For a long time, many women who had abortions due to catastrophic fetal diagnoses only told their stories in private. Mourning pregnancies they desperately wanted and fearing the stigma of abortion, they sought the closely guarded solace of online communities, identified by the way many doctors had described the procedure — TFMR, or “termination for medical reasons.”
In the two years since the Supreme Court overturned Roe v. Wade, their pain has deepened into anger over new abortion bans across the country. Although these women are responsible for a fraction of abortions in the United States, they have emerged as the most powerful voices in the country's post-Roe debate. They speak out against bans with their stories of crossing state lines and feeling like criminals. seeking care.
Many of these women were initially against abortion, but now that they have changed their minds, they have also changed the way Americans talk about it. They have also helped move from private fear to public outrage shift public opinion towards more support for abortion.
“After going through all of this, I wondered: Why aren't we being the example for abortion rights?” said Riata Little Walker, speaking from her home in Casper, Wyo. traveled for an abortion in Colorado at 22 weeks, after doctors diagnosed her fetus with Down syndrome and a heart defect that they said would require surgery and later a transplant. survived until delivery.
“Yes, your body, your choice, but that's not the story that attracts people,” she said. “We have to get our stories out there, because otherwise it's so easy for people here to say, 'But they're killing babies.'”
Ms. Walker is Catholic and has worked for Wyoming Republicans, including Sen. John Barrasso. She was against abortion and didn't realize she was having one because doctors called it “termination.” In the months that followed, she supported abortion no matter the reason, and after Roe was overturned in June 2022, she testified against the abortion ban passed by the Wyoming Legislature.
Although most prohibit abortions to save the life or health of the pregnant woman, few women these exceptions are allowed, and only a handful of bans allow abortions due to fatal fetal abnormalities. There are no bright lines to define 'fatal' or 'medical reasons' the procedure is the same whether it is described as termination, TFMR or abortion.
That makes these cases complicated for doctors, lawmakers and for the women themselves: What qualifies as a medical reason?
The women speaking out say their experiences have led them to believe that the law cannot and should not attempt to address complex issues endlessly varied medical fallen. In it, they appeal to rare common ground in what has been a bitter, decades-long debate: regardless of whether they identify in the polls as “pro-life” or “pro-choice,” Americans overwhelmingly say so that the decision to have an abortion should be a decision women and doctors, not the government.
These women say they now feel compelled not only to speak out, but to use the word “abortion” to remove the stigma they themselves have placed on it.
“We never knew all these things before because before all this, they were never talked about,” says Kimberly Manzano, who flew from Texas for an abortion in New Mexico 18 weeks after scans showed her fetus was missing limbs, organs and organs . genitals.
Mrs. Manzano describes herself and her husband as “great Christians,” who thought abortion was something “promiscuous women” did to end unwanted pregnancies. Their pastor assumed they would qualify as a medical exception to the Texas ban. They did not.
“We feel like it's our calling to our child that we lost and we need to talk about it, educate people, because I feel like we were so uneducated,” she said.
Some of the women appear in advertisements in in favor of ballot measures for abortion rights or candidates. Others confront campaigning politicians, to give evidence or enter into lawsuits. But mostly they talk to friends, relatives and colleagues.
Polls show that people who have heard stories about women who had to cross state lines for an abortion due to serious pregnancy complications are more likely to support legalized abortion. This applies even to Republicans or those who believe abortion should be illegal in most cases. Stories like this also have displaced voters those who are against abortion should support it ballot measures that established broad abortion rights in conservative states like Ohio and Kansas.
“Telling people's stories makes it real,” said Megan Kling, who traveled from her home in Wisconsin to Minnesota for an abortion 23 weeks after a scan revealed her fetus had a disease. no kidneys, so did not produce amniotic fluid and would die after delivery, if not in the womb. “You want to think that every woman is perfectly healthy, that every pregnancy is perfectly healthy, when in reality anything can go wrong.”
Ms. Kling said some family members have argued that her situation is different: They support abortion if the fetus has a devastating condition, but do not want women to use it as contraception. She understands because she has never seen herself as someone who would choose abortion. “But women need health care options, and that's what they don't understand: abortion is health care,” she said. “That's what these stories bring to the fore.”
