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The Roots of Texas’s Approach to Reproductive Health

The Roots of Texas’s Approach to Reproductive Health

Sitting in her San Antonio living room, I was flooded by the fixtures of a “happy home.” I was surrounded by seasonal Halloween decor, dogs were licking my feet, and a kindergartner in a tutu was offering me juice. Kendra Joseph was doing the hostess thing, preparing to tell me her story, but I could already see the suffering in her husband Eric’s face. Polite, but intense, he kept a wary eye on Kendra, possibly wondering if talking with a journalist was indeed a good idea.

Texas had recently passed a law prohibiting almost all abortions. The lobbying, marching, press-releasing voices had gotten a lot of play in the run-up to the new law, resulting in two narratives: “bans off our bodies” versus “life begins at conception.” I wanted to expand the conversation, to look for the ripple effects of the bill beyond the spotlight.

It was my birth doula who introduced me to the Josephs. Kendra had, two years earlier, terminated a pregnancy in the second trimester when she found out that the baby she very much wanted was suffering from painful, life-limiting birth defects. Kendra’s medical history put her in a high-risk category, so any pregnancy she carried to term could be her last. She and Eric sat down and considered a balance of suffering. Should they wait out a probable miscarriage and almost certain death of the newborn within hours of delivery, to the devastation of their then-preschool daughter and possible preemption of future pregnancies? Or should they end the life of the unborn baby to minimize the suffering, both his and theirs? 

Kendra chose to have an abortion in 2019. Several miscarriages later, in 2021, with Texas’s new law and a high risk of other complications, Kendra and Eric were worried about trying again. Their eyes welled with tears while they told their story. Eric’s face flushed with frustration from time to time when talking about the counternarrative others had proposed, seeking to undermine their confidence that the decision they were making was necessary. My chest grew tight with sorrow for the baby they wanted, and the fear they felt. But even sitting at that table, our voices wobbly with emotion, I could already hear the rebuttals on social media. Like Eric, I knew the counternarrative, and I knew how Kendra’s suffering did nothing to unsettle it.

The counternarrative had been my upbringing. I knew it better than I knew every line of my favorite movie in high school, Tombstone, a historical fiction based on figures that had grown larger than life and achieved legendary status well beyond their actual historical significance. That’s not unlike the abortion conflict, which has made single-issue voters out of so many Americans, mostly because it became an easily dramatized icon for a clash of cultures. Fictionalized versions of Wyatt Earp and Doc Holliday uphold and whitewash the taming narrative of the 1880s Wild West. Abortion exemplifies and oversimplifies the religious right’s 1980s battle for the soul of America. And like gunslinging-hero stories do for the settling of the West, the iconic status of the abortion conflict overshadows the real human suffering involved. In a movie moment harrowingly accurate to both 1880 and 1980, a dashingly squinty Kurt Russell, playing lawman turned entrepreneur Wyatt Earp, surveys the dusty stagecoach town waiting to be monopolized and says to the other Earps, “We’ll make our fortune, boys.”

The burden placed on childbearing women has always been a subject of discussion, starting literally “in the beginning.” Or at least two chapters of the Bible later, when Eve was told that having babies would be painful. Painful is only the half of it, though. Having children is dangerous. You know that book What to Expect When You’re Expecting? Well, if it had been written anytime before the 1920s, it probably would have been just a single page: Expect to die, because you might. If you don’t, call your mom and ask her what to do. Unless she died in childbirth, which she might have.

Even now, when the risk of dying is much, much lower, it does still happen, in damning racial disproportion, as do catastrophic injuries. Women get diabetes while pregnant. Preeclampsia, frequently fatal in previous generations, can still damage the liver and kidneys. Some are violently ill for the entire nine months of pregnancy, to the point of needing intravenous fluids. Even those of us with “normal” deliveries were often millimeters away from life-altering complications. Had it not been for the top-notch surgeon on call the night I had my son, I would have had to catheterize myself in order to pee for the rest of my life. Then there are the statistics on increased poverty for single mothers and intimate-partner homicide. Being pregnant, having a baby, and raising a child are not always the blessed events we’d like them to be.

In the mid-1800s, many states had antiabortion laws on the books. But, as Marvin Olasky reported for Christianity Today, such laws were rarely enforced. I see this as a sign that judges and juries knew that pregnancy was socially, ethically, and economically complicated, to say nothing of the physical dangers. It was highly likely that judges and juries in the nineteenth century had seen those dangers play out close to home. In a world where pregnancy had a mortality rate between five hundred and a thousand of every hundred thousand, there would have to be reasonable debate about whether or not a woman could end a pregnancy. And for a long time, even as medicine advanced, there was such reasonable debate.

This was a lively, multifaceted conversation, because there were also multiple viewpoints on fetal development. Reform Jews believed that life begins at breath. Catholics believed it begins at conception. Protestants were all over the map before the 1970s, and most considered various factors when weighing in on abortion and whether it was ethical in specific cases.

Our ability to discuss and debate the medical ethics of childbirth changed when abortion became a powerful coalition-building issue for the Moral Majority, a moment Dartmouth historian Randall Balmer documents in his book Bad Faith: Race and the Rise of the Religious Right. Since many Catholics weren’t wholly on board with segregation and many women weren’t super activated by hawkishness in the Cold War, conservatives needed a moral rallying point to deliver votes.

In the religious right, conservative politicians found a vote-producing dairy cow, and abortion was the ring in its nose. They could guide her wherever they wanted to go, to any primary or gubernatorial race so a politician could fill up his vote bucket with those creamy pro-life votes. But for the ring to stay relevant today, it has to work post-Roe. Now that Dobbs v. Jackson Women’s Health Organization has replaced Roe, making abortion a state-by-state issue, red-state politicians are in a race rightward to establish themselves as the most pro-life.

