Ed Sullivan Show would tell jokes about wife beating. Women drivers also were a favorite topic of humor, right after mothers-in-law.  A lot of "humor" in the 1950s and 1960s was basically an expression of hostility to women, something Betty Friedan noticed. As recently as the 1970s a publisher I was working for put out a "joke" book for after dinner speakers, and the old fart who wrote it included some wife beating and ugly wife jokes, which the editor deleted with no comment. The author was outraged. The publisher, fortunately, had enough sense to agree with the editor. 

      • "Women drivers also were a favorite topic of humor, right after mothers-in-law"

        An old co-worker of mine would frequently used the phrase "it's colder than you mother-in-law's kiss" when the weather got cold. I always thought it was kind of funny given my not so warm relationship with my own mother in law. I never thought it was sexist just an expression of mothers who thought their daughter could have done better? Though looking at it from your point of view it is a bit of meanness directed specifically at women. I guess I should stop using that line?

        • Speaking to references to the cold.

          I always liked the line..It's so cold out my laywer has his hands in his own pockets.

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    • It occurs to me also that the insults and open hostility shown by the politicians toward women with problem pregnancies is similar to what happened to rape victims before the 1970s. It used to be a running joke that the only way to get a rape conviction against a (white) man was if the victim were a dead nun. (Of course, if a black man was accused of raping a white woman, his days were numbered.) Women who reported rapes were first humiliated by the police, who often decided not to bother with the case. It's estimated that in the 1859s about 80 percent of rapes were never reported. If a case went to trial, which was rare, the defense lawyers could destroy the woman on the stand. If she couldn't prove she fought back hard enough, that was considered "consent." If she was wearing "provocative" clothing (anything that wasn't a nun's habit) or out after dark, she was "asking for it." The feminist movement was able to achieve some reforms in the 1970s that gave rape victims a little protection from the criminal justice system, although it's still not great. 

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  3. But government health care will create DEATH PANELS!!!

    Remember that one?

    No state legislators did. Mostly white male socalled christian legislators.

    Now it is law=let her die.

    Funny conservatives scream when issue is made up and silently turn their eyes away when it is real.

     

     

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    • "Death Panels" composed of state legislators, people who think they know more than doctors.

      Deferring and learning from someone more intelligent than you is a sign of intellectual prowess.  Something I don't see in many states.

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  4. Tomorrow the party of Babies, Bullets, and Bibles adds another B-word.  Blizzard.  Credit Maureen Dowd for noting how appropriate this event is, as the Donald has dedicated his life to the art of the snow job.  This looks like all the other B-words, taken to the extreme it looks really bad.  Sane levels of republican levels of policy on any of the B-words probably dates back to the Eisenhower administration, but the trend line on all of them is toward crazy and even crazier.  Babies has turn into an obsession with the fetus or any biological cell group that even resembles a fetus.  Soon look for the formation of the Fetus Force, an elite gestapo style military branch with dark sites, war-time powers, and of course total immunity.  Who know where it goes from there.  I'm sure MTG is working on the plans now.  

    When your party leader, Snow Job, is the patron saint of the seven deadly sins, you need a single-issue litmus test for moral fiber.  Only having one, nothing can be considered as too extreme.  The Cult must do and think as the leader directs.  

    Maybe the winds of the Blizzard will get the political pendulum swinging back to the middle.  We are beyond bat shit crazy on this one.   The modern republican party, always at your cervix.  

     

     

     

     

     

     

    • If Trump wants to drive up his numbers in Iowa he needs to be arranging for snowplows and drivers with four-wheel-drive SUVs to be sure the rural folks can even get to the caucuses. 

      • It's minus 9 (-9) here in northwest Indiana today, I would walk a couple miles if I had to to vote against Stump!

         

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    • For the right winger, it's all about winning. They cannot be generous and fair-minded, because losing is the end of their world, in their mind. 

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