The Road Past Roe

One out of four women will get an abortion in her lifetime. The fall of Roe won’t change that.

Protests in support of abortion rights erupted across the country last year when the U.S. Supreme Court reversed almost 50 years of jurisprudence in Dobbs v. Jackson Women’s Health Organization. Our guest today takes Republicans to task for not really caring about what women face after they are forced to carry unwanted pregnancies to term. She faults Democrats, meanwhile, for failing to defend the right to choose with rhetoric that affirms a procedure that benefits families and communities. The road ahead, she says, will be difficult. Will the debate turn now on questions of reproductive justice? Either way, she’ll keep working to preserve abortion access, no matter what legislators do to ignore the will of the people.

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S6 E3. The Road Past Roe

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The end of federal protection for abortion rights has led to a patchwork of state and local laws banning and even criminalizing healthcare choices that women continue to make every day. Amy Hagstrom Miller, founder and CEO of Whole Woman’s Health, visits Will and Siva’s class to discuss the implications of these developments for her work, as she combats a culture of shame and stigma around abortion. She says it’s time to look for change beyond the judiciary — and to get men caring about reproductive justice.

Demonstrators support Whole Woman’s Health in its case before the U.S. Supreme Court, on the day the decision came out, June 27, 2016.

Jordan Uhl / Wikimedia Commons

Hagstrom Miller’s company won a landmark case in 2016 against a Texas law that tried to put undue burdens on abortion clinics. But after a sharp right turn, the U.S. Supreme Court voided the legal precedents set in Roe v. Wade and Planned Parenthood v. Casey. Abortion, meanwhile, has gotten safer than ever — it’s significantly safer than childbirth — and continues to be widespread across demographic groups.

Most of the patients that Hagstrom Miller sees, in fact, are observant Christians. And 70 percent of Americans support a woman’s right to terminate her pregnancy. Our students ask some good questions on this episode, about access, about the discourse of regret, and about how this issue became so polarizing in the first place.

Meet

Amy Hagstrom Miller

Amy Hagstrom Miller is the founder and CEO of Whole Woman’s Health, an organization with nine clinics across the country seeing more than 30,000 patients annually. Hagstrom Miller is an entrepreneur and former counselor who also oversees the nonprofit Whole Woman’s Health Alliance. Her company prevailed in Whole Woman’s Health v. Hellerstedt, which established that states cannot target clinics providing abortion with medical restrictions that have no basis in science. Whole Women’s Health is based in Charlottesville, Va., where our show is produced. Follow Hagstrom Miller on Twitter at @AmyHM.

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Busy Phillips

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Last year, Whole Woman’s Health invited Freaks and Geeks actress Busy Philipps to tour the company’s flagship clinic in Austin. Join Hagstrom Miller and Philipps on a virtual tour — of consultation areas, the lab and the “Eleanor Roosevelt room.”

Or read this story for an inside look at the Charlottesville clinic.

Texan women take issue with their state’s abortion ban, on Oct. 2, 2021, outside the statehouse in Austin.

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Hagstrom Miller wrote for the Tribune News Service about how, in September 2021, Texas’s Senate Bill 8 banned abortions after six weeks of pregnancy, vastly restricting her work. Six weeks into a pregnancy is about two weeks after a woman has first missed her period, and before most women even know they are pregnant. Hagstrom Miller also says anti-abortion protestors are feeling emboldened: “Our staffers are being surveilled constantly,” she wrote, as they manage a spike in threatening phone calls and sidewalk demonstrations.

Then-Justice Stephen Breyer delivered the 5-3 majority opinion in 2016 in Whole Woman’s Health v. Hellerstedt. In the trial’s discovery phase, the organization turned over 10,000 emails and seven years’ worth of financial documents. At the time, Hagstrom Miller spoke with Slate’s Dahlia Lithwick (a one-time guest on Democracy in Danger) about the case.

Check out this profile of Hagstrom Miller by Carol Diggs for C-Ville Weekly, published after the opening of the company’s Charlottesville clinic in 2018. The national debate on abortion “isn’t really about abortion,” Hagstrom Miller told the newspaper. The real issue is how society understands the reproductive choices for women, she argues: anti-abortion activists fight to limit the procedure but also challenge sex education, proper counseling and birth control.

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You’ll hear on the show an argument for how the GOP made common cause with the religious right to make abortion a wedge issue in American politics — one that disproportionately affects black and brown women. Dartmouth College professor Randall Balmer has another story to tell about the rise in power of conservative Christianity: segregation.

Jennifer L. Holland of the Organization of American Historians offers a primer on the prolife movement in America.

Studies show that lack of access to abortion disproportionately affects African Americans.

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Hagstrom Miller recommends reading up on the University of San Francisco’s Turnaway Study, released last summer. It tracked 10-year outcomes for women who were denied abortions. Ninety-five percent of women who did receive an abortion, the study found, affirmed that they made the right choice.

For women who wanted an abortion but couldn’t get one, that study and others have confirmed much worse economic and mental health outcomes — including suicide.

Matthew Kacsmaryk — who once signed a letter calling transgender identity “a delusion” — testifies before the Senate Judiciary Committee in December 2017. He joined the 5th Circuit in June 2019.

U.S. Senate / Wikimedia Commons

Judge Matthew Kacsmaryk, an anti-abortion Trump appointee, presides over the U.S. District Court for the Northern District of Texas. The Washington Post considers the role Kacsmaryk could play in deciding the fate of legal access to abortion pills.

Just months ahead of the Dobbs decision, polling by CNN and the SSRS Opinion Panel found that 69 percent of Americans opposed overturning Roe. Majorities in 43 states of the Union support legal abortion, including many where Republican-controlled legislatures have outlawed the procedure, according to the Public Religion Research Institute.

The Guttmacher Institute analyzes just how common abortion is — especially among poor women younger than 45, who terminate their pregnancies at a rate of nearly 37 per 1,000.

Anti-abortion activists pray for an end to legal abortion outside a Planned Parenthood clinic in Ferndale, Mich., in 2017. The religious right and the Republican Party were not always so aligned on this cause.

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High-profile figures like Serena Williams and Beyoncé have opened up recently about the risk of fatal childbirth for women of color. New abortion restrictions in Florida recently forced one woman to carry a pregnancy to term, even though she knows her baby will die within hours after birth. Many women are crossing state lines to make painful choices about their reproductive health. Five have just sued Texas over such risks, saying doctors are too scared to approve medical exceptions to the state’s abortion ban.

Healthcare Dive tracks abortion bans across the United States. This portal is managed in part by former D in D editor Sydney Halleman, who works for the news site.

Journalist Rebecca Traister joined us on the show last year to discuss, among other things, where progressives went wrong on women’s rights in the last half century.