A 23-year-old woman with health concerns fled Missouri to get an abortion.
(Getty)

She Feared Giving Birth Would Kill Her. She Fled Her State for an Abortion.

“I was worried about hermorrhaging again. I was worried that this time I wouldn’t actually make it.”

A week after the Supreme Court overturned Roe v. Wade, the 23-year-old woman decided that she couldn’t wait any longer. She needed a pregnancy test.

She hadn’t had a period in weeks, but that hadn’t triggered any alarm bells. The young woman, who VICE News is identifying by the initial R. for privacy reasons, said her period frequently goes missing. But then the evidence started to mount. R.’s breasts started to swell and ache. On July 1, R. said, she went to Walgreens with her friend and picked up two boxes of pregnancy tests.

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Six tests later, R. couldn’t deny the truth any longer. She was pregnant.

“I just wanted to jump down some stairs,” she recalled.

R. is already the single mother of a rambunctious 2-year-old. A nursing assistant, she dropped out of college to take care of her daughter and relies on food stamps. She also has an irregularly shaped uterus, which renders any pregnancy deeply complicated. Even though R. gave birth to her daughter through a scheduled caesarean, she ended up losing 40 percent of the blood in her body during birth, said R., who said she got pregnant this time despite being on the pill.

When R. considered the prospect of giving birth again, “I was worried about hermorrhaging again. I was worried that this time I wouldn’t actually make it.” 

R. never imagined she would get an abortion. But when she discovered she was pregnant, getting out of her home state and into an abortion clinic suddenly seemed like more than a matter of her own life and death. It felt like the best chance she had to give her child a better future. 

“I just wanted to jump down some stairs,” she recalled.

R. lives in Missouri, the first state to announce that it would ban almost all abortions after the overturning of Roe v. Wade. To end her pregnancy, she had to join the wave of people fleeing their home states in search of abortions at the relatively few clinics left in the United States. Like R., many of those patients are likely to be poor, young parents who will struggle to pay for that exodus—but giving birth is probably even more expensive and dangerous. 

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In Missouri, abortions are only permitted “to avert the death of the pregnant woman” or if there is a “serious risk of substantial and irreversible physical impairment of a major bodily function of the pregnant woman.” 

Specifically, R. said she has what’s known as “bicornuate uterus,” a congenital abnormality that makes a uterus look heart-shaped (as opposed to pear-shaped). People who have bicornuate uteruses face significant risks of miscarriages, going into labor early, and giving birth to babies that weigh too little. They also have a heightened risk of perinatal mortality, meaning that their babies are in greater danger of dying until a week after birth.

When R.’s doctor confirmed her pregnancy, R. said, the doctor made no mention of abortion. Instead, R. said, the doctor immediately started making R. pick out a hospital where she wanted to give birth. On an ultrasound image of R.’s fetus, viewed by VICE News, there is a typed message: “BABY!!”  

“I wasn't given an option but to have it,” said R., who provided records and photos to back up her account. She was afraid to even broach the subject of abortion with her doctor; the abortion ban was like the maw of some mysterious animal, ready to devour her if she made a wrong move. “I didn't know what to do. What happens if you get abortion? Do you get arrested? Is there a fine? Like what? Why is it illegal? What happens if you do it?”

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R.’s uterus may be unique, but her circumstances are not. In many ways, R. resembles the typical Roe-era abortion patient. Most were in their 20s, according to the most recent data collected by the CDC before Roe’s fall. Sixty percent had already given birth at least once, meaning they’re likely parents already. The vast majority were poor: In 2014, 75 percent of all abortions occurred among low-income patients, according to the Guttmacher Institute, which tracks abortion restrictions. One survey of about 1,200 abortion patients found that more than 70 percent said that having a baby would interfere with their work, education, or ability to care for their dependents, and that they could not afford to have a baby.

R. started calling out-of-state abortion clinics almost immediately after discovering she was pregnant, but they were all booked up, R. said. (In the wake of Roe’s overturning, blue-state abortion clinics have reported being swamped by patients fleeing abortion bans.) She started to look into back-up plans, but they all seemed to come with a catch. She put herself on a callback list at an Illinois abortion clinic, but she wasn’t sure whether she would actually get an appointment in time. She thought about flying out to her sister, who lives in a state where abortion rights are protected, but she wasn’t sure how she would coordinate childcare. She started looking up natural ways to make herself miscarry, trawling through online instructions about how to turn mugwort, Queen Anne’s lace, and wormwood into teas. But she had no idea where to find those herbs.

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“You’re forcing all these females to have these babies, but you walk to the store and there’s barely any fucking formula anywhere,” R. said. “So you’re forcing us to have these kids, but you guys can’t even provide the stuff for us to take care of those kids.”

Have you struggled to get an abortion since Roe v. Wade was overturned? Have you had your medical care delayed or denied because of Roe's overturning? Have you decided to continue a pregnancy after being unable to get an abortion? Reach out to carter.sherman@vice.com, or DM her on Twitter at @carter_sherman for Signal.

R.’s sister, N., corroborated much of R.’s account. N. said she even went to a doctor in her own state and asked for abortion-inducing pills that she could mail to R. The doctor refused, N. said.

As the days passed, R. said her morning sickness became unbearable. “I would throw up brushing my teeth. I would throw up drinking water,” she recalled. “Everything made me gag.”

People who have bicornuate uteruses face significant risks of miscarriages, going into labor early, and giving birth to babies that weigh too little. They also have a heightened risk of perinatal mortality, meaning that their babies are in greater danger of dying until a week after birth.

