A Tennessee woman is the latest example of how, as long as states are allowed to ban abortion, we have to expect horror stories about the results of those bans. Her state’s ban forced Mayron Hollis into carrying a dangerous pregnancy until it turned into such an immediate threat to her health that doctors performed a simultaneous cesarean delivery and emergency hysterectomy. While Hollis’ story is an extreme, it reveals how bans like Tennessee’s affect the delivery of health care and outcomes for everyone in need of abortion care.
At the time of Hollis’ pregnancy, Tennessee’s abortion ban had a theoretical exemption for the life of the mother—but doctors could only invoke it as a defense to being charged with a felony for providing an abortion to begin with. Needless to say, few doctors were willing to run that risk. In April, Gov. Bill Lee signed a law slightly expanding the medical exemptions, but that’s not going to be enough. Other states already have life- or health-of-the-mother exemptions and it’s still common for doctors (and, even more so, hospital lawyers) to demand that pregnant people face imminent death before getting care. Stories like Hollis’ can still happen in Tennessee, even under the tweaked version of the law.
In Tennessee, as in some other solidly Republican states, lawmakers overreached what voters wanted. Republican lawmakers presumably felt they were on strong footing: A decade ago, Tennesseans opposed abortion by a 24-point margin, but by 2022, following the Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision, public opinion on abortion had shifted, with roughly equal proportions of people polled saying they were “pro-choice” and “pro-life.” Voters in the state wanted broader exemptions to an abortion ban, but few knew what was in the new law. Once its implications had a few months to settle in, Lee and Republican legislators were apparently feeling enough pressure to get them to change the law, however inadequately.
Hollis got pregnant soon after giving birth by cesarean section, and her doctor warned her that this put her at risk of cesarean scar ectopic pregnancy, in which a pregnancy implants in the scar from a previous cesarean. The condition can cause the uterus to rupture, which can be fatal. The Society for Maternal-Fetal Medicine “recommend[s] against expectant management of cesarean scar ectopic pregnancy”—but that is exactly what Tennessee law required of Hollis, unless her doctors wanted to have to defend themselves against felony charges. As a result, she went through an excruciating, dangerous pregnancy.
At 25 weeks, Hollis was hospitalized for four days, then went home only to return to the hospital a day later. Her bleeding was so intense that she had to receive blood transfusions through both arms, both legs, and her neck. She had a simultaneous cesarean delivery and emergency hysterectomy, which was necessary to stop the bleeding. Her daughter Alayna spent more than two months in the hospital before going home, and in the following months had to return to the hospital five times.
No one should have to go through this, but equally appalling stories are coming out of other states that have banned abortion. Five women sued Texas, seeking clarification of exactly what exemptions apply to that state’s abortion ban after they were denied abortion care despite threats to their own health or fetal conditions incompatible with life. One, Amanda Zurawski, was finally allowed an abortion after her fetus’s heartbeat stopped, but due to the delay Zurawski developed a secondary infection, required a blood transfusion, and ended up in the ICU. Even after surgery to remove scar tissue from her uterus and fallopian tubes, one of her tubes could not be opened.
Those five women are not alone. The New York Times reported:
A study from two Dallas hospitals reported on 28 patients whose water broke or who had other serious complications before 22 weeks’ gestation, and who, because of Texas laws, didn’t receive medical intervention until there was an “immediate threat” to their lives or fetal cardiac activity stopped. On average, the patients waited nine days, and 57 percent ended up with serious infections, bleeding or other medical problems, the report said.
A recent survey of medical providers by the University of California, San Francisco found that care for Black and Latina patients was particularly damaged by abortion bans.
Abortion bans, with the refusal to provide care in cases that threaten the health of the mother or where the fetus cannot survive, are a direct cause of unnecessary crisis, trauma, and lasting health complications.
Hollis’ experience also shows—in a particularly extreme way—the costs abortion bans impose on people denied abortion because they can’t afford to leave the state. Not knowing Tennessee was about to ban abortion, Hollis took her time in deciding whether to continue with a risky pregnancy. She decided to terminate the pregnancy on the day Tennessee’s ban went into effect. That meant going out of state was her only option. But she and her husband couldn’t afford to take the time off work.
Because they couldn’t afford that time off work and travel costs, Hollis had to carry a life-threatening pregnancy to term. She was put on bed rest at one point—time she couldn’t afford to take off work—and was hospitalized for days. She had bleeding so intense that it required multiple blood transfusions. She had major surgery. She has a baby who spent months in the hospital and has had to return repeatedly. The medical bills must be astronomical, in addition to far more lost work time than what she concluded she couldn’t afford to miss to travel for an abortion last year.
"[I've] just been stressed out a little bit not knowing what's going to go on with my daughter, how I'm gonna get her what she needs and what's gonna happen next. So I'm just trying to hang in there," Hollis told ABC News. She added, "It's been really hard to go back to work because I don't have the means to pay for the adequate care that she needs. So I've been trying to get help."
Being denied an abortion often has serious negative economic impacts, even in cases without the dramatic physical dangers Hollis faced. Studies have shown that women who seek abortion and are turned away are more likely to end up in poverty and facing outcomes like bankruptcy or eviction than their counterparts who are able to have abortions.
Tennessee’s abortion ban denied Mayron Hollis the right to make decisions about her health, in consultation with her doctors. The result was major surgery, the loss of the chance to decide to have more children in the future, immense physical trauma, and economic hardship. Policy shouldn’t just be prediacted on extreme cases—everyone should have the right to decide whether to carry a pregnancy to term—but the fact that Republicans in states like Tennessee have passed abortion bans extreme enough to lead to cases like Hollis’ shows how deep the hostility to women’s reproductive autonomy runs.
How can Democrats win the messaging war? It turns out there's actually a science to it, as strategic communications consultant Anat Shenker-Osorio tells us on this week's episode of "The Downballot." Shenker-Osorio explains how her research shows the importance of treating voters as protagonists; how Democrats can avoid ceding "freedom" to Republicans by emphasizing "freedoms," plural; and why it actually makes sense to call out "MAGA Republicans" (even though, yes, it's all Republicans).