Abortion has faded from the headlines since the Dobbs decision of 2022, and Republicans like it that way. In the immediate aftermath of the supreme court’s overturning of Roe v Wade, as millions of women lost access to the dignity and self-determination that abortion provided them, clinics shut their doors, and the extent of Dobbs’s horrendously adverse public health implications started to become clear, abortion was always, it seemed, in the headlines. There were plenty of stories. There was the first known woman to die as the result of an abortion ban; and then the second; and then the third. There were the various lawsuits and ballot initiatives that for a while turned access off and on and then off again in various states; then there were the state supreme court elections, races that were newly transformed by the abortion debate and on which the health and status of a state’s women now relied. There were the clinics that shut their doors in Republican-controlled states, many of which had provided the essential, stigmatized care for decades, under hostile conditions, with persistence and innovation and determination that were staggering.
But the stories have faded from the headlines as the years have gone by. Feminism has gone dramatically out of style, with the big women’s rights NGOs wounded enough by Dobbs and attacks from the Trump administration that they have been largely unable to push their agenda in either media or policy, and algorithmic social media driving a rise in gender conservatism and politicized misogyny, particularly among young men. But maybe more importantly, abortion has ceased to be a story because the horrors of abortion bans have ceased to be news: the US has grown used to the swift and dramatic erosion of women’s health and status that has followed Dobbs, grown used to the horror stories and upward ticking body counts, grown into ease, and even a kind of compliant boredom, with women’s death and indignity.
But lately, there have been efforts to change that. Pro-choice activists and health researchers have advanced stories about the extent of Dobbs’s impact on women’s health, looking to advance new studies, particular stories and illuminating statistics that reveal the extent of the danger and damaged posed to women by Republican governance. And Republicans, in turn, have looked to quash stories about the impact of abortion bans and suppress data that illustrates their impact, fearing, it seems, that being reminded of what abortion bans mean in practice will further dampen their party’s odds in the coming midterms.
First, there’s Texas. The Lone Star state was the first to implement a near-total abortion ban in September 2021, about nine months before Roe was struck down, after the supreme court used its controversial shadow docket to allow Texas to ban abortion without full briefing or argument. That means that Texas has an unusually large amount of data on how abortion bans affect women’s health and status: no other state has had an abortion ban in place for as long. But state health officials in Texas, most of them appointed by the solidly Republican state government, have dragged their feet on studying the impact of abortion on maternal health outcomes – maybe because they don’t think they’ll like what they find.
After the state committee refused to expand the purview of its longstanding maternal mortality data collection to include adverse health outcomes caused by delayed or denied abortion care, investigators at ProPublica did so themselves, finding that in 2022 and 2023, the first two full calendar years that the state’s abortion ban was in effect, that the rate of sepsis in Texas patients who experienced miscarriages in the second trimester increased by more than 50% – probably because doctors, fearing sanction and prosecution under the new laws, delayed administering the very simple dilation and curettage procedure that would have spared the patients’ lives until the women’s condition worsened to the point of death. The new law, in short, forces healthcare providers to play chicken with women’s lives, like daredevil teenagers standing in the path of oncoming headlights and daring themselves to stand still before leaping out of the roadway at the last available minute. Predictably, this has had fatal results. The same ProPublica study found that in the first two years after the ban went into effect, 120 pregnant or postpartum women died in Texas hospitals – a dramatic increase over previous years.
But despite the growing body count, Texas health authorities evidently remain determined to cover up the fatal results of the abortion ban. Every year in early September, an official medical body in the state issues a report on the maternal and infant death rate in Texas – data that is essential for health researchers, even as the methods of its collection have become disputed and politicized in the post-Dobbs era. But this year, in an unprecedented move, the release of the report was postponed – pushed back from its longstanding date of 1 September, all the way to 1 December. The delay means that whatever the report says about the state of pregnant women suffering, sickening and dying in Texas, that information will be kept confidential until after the midterms. Voters will be deprived of it as they make their choices in November.
It’s easier to understand why Republicans want to hide data on the health effects of abortion bans when you realize just how profound those impacts are. New studies show they are quite profound indeed. An analysis of CDC data reveals that since Dobbs, women are dying at alarmingly high rates from ectopic pregnancies – in which an embryo implants in the fallopian tube, rather than the wall of the uterus, a condition which has no possibility of leading to a live birth and which is fatal if left untreated. Ectopic pregnancies are easily detectible using ultrasounds, and simply terminated with a shot; there is no reason, medical or moral, why they should be fatal. And yet, between 2020 and 2025, they killed nearly 200 women in the US – almost doubling the number who died in the previous six years. The culprit? Probably the same phenomenon that is driving the increase in sepsis among pregnant women in Texas: doctors, scared to do their duty by their patients because of sadistic, punitive and misogynist abortion bans, are forced to subordinate medical best practices to the incoherent demands of the law. The rate of ectopic pregnancy deaths in states with abortion bans is nearly double that in states where abortion is legal.
Neither Democrats nor the media seems interested in making abortion a centerpiece of the midterm campaign cycle, and so Republican efforts to bury this data have been largely successful. But there are still those struggling to assert the value of women’s lives. This month, the family of Tierra Walker, a 37-year-old mother who died at 20 weeks pregnant in a Texas hospital in 2024, after doctors had repeatedly denied her an abortion to treat her worsening pre-eclampsia, sued the Texas attorney general and Republican Senate nominee, Ken Paxton, and others for wrongful death. They allege that Walker, who had suffered multiple seizures and had become unable to work due to her condition, was subjected to neglect and indifference by a Texas medical and legal system that cares more about enforcing pregnancies than it does about civil rights, personal dignity, public health or human life. When she died, her son, then 14, lost his mother. Ken Paxton, and all the other abortion-ban supporting Republicans on the ticket in November, should have to answer to him.
Moira Donegan is a Guardian US columnist