Courts have long taken up investigations into miscarriages and stillbirths, suspecting that women purposefully induce them, and those who are watching conservative state legislatures expect that such investigations will increase. As doctors struggle to figure out where they can and cannot legally intervene, imminent death has become the only reliable measure of a “health risk.” It’s a chaotic time to have an impregnatable uterus. Or to have a uterus that is difficult to impregnate, for that matter—many of these laws may restrict certain procedures commonly used during in vitro fertilization.

The goal for many politicians and activists in this race to the extreme is not to find the right balance, or a consistent ethic of life, but to find the most antiabortion stance out there, to claim the prize for “most pro-life,” either because they themselves were raised on the rhetoric or to get that pro-life voter milk.

In response to the deepening of the antiabortion trenches, those who want to expand abortion access have also become entrenched in extreme positions, and that has left very little room for pro-life Democrats. Supporting abortion as a legal right is all but essential to be a viable candidate in the Democratic Party. As part of their ethic of life, socially minded Catholics and evangelicals are against the death penalty and for strengthening social safety nets, immigration reform, and gun control. But they are outliers in the Democratic Party, because they include the unborn in that life-affirming ethic. Even socially progressive Americans who are not necessarily politically affiliated are, post-Dobbs, being explicit about supporting “a woman’s right to choose.” Being anything less than shout-your-abortion enthusiastic will leave you politically homeless in this hyperpolarized conflict.

“There is no issue over which Americans are divided more starkly and passionately than abortion,” writes legal scholar Jamal Greene in his pre- Dobbs book How Rights Went Wrong. “Partisans in the debate over abortion rights seem to agree on nothing, indeed seem to hold views that are literally irreconcilable. They seem, moreover, to hate each other.”

So what was it that made abortion such a key issue for the church?

The rising threat of feminism in the twentieth century was a real concern to many in the church; it busied women not with free volunteer hours but with paid work. It challenged the denominations in which men enjoyed uncontested authority. Feminism gave women control over their budgets and their bodies—things some men had rather enjoyed controlling.

Feminism challenges the Christian patriarchy from the very first page—maybe the second or third page, depending on the size of the print in your Bible. In the creation story, after Adam and Eve fall from grace, God curses them, and in Genesis 3:16 God says to the woman, “I will make your pains in childbearing very severe; with painful labor you will give birth to children.” In the hands of complementarian teaching, this curse is expanded beyond just the pain of labor to explain the ravages of raising children in a world determined not to help. It creates the self-sacrificial mom who gives up her body, her time, and her mental health for her kids and chuckles with long-suffering affection when they forget her birthday, interrupt her conversations, and wake her up at all hours of the night.

But wait; it gets better. The curse goes on to say, “Your desire will be for your husband, and he will rule over you.” Complementarian teaching, based on the premise that men and women hold different, God-ordained roles, interprets this to mean that women, who were designed to be subject to men, will fight against that design and wish to be over men, and men will be domineering.

The complementarian curse—that both raising kids and being married are going to be sources of suffering—is used to reverse engineer the nature of women. Because God cursed those two activities, they must have been woman’s entire purpose.

Wait, though. A man’s curse is specific to work; does that mean he’s supposed to stay out of the home? No, because, according to the complementarians, he’s very much needed at home to rule over his miserable, accursed wife.

Whatever your belief about the historical accuracy and divine inspiration of the creation narrative, much suffering has come from the doctrine that women’s only sanctioned place is in the home. It has blocked women from education, economic independence, and voting rights and kept many in dangerous situations—including pregnancy. When feminism came along and told women there was an option other than misery, it messed with that dynamic. Tied into nearly every antiabortion sermon I have heard is a little detour of lies fomented by the sexual revolution and feminism. Unwanted pregnancies wouldn’t happen without sexual immorality, and women wouldn’t mind having more and more children if they weren’t trying to advance their careers. Blaming feminism for abortion is rooted in a theology that sees women’s desires for bodily autonomy as a curse.

Lost are the Kendra Josephs. Lost are the women being exploited and abused. Lost are the women who need chemotherapy and other lifesaving treatments incompatible with pregnancy.

Moral language creates easier binaries (right versus wrong), which makes it easier to establish distance. I think that’s why we prefer to talk about abortion as a moral issue, not an ethical or a medical one. But with the overthrow of Roe, an interesting thing started to happen. Because “abortion” is a medical term that applies to all sorts of methods and causes for ending a pregnancy, laws prohibiting abortion quickly ran into sticky situations. Having committed to the “abortion is evil” party line, lawmakers tried to argue that certain abortions were, in fact, not abortions. One pro-life activist, speaking before Congress, said that a ten-year-old having an abortion after being raped would not really be an abortion—which is incorrect. It’s not even true to say that abortion always means the death of an unborn child. When I had my “spontaneous abortion,” there was nothing inside the pregnancy sac. It was what is called an anembryonic pregnancy. No baby. No human life, other than mine.

I’m not saying that there are no selfish reasons for abortions, or that there are no happily-ever-after abortion stories. However, when we insist on those two narratives, we will always see abortion as a political issue, and we will have no compassion for those who suffer inside of it.

This article was adapted from San Antonio–based journalist and author Bekah McNeel’s forthcoming book, This Is Going to Hurt: Following Jesus in a Divided America, from Eerdmans Publishing.

When you buy a book using this link, a portion of your purchase goes to independent bookstores and Texas Monthly receives a commission. Thank you for supporting our journalism.

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