A. had an inkling that something had gone wrong with her abortion.
She’d already had to beat an obstacle course just to get one. A. lives in Wisconsin, which has banned almost all abortions in the weeks since the Supreme Court overturned Roe v. Wade. So when A., whom VICE News is calling by an initial for privacy reasons, realized she was pregnant, she said she headed to Illinois to terminate her pregnancy.
She took pills to induce the abortion and expected to bleed heavy clots. But that didn’t happen, she said. Instead, as she watched Disney movies and snacked on Sour Patch Kids, trying to endure the cramping, A. had only light bleeding.
That's when the 24-year-old started to worry that the abortion had not completely worked. A visit to the OB-GYN back in Wisconsin confirmed her fear: There was still tissue from the pregnancy in her uterus.
Then, A.’s doctor told her that they could not immediately deal with that tissue—which, if left in A.’s body, could send her into deadly sepsis or lead her to hemorrhage.
In order for the doctor to help A., they had to prove through days-long testing that the incomplete abortion had rendered the pregnancy non-viable. If the pregnancy was viable, under Wisconsin’s abortion ban, an abortion is permissible only if it’s to “save the life of the mother.” And A.’s case, although it could potentially land her in the hospital, was not yet life-threatening enough to qualify. VICE News spoke to both A. and her doctor multiple times.
“That was the part that was really incredible, that they couldn't trust the expertise of a doctor that has trained and has been working in her field and has accreditations, passed her boards—that her opinion wasn't enough,” A. told VICE News in August, before she found out if her pregnancy was still viable. “This is so stupid. This is a massive nightmare.”
In Wisconsin, if someone performs an abortion when it’s not life-saving, they could be fined up to $10,000 and face six years in prison. There are no exceptions for rape or incest.
“America's an amazing country with all these amazing developments in technology, and yet you can't figure out how to get access to healthcare to your community,” A. continued. “Are you kidding me?”
A.’s doctor told her that they could not immediately deal with that tissue—tissue that, if left in A.’s body, could send her into deadly sepsis or lead her to hemorrhage.
A. first realized she was pregnant roughly four weeks into her pregnancy. She had stopped using hormonal birth control because of its “insane” side effects, and instead tried to rely on a fertility awareness-based birth control method.
It didn’t work. Normally an avid gym-goer who wakes up at 5 a.m. to work out, A. said she started to struggle to get out of bed. Her breasts felt tender. When her pregnancy test turned out positive, A. said that she booked an appointment for an abortion that same day.
“I don't think we are ready financially at all for the cost of giving birth, the cost of daycare, the cost of the child care,” A. said. “We also have long-term plans to move abroad, to move to another country, and other things that are incredibly difficult to do with any child and would be a lot more difficult if we had a kid right now.”
“I can barely do my laundry,” A. added. “I don’t think I should really be taking care of a child.”
A. said she and her partner drove to Illinois because it was the closest and quickest option. A. chose to undergo a medication abortion, where an abortion is induced using doses of two different drugs spread out over several hours. It’s an incredibly popular method: In 2020, more than half of all U.S. abortions were carried out using medication, according to preliminary data from the Guttmacher Institute, which tracks abortion restrictions and trends.
“I can barely do my laundry,” A. added. “I don’t think I should really be taking care of a child.”
Medication abortion is generally safe and effective. One 2013 study, which examined how nearly 50,000 women responded to medication abortions, found that only about 5 percent of medication abortions failed. (Typically, failure meant that the patient needed surgery to complete the abortion.) The study also found that only 119 women ended up hospitalized, with 45 receiving blood transfusions.
In other words, the risks are minimal, but they exist. And A., it turned out, was among the people for whom the risks became all too real.
After the abortion, A. went to her usual OB-GYN, Dr. Jill Masana. She wanted to double-check that her abortion had worked and get back on more reliable birth control. Initially, A. said, she told Masana that she’d had a miscarriage, because she worried that she could jeopardize her doctor’s license by revealing the truth.
But A. said that when Masana picked up on the fact that she wasn’t too upset about supposedly miscarrying, A. admitted she’d had an abortion.
“It felt good, telling someone that you've gone through something like this,” A. said. “Every time you tell someone, especially someone that you trust or that it is a provider, someone that you care about, you take a little bit of the weight off your shoulders because you feel less alone.”
If a patient has tissue from a pregnancy in her uterus, Masana first determines whether the pregnancy is still viable. That process can take days, especially if the patient’s pregnancy is in its early stages, like A.’s was.
Before Roe was overturned, Masana said, “especially in the case that it was a non-desired pregnancy and most likely the signs were pointing towards it [had] failed, we’d intervene right way.”
Now, under Wisconsin’s abortion ban, if a pregnancy is viable, Masana can’t help.
“It's crazy for me to ship my patients out of the state and then they come back, have a complication from it or something else, and then even still have my hands tied,” Masana said. “It just feels wrong. It just feels against that Hippocratic oath of ‘Do no harm.’ By waiting, I feel like I’m doing harm.”
