A 33-year-old mother of three from central Texas is escorted down the hall by clinic administrator Kathaleen Pittman prior to getting an abortion, Saturday, Oct. 9, 2021, at Hope Medical Group for Women in Shreveport, La. The woman was one of more than a dozen patients who arrived at the abortion clinic, mostly from Texas, where the nation's most restrictive abortion law remains in effect. (AP Photo/Rebecca Blackwell)

Somewhere in Texas, a pregnant woman sits on the exam table inside a doctor’s office, walls dressed with illustrations of a fetus, reproductive organs and other charts. She is anxious, twisting her wedding band as her worried husband stands conversationless beside her. When the doctor arrives, it isn’t good news. “Your baby has a catastrophic brain abnormality,” he tells them, explaining that even if the fetus survived to delivery it would live for only a matter of hours, which would be marked by seizures, suffering and eventual death.

“I wish I could tell you what to do,” he says, “but there’s only one person who can make this choice.”

The woman wipes away tears, steeling herself.

“And that person is Greg,” the doctor says.

“Who the f—is Greg?” her husband asks.

Cut to the smiling portrait of the Texas governor and the magic red phone with a direct line to his office that the doctor uses to explain the situation. After some “sures” and “OKs,” the doctor hangs up. “That’s gonna be a no,” the doctor says. “Best of luck to you,” he adds as the door slams behind him.

Are we laughing or crying? A little bit of both.

The ad put out by the newly formed Mothers Against Greg Abbott political action group circulated on Twitter this week, garnering nearly 18,000 likes by Wednesday morning.

It’s satire, of course. But satire only resonates when it hits truth square in the eye.

Women and doctors have long faced excruciating decisions when pregnancy outcomes threatened the health of the mother. Up until recently however, these decisions had been, by and large, up to just those two people. Following the Supreme Court decision striking down the federal right to abortion, and triggering a wave of legislation criminalizing abortion in many states, doctors are having to parse legal text and weigh criminal penalties before offering potentially life-or-death care.

The woman waiting on the exam table, meanwhile, risks fevers, infections, hemorrhages and worse while her doctor considers just how sick she must be, how long she must bleed, how close to death she must be before abortion becomes a legal option.

All of this was anticipated and not just by people fearful of what the overturning of Roe could bring. Here in Texas and elsewhere, we’ve been living in legal limbo for months.

A study at two Dallas-area hospitals found that for pregnant women who would have received the option of abortion in the past due to troubled pregnancies, they were now being forced into dangerous and likely traumatic situations. The risk for some sort of serious health complication nearly doubled among the women included in the study, likely as a result of the restrictive policies Texas had in place even before Roe was overturned. Without Roe, those policies promise to become even stricter.

And what about the “pro-life” goals of those policies? Did the study show that forcing such women to give birth saved lives? No.

All but one of the 28 cases ended in fetal or infant loss. Of eight infants delivered with some cardiac activity, all but one died within 24 hours, according to the analysis in the American Journal of Obstetrics and Gynecology. The women, meanwhile, suffered a range of negative conditions, including infections, hemorrhaging and other serious concerns in 43 percent of cases. Overall, 57 percent of the patients had some short- or long-term, pregnancy-related health condition compared with just 33 percent of women in similar circumstances who received care in states without the same restrictions and penalties on abortions Texas imposed through Senate Bills 8 and 4.

Though the study was small, its findings were echoed among other researchers.

“People have to be on death’s door to qualify for maternal exemptions to SB8,” one practitioner explained in a recent analysis in the New England Journal of Medicine that interviewed both Texas health professionals and Texans with pregnancy complications.

The array of things that can go wrong in a pregnancy is dizzying, as any expectant parent who’s wandered into the “complicated pregnancy” chapter in their “What to Expect” book knows. It’s also incredibly complicated and technical, connected to a real person whose medical history is entirely unique. That’s why prenatal care — with a medically trained professional — is so important.

We’re not aware of any prenatal care recommendation that actually included a consultation with “Greg,” or any other politician. Yet, women and doctors are dealing with political overreach every day now in exam rooms across the state and country.

As written, the Texas trigger law should still allow for abortion in emergency situations but what qualifies as serious enough when a doctor is also facing jail and fines? What about a miscarriage when there is still a faint fetal cardiac flutter for the moment but also increasingly serious potential risks to the woman as she waits? There is too much uncertainty in the language of the bills and the intent behind them.

And that’s to be expected. That’s why politicians have no business writing medical guides and dictating standards of care. But then again, confusion and second-guessing may have been exactly the point of such clumsily crafted laws.

The co-dean of the Rutgers Law School, Kim Mutcherson, whose works focuses on reproductive justice, told NPR that these legislators "want to make it as difficult as possible, and one of the ways that you do that is [by] creating a standard where people don't know with specificity whether what they're doing is right or wrong."

That seems to be the case in Texas where the state is suing the Biden administration over federal guidance that sought to reassure doctors that they had permission to perform abortions in emergency situations, including for ectopic pregnancies in which, because the fertilized egg doesn’t implant in the right place, the pregnancy is not viable and can quickly become life-threatening.

In the real world, there’s no red phone to call up the governor, or lawmakers, to confirm the legality of an abortion in a dire medical situation.

"You have to wait until somebody gets in trouble,” Mutcherson continued. “You have to wait until there's a case. You have to wait until somebody gets arrested. And then you start to understand, 'OK, this is what the parameters are.'” That will take time — time many women don’t have.

So, we ask the ‘pro-life’ champions out there, including those writing the laws binding doctors’ hands and women’s bodily autonomy: how much suffering is enough? How much bleeding out does a woman need to do before her life is worthy? How many women will have to deliver babies, hold them, just to watch them die? How many women will be forced into deadly outcomes that won’t allow them to even make it that far?

Doctors and women need to be the clear authorities on their own health, for emergency care and for miscarriage care. Not Greg. Legislation restricting and criminalizing abortion needs to at least make clear that medical professionals can and should use their own reasonable — and trained — judgment. Prosecutors need to make clear they respect that authority. It won’t restore women’s autonomy but such clarification and reassurance will give their doctors more room to provide the care they were trained and licensed to give.

And yes, it may also save women’s lives, assuming that’s still a priority.

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