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When Julianne McShane wanted to report on how some of the most vulnerable women in the United States were dealing with the Supreme Court’s decision to overturn Roe v. Wade, she knew exactly where she needed to go: Tulsa, Oklahoma. Oklahoma is where two realities collide. It is one of 16 states that have banned abortion almost entirely. “And it has some of the highest rates of intimate partner violence nationwide,” McShane said. “People might not realize how dangerous it is to be pregnant in the context of an abusive relationship, and abortion restrictions, obviously, just make that even more difficult.”
McShane wanted to quantify how difficult things were becoming for women in Oklahoma. So, she met up with a domestic violence advocate named Heather Williams. Williams is not exactly a social justice warrior. She’s a former cop. But she told McShane this story about how abortion restrictions have upended her world. Back in the summer, she was called to a local hospital to counsel a woman who had requested a rape kit. She does this frequently; she holds the victim’s hand and tells them what’s going to happen next.
“This woman is in the hospital bed, and a standard part of the forensic exam is to give a pregnancy test,” McShane said. “And so they give her the test, and they inform her that the result is positive. And Heather said that she was frozen initially, and then she just broke down crying.”
Imagine yourself in Heather Williams’ shoes. Because of Oklahoma’s ban, there’s no abortion provider for her to recommend. Oklahoma also passed one of those “vigilante” laws a while back, the ones that allow strangers to sue you for aiding or abetting an abortion. It got tied up in court, but still, laying out medical options—it felt like a risk. It changed how Williams thought about her work.
“I don’t think Heather would consider herself an abortion rights advocate, necessarily. But she sees the survivors that she works with, and she knows that it needs to be an option that’s available to people,” McShane said.
And Oklahoma isn’t the only place where scenes like this are unfolding. “It’s happening all over the place,” McShane said. “And advocates across the country are in this difficult position of not knowing what they can tell survivors, of fearing that if they do give them information, that they could be criminalized.”
On a recent episode of What Next, we spoke about how the new abortion landscape is causing chaos for domestic violence advocates and for victims. Our conversation has been condensed and edited for clarity.
Mary Harris: Before talking about how the Dobbs decision is impacting domestic abuse survivors in this country, I asked Julianne McShane to lay some groundwork for me. At the top of the show, she called pregnancy dangerous for American women. I asked her why.
Julianne McShane: Homicide is actually a leading cause of death for pregnant people in the United States, which is probably pretty shocking to a lot of people. And researchers say that this is probably due to the prevalence of both firearms and intimate partner violence, and obviously widespread access to firearms in this country is something that facilitates intimate partner violence. Many of the experts I talked to pointed out also that domestic violence tends to start or intensify during pregnancy.
It’s a time of stress.
Particularly if there’s stress about money, if the pregnancy was unplanned—those are things that could drive someone who’s abusive to become more abusive, or to be abusive for the first time. There’s also a paradox. Oftentimes, abusers will actually purposefully try to get someone pregnant to keep them under their control. But then, once they become pregnant and the reality of a future child becomes more clear, abusers can actually get jealous about the fact that a future child is going to take attention away from them. And so that can also be another factor.
There’s even this phrase, reproductive coercion, to explain what’s going on here.
Reproductive coercion refers to any kinds of threats or violence against someone’s reproductive health or decisionmaking capacity. That’s how the National Domestic Violence Hotline describes it. This could look like forcibly getting someone pregnant, refusing their access to birth control, sabotaging birth control during sex—also, forcing someone to get an abortion, although evidence suggests that that’s rare and not a widespread issue.
Are there any numbers that show how the Dobbs decision has impacted any of these things, either the homicide rate for pregnant women or reproductive coercion?
The National Domestic Violence Hotline said that there was a 98 percent increase in reports of reproductive coercion the year after Dobbs, compared to the year before—more than 2,400 callers, the year after, reporting experiencing some form of reproductive coercion, compared to about 1,200 callers the year before that decision.
Were people referencing the law?
Some of the callers were saying that their abusers were referencing the abortion ban in their state. And this is also, broadly, a tactic that experts expect to increase. Basically, when the state hands down these abortion restrictions, it can wind up enabling abusers because it suggests that the state has no interest in giving them access to abortion and supporting their reproductive autonomy. So, it’s something that an abuser can also restrict. And it does sound like, from the anecdotes that I heard, sometimes this is what people are reporting.
What about the death rate for pregnant women? Is there any data when it comes to that?
There was a study that was published in February that found that actually, under Roe, so even before Dobbs, pregnant and postpartum people in states with abortion restrictions had a 75 percent higher rate of homicide than those in states that protected abortion access. And all of those people weren’t necessarily being killed by people that they were in intimate partner relationships with. But that study also found that pregnant people who died of homicide were more likely to die because of intimate partner violence than people who weren’t pregnant and died of homicide.
I know that correlation doesn’t equal causation, but this correlation seems very strong.
Like I said, homicide is a leading cause of death for pregnant people in this country. So when you add an inability to control your reproductive life and to end a pregnancy that might be unplanned or unwanted by the abuser also, this is probably only going to get worse.
Would you call what’s happening with abortion and domestic violence an unintended consequence of the Dobbs decision or something else?
I do think you could say it’s an unintended consequence. Many of the arguments that anti-abortion lawmakers and other activists are making in their efforts to try to get the Supreme Court to ban medication abortion, which they’ll discuss next week in the oral arguments that are slated for Tuesday, tend to make the argument that abusers use abortion as a tool of abuse—that medication abortion facilitates domestic violence and harms survivors of domestic violence.
But the reality is, coerced abortions are overall quite rare, and it’s far more common for abusers to forcibly get someone pregnant and keep someone pregnant as a way to keep them under their control. And banning abortion access actually harms survivors more than anything.