Have you struggled to get an abortion since Roe v. Wade was overturned, or had your medical care delayed or denied because of Roe's overturning? Reach out to firstname.lastname@example.org, or DM her on Twitter at @carter_sherman for Signal.
At least 16 states currently have some kind of abortion ban on the books that would have been illegal under Roe; 12 of those bans are near-total. All have some type of exceptions for medical emergencies, but what counts as an emergency can differ from state to state.
This varying, often imprecise language, crafted by anti-abortion activists and politicians who tend to lack medical degrees, has left doctors struggling to help patients navigate the complex reality of pregnancy and the dangers that come with it. They’ve been forced to watch as patients combat health conditions that, prior to the overturning of Roe, they could have helped.
“We’re waiting for patients to get sick, or get sicker, to be sick enough as to be able to intervene.”
In reporting this story, VICE News spoke to multiple physicians who shared outlines of patients’ stories and encouraged patients to reach out to VICE News on their own. Some doctors told VICE News that they feel like they are expected to simply watch patients edge closer and closer to death—and once they prove a condition is serious enough that they won’t be liable for helping, grab them back from it.
“We’re waiting for patients to get sick, or get sicker, to be sick enough as to be able to intervene,” said Dr. Tani Malhotra, a maternal fetal medicine specialist in Ohio, who did not treat A. In Ohio, abortion is banned as early as six weeks into pregnancy, unless it’s necessary to “prevent the death of the pregnant woman or to prevent a serious risk of the substantial and irreversible impairment of a major bodily function of the pregnant woman.”
“We have the medical education, the training, and the experience to know what to do in which situations for keeping it patient-centered, making sure we center our decisions with the patient around the patient and their desires,” Malhotra added. “And now our decisions are centered around the law.”
The difference between a ban that allows abortions only in potentially fatal cases and a ban that permits them to preserve a patient’s health may seem small. But it could be a matter of life or death.
In cases like A.’s, patients run the risk of starting to hemorrhage or contracting an infection, which can lead to sepsis, both Masana and Malhotra told VICE News. Although the chance of these conditions occurring is relatively small, they can turn deadly serious very quickly.
“Is the likelihood that she’s going to have crazy-bad bleeding or an infection super high? No, but the risk from it is just so great, and the possibility of what could happen from that is bad,” Masana said. “Someone can go from looking, clinically, in front of you, fine, talking to you, maybe appearing overall pretty well—and then all of a sudden their vitals can just tank and they can really get sick fast.”
Malhotra also pointed out that although these conditions are rare in the United States, that may change now that Roe is no longer the law of the land.
“They’re rare because people have always been adequately and appropriately treated,” Malhotra said. Asked if maternal mortality will increase, now that Roe is gone, Malhotra said, “I have no doubt in my mind.”
Many of the abortion bans also now specify that the procedure is only permitted in cases when a pregnant person’s physical health is at stake—not their mental health. Before the Supreme Court decided Roe v. Wade in 1973, pregnant people could sometimes secure legal abortions by convincing doctors that they would die of suicide if they were not allowed to have the procedure. Now, even that avenue to an abortion is cut off.
“I'm really angry, I think is the best way to put it. I have this fury and rage towards the systems that have created such a horrible situation.”
Ultimately, A. said that Masana was able to determine that her pregnancy was not viable, clearing the way for her to have a procedure to remove the rest of the tissue. As she waited for word on the pregnancy’s viability and then for the procedure itself, A. said she bled heavily, leaving her lethargic and feeling unable to move on with her life. She watched romantic movies, like When Harry Met Sally and the Netflix drama Purple Hearts, to distract herself. She bled through a box of 20 pads in a week.
“It's hard when you're on hold and then you also, at the same time, are trying to get to where you're going to receive care,” A. said. “I'm truly relieved and excited to know that I can receive care and that I can move forward with finding and having care nearby instead of having to go across state lines.”
The day of the procedure, A. said, she learned she had lost so much blood that she’d become anemic. Within a few days of the procedure, however, she felt much better, both physically and emotionally.
“I’m right as rain. I feel great. It feels kind of like a dream, the whole thing,” she told VICE News. But, A. added, “It was a really intense experience, and I don’t know if I’m really recovered from it yet.”
As a woman with a supportive family, a partner who was willing to split the cost of the abortion, and a job flexible enough to accommodate her medical needs, A. said that she likely had an easier experience than most people confronting an unwanted pregnancy and all its possible complications. She felt educated enough to advocate for herself and her healthcare. But all of those privileges still weren’t enough to shield her from the fallout of the end of Roe v. Wade.
“It's the first time in my life I was denied care by a medical professional, and that is arguably one of the most traumatic things a woman will ever go through,” A. said. “I'm really angry, I think is the best way to put it. I have this fury and rage towards the systems that have created such a horrible situation.”
Follow Carter Sherman on Twitter.