The Pro-Life Movement’s Cruelty Problem

She stays quiet because of her child, my patient tells me. But despite her passivity, her husband always manages to find something wrong with her. He shouts at ungodly volumes, threatening, “Don’t make me do something to you that I’ll regret!” Another time, “You’re making me angry enough to hit you!” She invariably cowers in terror, shielding the child from him.

“Like a switch, he shuts it off and turns to our son, smiling, comforting him, even when he’s just threatened me. I don’t understand it,” she weeps in my office. “How can he lose control one minute at me, and then be so calm the next?”

“Because he doesn’t lose control,” I reply. “He knows precisely what he is doing.” I show her the Power and Control Wheel, a useful tool in the psychiatry clinic for identifying behaviors consistent with coercive control, and tears pour down her face. “This is my life, and I can’t keep going like this.”

The couple has been trying for another child for 2 years, and she’s suffered repeated miscarriages with little respite in between. The last attempt ended in ectopic pregnancy and emergent salpingectomy (removal of a fallopian tube). She almost died. With these recent revelations of her husband’s cruelty, I wonder if she truly wanted to be pregnant again, if “no,” was ever really an option for her.

Pregnancy is a known risk factor for escalating intimate partner abuse. Simultaneously a tool of control by an abuser and a narcissistic injury to the abuser — it represents a shift in the victim’s focus from the abuser to the pregnancy and therefore a perceived rejection — it has potentially lethal consequences for victims, with homicide, most often with a firearm, as the leading cause of maternal mortality in the U.S.

Reproductive coercion is inextricably linked to domestic violence, and indeed the erosion of reproductive rights post-Roe has highlighted that dangerous public health association. Abortion restrictions enacted in “trigger-ban” states after Dobbs were found to significantly increase rates of intimate partner violence for reproductive-age women and predicted to add an estimated $1.2 billion in social costs. The evidence is clear. These restrictions are expensive, draconian, and overtly dangerous for patients.

Within the last month, two alarming developments in the “pro-life” fight illustrate the increasing cruelty within the movement, putting women at increased risk of health complications both from pregnancy and intimate partner violence.

Proposed Ban on Dilation and Evacuation

House Republicans proposed a federal ban on dilation and evacuation, a common abortion method in the second trimester and an important component of miscarriage care. The legislation states that efforts to save the life of the mother are exempt, but we know from experience that such exceptions are often ineffective, as the threat of criminal consequences invariably has a chilling effect on doctors’ and hospital lawyers’ willingness to act to save the mother.

The leading champion of the ban is Rep. Kat Cammack (R-Fla.), whose own reproductive care for a life-threatening ectopic pregnancy was thrown into chaos under Florida’s abortion restrictions, which confused doctors and caused them to delay her care.

You’d think such a harrowing experience, variants of which have brutally killed other women, would inspire empathy and thoughtfulness around healthcare legislation. You’d think Cammack would have developed a personal appreciation of the fact that miscarriage care overlaps heavily with abortion management (other lawmakers have demonstrated their ignorance here) and that blanket bans on medical care that threaten doctors serve no one.

Yet, Cammack continues the same trend of uninformed and bullish legislation, which will have consequences for patients like her who emergently need miscarriage care.

Codifying Personhood and Defining Abortion as Murder

A controversial North Carolina bill introduced by Republican Representatives codifies fetal personhood and defines abortion as murder. It legally condones use of force, even lethal, to defend the life of another, under the definition of life delineated by fetal personhood.

Need I say more about how abjectly cruel this bill is? In practice, it would likely encourage threats against clinics providing comprehensive reproductive healthcare and condone vigilante killings of doctors and pregnant women. It also puts women at increased risk of violence or even death if they try to take control of their reproductive choices in the context of intimate partner violence.

What if a woman with an abusive partner tries to obtain an elective abortion because she’s trying to escape her abuser? Would the abuser be justified in holding her against her will? Or even restraining or attacking her to “defend the life” of the fetus? And don’t deflect by telling me she should have “just chosen a better man” or “didn’t have to spread her legs” (I have heard both things). Abusers rarely reveal themselves until it’s too late, and women in abusive relationships often don’t have a choice about when they engage in sexual activity.

These seem like absurd hypotheticals, but the post-Roe era with its very real ramifications that have demonstrably endangered the lives of women and girls nationwide compels us to ask these questions. I remember my own conservative family claiming that the dreaded Left was “fearmongering” and overreacting when concerns about criminalizing miscarriage were raised years ago. Those concerns were not overreactions; they have become reality in today’s America.

Limiting Reproductive Rights Isn’t Really “Pro-Life”

Whom exactly is this movement protecting? Pro-lifers will say, “the life of the unborn,” but is an abusive man who would restrain or beat the mother of his child a protective figure for a child? Is a fertilized egg implanted in a fallopian tube that will likely rupture a life that can be saved? Should miscarriage tissue remain stuck in a woman’s uterus because the procedure needed to remove it safely is ignorantly deemed barbaric?

Let’s not pretend that all measures limiting reproductive rights are “pro-life.” It is absolutely possible to be pro-life and decent: promoting social infrastructure that can support women (paid leave, education access, affordable childcare); combating community violence in part by holding abusers accountable for their actions; and widespread investment in meeting our society’s basic needs, including housing, food access, and healthcare.

The current brand of the pro-life movement is cruelty, and now, it is overtly legitimizing violence against women and healthcare providers.

We live in a time when evidence is casually disregarded, scientific nuance is dismissed, education is devalued, shock and outrage garner more attention than facts, and consequences are negotiable. Bluntly, it is transforming us into an increasingly stupid and cruel population.

This is not political commentary. It comes across as such because the issue of reproductive rights has become so partisan. But even Republican lawmakers are appalled at the extreme reach of this disconcertingly cruel movement that apparently promises to defend life, no matter how many women are terrorized or killed in the process. Some are deeply regretful of the laws they have championed, now appreciating their human toll. More courageous voices like theirs are desperately needed. Decency belongs to no specific political side.

These legislative measures are without a doubt indecent and it is incumbent upon us to follow the evidence, common sense, and our compassion to protect our patients. This is madness, and it needs to stop.

The views expressed above reflect only those of the author and are not shared by any institution with which she is affiliated.