For a long time, many women who had abortions because of catastrophic fetal diagnoses told their stories only privately. Grieving pregnancies they dearly wanted and fearing the stigma of abortion, they sought the closely guarded comfort of online communities identified by the way many doctors had described the procedure — TFMR, or “termination for medical reasons.”
In the two years since the Supreme Court overturned Roe v. Wade, their pain has been compounded into anger by new abortion bans across the country. Although these women account for a fraction of abortions in the United States, they have emerged as the most powerful voices in the nation’s post-Roe debate, speaking out against bans with their stories of being forced across state lines and left to feel like criminals in seeking care.
Many of these women started out opposing abortion, but as they have changed their minds, they have changed the way Americans speak about it. Shifting from private anguish to public outrage, they have also helped shift public opinion toward more support for abortion.
“After going through all this, I wondered, why are we not the poster child for abortion rights?” said Riata Little Walker, who traveled from her home in Casper, Wyoming, for an abortion in Colorado at 22 weeks, after doctors diagnosed Down syndrome and a heart defect in her fetus, which they said would require surgery and later a transplant if it survived until delivery.
“Yes, your body, your choice, but that’s not the story that pulls people in,” she said. “We have to bring our stories to the front because otherwise it’s so easy for those over here to do, ‘But they’re killing babies.’”
Walker is Catholic and had worked for Wyoming Republicans, including U.S. Sen. John Barrasso. She opposed abortion and did not realize she was having one because doctors called it “termination.” In the months that followed, she came to support abortion whatever the reason, and after Roe was overturned in June 2022, she testified against the ban on abortion passed by the Wyoming Legislature.
Although most bans allow abortions to save the life or health of the pregnant woman, few women have been granted these exceptions, and only a handful of bans allow abortions for fatal fetal anomalies. There are no bright lines to define “fatal” or “medical reason,” and the procedure is the same whether it’s described as termination, TFMR or abortion.
That makes these cases complicated for doctors, lawmakers and for the women themselves: What qualifies as a medical reason?
The women speaking out say their experiences made them believe that the law can’t and shouldn’t try to address complex and endlessly varying medical cases. In this, they appeal to rare common ground in what has been a bitter, decades-long debate: Regardless of whether they identify as “pro-life” or “pro-choice” in polls, Americans overwhelmingly say that the decision to have an abortion should be up to women and doctors, not the government.
These women say they now feel compelled not only to speak out but also to use the word “abortion,” to remove the stigma they themselves put on it.
“All these things we never even knew before; because before all of this, it was never spoken about,” said Kimberly Manzano, who flew from Texas for an abortion in New Mexico at 18 weeks after scans showed her fetus was missing limbs, organs and genitalia.
Manzano describes herself and her husband as “big Christians,” who thought abortion was something “promiscuous women” did to end unwanted pregnancies. Their pastor assumed they would qualify as a medical exception to Texas’ ban. They did not.
“We feel it’s our calling to our child that we lost that we do need to talk about it, to educate people, because I feel that we were so uneducated,” she said.
Some of the women are appearing in ads in favor of abortion rights ballot measures or candidates. Others are confronting politicians on the campaign trail, testifying or joining lawsuits. But mostly, they are talking to friends, family members and colleagues.
Researchers say it’s not clear how many of the roughly 1 million abortions each year in the United States would be considered “for medical reasons” but that they are rare.
Still, TFMR or “ending wanted pregnancy” communities have flourished online.
Even within online communities, there is debate: Is it acceptable to terminate if a child would live only a few hours? A few days? A few years? Women describe weeks of waiting for additional scans, hoping for miracles, poring over statistics on survival rates and research on quality of life. Some elect to continue their pregnancies.
The women might seem to be making the case for medical exceptions — dozens have joined lawsuits filed by the Center for Reproductive Rights in four states, seeking to clarify what conditions qualify as exceptions under abortion bans. Instead, “Exceptions don’t work, is what we’re proving,” said Ashley Brandt, a plaintiff in Texas.
Brandt traveled to Colorado to abort a twin that had acrania — it had no skull — and posed a threat to her other fetus. “It wasn’t just me at risk; it was my viable daughter,” she said. “We still were not an exception.”
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