There’s some new data that’s coming out that shows that in the years since the Dobbs decision, the abortion rate has actually gone up in the United States by, I think, 10 percent. I wonder what you make of that, given what you’re finding in terms of evidence that pregnancy is being used as a tool of abuse and how limited advocates are in terms of what they feel they can talk about.
That’s a good question. The fact that abortion is staying stable and increasing in places, post-Dobbs, just underscores the reality that it is still needed and that banning abortions does not stop people from getting them. That statistic is also probably due in part to the spread of telehealth abortion. We also know that that is increasing since the FDA in 2021 began allowing these pills to be prescribed virtually and to subsequently be mailed.
Experts in this space also talk about the significance of telehealth abortion for people in abusive relationships because it can actually take away many of the barriers that people in abusive relationships may otherwise face to getting abortion care in person. So, for example, getting abortion pills mailed to your house means that you don’t have to come up with a lie or figure out how to explain to an abusive partner why you need to travel, why you need to take time off work, why you need access to the car, why you need more money for gas or maybe even lodgings for an overnight stay somewhere. Self-managed abortion through abortion pills also looks like a miscarriage. So it does away with that level of scrutiny that you might get from an abuser.
I just talked with the physician behind Aid Access, which is one of the largest telehealth abortion providers, and she relayed to me an anecdote from someone who had ordered abortion pills from Aid Access and had an at-home medication abortion in the context of dealing with what seemed like some sort of abusive situation. And this person reached back out to Aid Access after and said, “Thank you so much for all of your help,” and said that her abusive partner left after her “miscarriage.” So, there you have an example of someone who was able to pass off a self-managed abortion as a miscarriage, and it actually sounds like it contributed to ending that relationship.
Wow.
When we look at the “friend of the court” briefs that anti-abortion activists and lawmakers have filed before the Supreme Court, many of them are totally blind to the context I just outlined. There definitely is an understanding gap, willfully or not, in how many anti-abortion folks understand the relevance of reproductive coercion to people experiencing intimate partner violence.
There are some older laws that are being seen in a new light because of how they intersect with the Dobbs decision. For example, the last few weeks I’ve read a lot about this Missouri law that seems to prevent pregnant women from getting divorced. I think it’s not actually a ban; it’s essentially how that’s been interpreted by judges, though, which is that if you’re pregnant, you need to tell the court you’re pregnant, and it ends up delaying a decision. There’s a Democratic lawmaker who’s trying to change the law there. Missouri is also a state that has completely outlawed abortion, with no exceptions for rape and incest. What does all that mean?
It’s just more evidence that these lawmakers do not understand the connection between the role that pregnancy can play in keeping someone in an abusive relationship and the importance of facilitating abortion access for them. We know that the right is also mounting an assault on no-fault divorce. There are, broadly, more efforts among the right to make it more difficult for people to get divorced. So, the fact that there are laws that are implicating pregnancy in this is not surprising. If they really want to support survivors of intimate partner violence and reduce or prevent domestic violence, that’s also going to require letting people end abusive marriages and letting people have access to abortion.
You’ve spoken to lawmakers, including lawmakers who have some pretty right-wing beliefs. When you speak to them, do you think they see these connections you’re talking about?
The one that I can talk about is a Republican state senator in Oklahoma who I called up when I was doing this reporting. His name is Darrell Weaver, and he has been a staunch advocate for victims of domestic violence in the state. He has introduced several bills, some of which have become law, that have harshened penalties for people who perpetrate domestic violence. Last year he pushed a bill that became a law that made the first offense of domestic violence against a pregnant woman a felony instead of a misdemeanor, so it increased the jail time.
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He clearly wants to help, in his way, pregnant women who are dealing with abuse.
Right. But when I asked him about abortion, he actually made a comment that wound up being very illustrative. He said that abortion is a hot topic. And if we talk about it in conjunction with something like domestic violence, it could make it more difficult to pass legislation that aims to tackle domestic violence.
He said, “If we clutter up these concepts, it’s going to diminish what we want to do.” It was interesting phrasing to me.
When I heard that, it really drove home to me that people like him that, in certain ways, have the best of intentions really don’t understand the connection between these issues.
I wonder what you said to him in that moment.
I did respond, actually, by citing some of the research. He actually claimed that I was stretching the conclusions, and that does not totally surprise me because the anti-abortion side does not have a strong track record when it comes to putting together a coherent evidence base for their claims. Like I said, many of the anti-abortion politicians and activists who are arguing before the Supreme Court that they should ban medication abortion are citing studies that are not based in evidence about the dangers of medication abortion for people in abusive relationships.
Reading your reporting, I was struck by how complicated and messy all the characters were, because they’re human. You talked about how Heather Williams, that domestic violence advocate in Oklahoma, she’s not especially pro-abortion. She’s not in the streets rallying for it. She just wanted to be able to talk to her clients about it and relay the information. What did someone like Heather Williams want a lawmaker like Darrell Weaver to know?
She said that she’s the one who winds up being in the hospital room, who has to comfort survivors like the one that she comforted last year who found out, in front of her, that she was pregnant by an abuser. She’s the one who has to tell them it’s going to be OK, even if she actually doesn’t know that it’s going to be OK. And what she said to me was that she wishes that they were the ones that had to comfort them.
That the lawmakers had to.
The bigger point there is that they’re not forced to confront the reality of these laws that they’re passing. They’re not in the room, seeing people’s dreams dashed and their futures become even more uncertain than they already are because they have an unplanned pregnancy that they don’t know if they can terminate. And that’s what Heather wishes they had to confront.