In mid-August, roughly seven weeks after she said she first learned of her pregnancy, R. finally got an appointment at an Illinois abortion clinic. R. lied to her ex to get him to watch their daughter, because she didn’t trust him to not hold the abortion over her head, she said. As she made the hour-plus drive to the clinic, R. was terrified. She worried that someone would discover what she was doing; N. warned her to make sure no one followed her from the clinic.

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Technically, abortion restrictions—including Missouri’s ban—tend to penalize people who provide abortions, not those who undergo them. But as surveillance of pregnant people deepens, patients facing rising risks of getting pulling into law enforcement’s anti-abortion dragnet. Some abortion opponents have also made no secret of their plan to crack down on what they call “abortion tourism,” or the practice of leaving a state for an abortion.

The anti-abortion activists outside the Illinois clinic didn’t make R. feel any better. The protesters held an enormous banner that urged her to talk to God and reevaluate her options, R. recalled, and handed out brochures claiming that medication abortions—which are induced using pills—could be “reversed.” (That claim remains unproven. The only randomized, controlled clinical study on “abortion reversal” ended prematurely when three women started hemorrhaging.) 

“It was just like them trying to cram down my throat, ‘This is wrong, what you're doing is wrong, blah blah blah.’ I already know what I’m doing is maybe in my own eyes not the best, but I have my own reasons for doing it. So I don’t need you to sit here and tell me that I'm a piece of shit for doing this,” R. said. “I get that you have your own opinions, but just keep to your fucking selves or go to Facebook, like everybody else does, and put it out there, but leave people alone.”

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The abortion appointment itself took hours, R. said, as she had to wait in a series of rooms while clinic staffers made sure that she wanted to get an abortion. If Missouri hadn’t banned abortion, R. said she would have chosen to a surgical abortion; with the ban, though, she worried that a Missouri doctor would be able to tell that she’d had an abortion. Instead, R. opted to induce her abortion using pills, because she could pass it off as a miscarriage if she needed to.

The abortion cost $495, records show. R. said she paid out of pocket.

Weeks after the procedure, R. still has a thorny relationship with the fact that she had one. Missouri’s ban kaleidoscoped her sense of guilt and shame. It made R. feel like a criminal, like the state was trying to punish her for having the audacity to get pregnant.

“I know it sounds stupid, but I feel like I murdered my own kid,” R. said. “I feel even worse that I had to hide it. I couldn’t even get help from the place [where] I live.”

“The state is trying to tell us what to do with our frickin’ bodies,” she said, “and it’s bullshit.”

For the most part, R. doesn’t pay much attention to the news or politics; they give her too much anxiety. She said she voted third party in the last election. R. does identify as “pro-choice,” but her opinion on abortion is more complicated than that political label might suggest. 

“I always had the mindset of, even if you make a mistake, you own up to your mistakes,” she said. “So you accidentally get pregnant, well, guess what? You have to raise it.”

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R. doesn’t regularly attend church anymore, but she grew up steeped in Christianity. No one at her childhood church even breathed the word abortion, she said. “That word was never brought up in the church. That wasn't even a thought,” she said. “You never spoke of it. That act was so sinful and terrible.”

Still, R. doesn’t think the state should have the ability to utterly ban abortions.

“The state is trying to tell us what to do with our frickin’ bodies,” she said, “and it’s bullshit.”

Regardless of the shape of someone’s uterus, the dangers of birth are real—and disproportionately high in a country that’s supposed to be the envy of the planet. The United States has the highest maternal mortality rate among high-income countries, even though U.S. women spend far more money on health care.

Between 2017 and 2019, an average of 61 Missouri women died each year while pregnant or within a year after pregnancy due to pregnancy-related complications, according to a 2022 report by the state’s health department. Three-quarters of those deaths have been determined to be preventable. As they do in much of the rest of the country, Black women in Missouri face staggering risks: Their pregnancy-related mortality rate is more than three times that of white women in Missouri.

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In the United States, the risk of dying during childbirth is 14 times higher than the risk of dying during an abortion.

N., who is 27, is planning on moving back to Missouri to be with her boyfriend and family. She wants to have kids, but she also has a heart condition and knows that any pregnancy will be risky, she said. 

“It's very scary and I want to be able to do it when I choose to,” N. said of pregnancy. “I’m a sexual assault victim from when I was young, as a child. It really affected me. Years of therapy for that. I think about how different it would have been if I had had to have my rapist’s child. That really makes me fear for my daughters and my niece.”

N. plans to once again leave Missouri when she decides to have kids. R. said that she, too, wants to move. Although Roe’s overturning isn’t her only reason for wanting to leave, it was the final push. 

When R. found herself pregnant a few years ago, there was no chance she would have an abortion. She had already suffered through one miscarriage, she said, and she considered her baby a miracle. Looking at her daughter now, R. can’t imagine having made another choice but to go through with the pregnancy. 

But having a baby totally changed R.’s life. Parenting and going to school, on top of working a full-time job, just became too much. “I stopped going to college,” R. said. “I can't travel. I can't just up and do anything I want, especially being a single mom. Her dad only takes her maybe three or four times a month.”

“I do regret having her sometimes,” she added. “But she is one of the biggest and best blessings of my life, and I wouldn't change it.”

For now, R. said, her daughter is her priority.

“I want her to have my full attention and love and know that she's loved, because I can give her enough love to make up for the family and people that don’t want to be in her life,” R. said. “Another kid would just take that away from her.” 

Follow @carter_sherman on Twitter.