Researchers say it's not clear how much of the approximately one million abortions per year would be considered “for medical reasons” in the United States, but they are rare.
Many of these women do not fit the usual angles of the abortion debate. They are annoyed by the clinical language of abortion rights groups; instead of saying “fetus,” they speak of the pregnancies they lost as unborn children. They name them, mark birthdays and imprint their little feet on souvenirs.
Ms. Kling found herself in an awkward position after she wrote letters to her state lawmakers, including the Republicans who represent her, in an attempt to move past her grief and anger after losing her pregnancy. She only heard from a Democrat, and later from Planned Parenthood and other groups, who asked her to speak at events in support of President Biden. She agreed, but explained that she didn't necessarily support him. She doesn't consider herself a Democrat, but she no longer feels like a Republican either.
“I feel like most people feel that way,” she said. “All the extremists are so loud that you almost feel like you can't say anything.”
Anti-abortion groups argue that bans only ban what they call “elective abortions” for unwanted pregnancies, and that any woman who needs an abortion for medical reasons can get one under the exceptions in those bans. She accuse the Democrats of manipulation medical patients for political purposes.
“Women have been wrongly told this is a compassionate option, but it contributes to the growing trend of disability discrimination and the pressure women face from the medical community to abort children who may have disabilities have,” says Dr. Ingrid Skop of the American Association of Pro-Life Obstetricians and Gynecologists.
On the other hand, abortion rights groups fear that elevating TFMR narratives furthers the message that abortion should only be protected if it is “justified,” and not that it should be every woman's right. “People need abortions for all kinds of reasons — financial, medical, life circumstances — and none of them should be stigmatized,” said Nancy Northup, president of the Center for Reproductive Rights.
Even within online communities, there is debate: Is it acceptable to terminate when a child has only hours to live? A few days, a few years? What about the “gray” diagnoses – where a fetus is likely to survive into infancy but will live a life severely limited by surgeries, drugs, machines and hospital admissions?
Women describe waiting weeks for additional scans, hoping for miracles, poring over survival statistics and quality of life research. Some choose to continue their pregnancy.
“Theoretically, if I were diagnosed with Down syndrome, I would keep them,” says Martha Sheppard. She and her husband, a teacher, discovered during a 20-week anatomy scan that their daughter's spine had not fused – the diagnosis was spina bifida – and that an unknown number of operations would be required, the first in utero. They moved from their home in Virginia to a Ronald McDonald House near a hospital in North Carolina for further testing and research. Three weeks later they decided to end.
“Keeping a child with spina bifida is also a loving decision,” Mrs. Sheppard said, “but my husband and I decided it was a loving decision not to bring her into the world with the body she had.”
It appears the women are pushing for medical exemptions – dozens have joined lawsuits filed by the Center for Reproductive Rights in four states, which attempts to clarify which conditions qualify as exceptions to the abortion ban. Instead, “Exceptions don't work, we're proving that,” said Ashley Brandt, a prosecutor in Texas.
Ms. Brandt traveled to Colorado to abort a twin who had acrania — he had no skull — and posed a threat to her other fetus. “It wasn't just me who was in danger, it was my viable daughter,” she said. “We were still no exception.”
She only heard about the option of selective aborting through a TFMR group online; her doctors were afraid to mention discharge for fear of prosecution. She saw the shame and isolation that women in those groups felt, and felt it herself. Some of the harshest comments, Ms. Brandt said, came from women who struggled with infertility and couldn't imagine choosing to end a pregnancy. Like many of the women now telling their stories publicly, she said her experience has made her more compassionate for women who choose abortion regardless of the reason.
“The picking and choosing, it has to stop,” she said. “We have to trust people to make their own decisions.”
But the women say it remains a struggle to simply explain that what they had was an abortion.
Months after Ms. Manzano's abortion, she noticed that her doctor had recorded it on her chart as a “spontaneous miscarriage.”
“We had to travel to New Mexico,” Ms. Manzano said. “There was nothing spontaneous about it.”
She has visited a grief counselor, who calls it her “medical miscarriage,” even after Ms. Manzano told him she preferred to say “abortion.”
“Neither of us corrects the other,” she said. But in order to grieve and heal through the process, I need to be able to say what it is.