IWhen Kathryn Archer took her young daughter to the local playground in Nashville, Tennessee, in January 2023, strangers often noticed her visibly pregnant belly and wanted to chat.
“When are you done calculating?” they would ask Archer. “Do you know if you’re having a boy or a girl?” “Oh, I bet your daughter is so excited to be a big sister.”
Archer didn’t know how to tell them the truth: in early January, Archer’s fetus had been diagnosed with a number of serious abnormalities that made a miscarriage likely. If Archer were to give birth, her baby could only be treated with surgery and lifelong assistance – pain that Archer was unwilling to put a newborn through. Without the operations the child has undergone might not survive, Archer’s baby would die shortly after birth.
But due to Tennessee’s near-total abortion ban, Archer was unable to end her pregnancy in her home state and instead had to wait more than three weeks for an appointment at an out-of-state abortion clinic.
“I don’t want to confide in a stranger that I need to have an abortion because my baby can’t survive outside my womb and I can’t get the care I need when I need it,” Archer recalled thinking. “Those three weeks were really bizarre, challenging and painful – more than necessary.”
IIn the nearly two years since the U.S. Supreme Court overturned Roe v Wade, sixteen states have enacted near-total abortion bans. In theory, these prohibitions have exceptions that allow people to undergo medically necessary abortions – but in practice, doctors and patients say, these exceptions are so vaguely worded as to be unworkable, causing doctors to delay care for fear of breaking the law. Dozens of women from states including Texas, Idaho and Oklahoma have come forward that they were denied abortions they should have been legally entitled to.
Archer is now one of seven women in Tennessee who, along with two doctors, have sued the state, asking a court to clarify the scope of the state’s exception for medically necessary abortions.
Currently, Tennessee doctors can use their “reasonable medical judgment” to perform abortions in serious emergencies, but abortion rights advocates say the standard is vague and subject to interpretation, leaving well-intentioned doctors vulnerable to prosecution. Lawyers for the Center for Reproductive Rights, which is representing the women, hope instead to establish that doctors can use their “good medical judgment.” performing an abortion while continuing the pregnancy would be unsafe. They also want to allow abortions when a fetus is unlikely to survive a pregnancy and live after birth – as in Archer’s case.
On Thursday, nearly all of the women in the lawsuit will gather at a Nashville courthouse for a hearing in the case.
“I felt like if I could share our story and join this lawsuit, and change even just one person’s experience, that it would be worth it to me,” Archer said.
aRcher and her husband decided to try for a second child around the time Roe fell. Archer was a longtime supporter of abortion rights and was aware of the risks that Tennessee’s abortion ban posed to her pregnancy.
“What if I have a miscarriage? What if something happened during pregnancy?” she remembered thinking. “But I was pretty much only thinking about the first trimester.”
Archer’s pregnancy appeared normal during the first trimester of pregnancy and into the second trimester. In early January 2023, Archer learned during her 20-week anatomy scan that she was having a girl.
Then the doctor told her, “This baby has diagnosable abnormalities from head to toe.”
A follow-up visit with a specialist confirmed that the fetus, whom Archer and her husband named Cecilia, had a litany of health problems, including brain damage, a bladder located outside the body and severe spina bifida that exposed the spinal cord and nerves . . These abnormalities, the specialist told Archer, made it unlikely that Cecilia would survive the birth, Archer’s lawsuit said.
Continuing the pregnancy, rather than terminating it, would also pose more risks to Archer’s own health.
“After that scan, both my husband and I felt strongly that terminating the pregnancy would be the best thing for us and for our family,” Archer said. “Our doctors were incredibly helpful. They cared for us in so many ways, but their response was essentially, ‘Our hands are tied now. We can’t help you anymore. ”
Archer and her husband immediately tried to find an appointment at an abortion clinic in another state. Because so many abortion clinics had closed their doors in the wake of Roe’s demise, several clinics were fully booked for weeks, Archer deeper into one pregnancy that could endanger her own health and increasing the risk that she would be forced to deliver a stillborn baby.
US abortion clinics performed more than 1 million abortions in 2023, a record high. But that number obscures a more complex reality: Abortion bans have closed scores of abortion clinics in the South and Midwest, leaving remaining clinics on the coasts swamped by a flood of patients from states with abortion bans. Abortion clinics in Kansas, where Archer initially tried to get an appointment, are now seeing roughly double the number of patients per month they saw before Roe fell. one recent analysis found.
Only a handful of U.S. clinics offer abortions after about 24 weeks of pregnancy. Abortions also take longer and become more expensive later in pregnancy.
Archer was eventually able to make an appointment at an abortion clinic in Washington, DC, about three and a half weeks after her 20-week anatomy scan. Because of the wait, “it went from a one-day procedure to a three-day procedure,” Archer said. “They’re giving her a chance to basically stop her heart. And then I had to come back 24 hours later, so there was a period where she was no longer alive, but she was still in my body… If I could have gotten the procedure earlier, I wouldn’t have had the longer, slightly more complex procedure .”
An abortion fund and a church helped Archer and her husband pay some of the costs, but they still had to pay more than $10,000 out of pocket.
“We got really good care because we have the resources,” Archer continued. “If we didn’t have those resources and that privilege, I don’t know what we would have done.”
One of the other women involved in the Tennessee lawsuit also found that her pregnancy was unlikely to result in a healthy baby, but she could not obtain an abortion. Against her will, the woman continued her pregnancy and gave birth to a stillborn son after 31 weeks of pregnancy.
Archer is now pregnant again and will give birth in May 2024 – almost exactly a year after Cecilia’s due date.
Before the abortion, Archer and her husband promised to scatter Cecilia’s ashes near water. “I just felt, on a spiritual level, that I was really connected to her when I was around the element of water,” Archer said. They also promised to take a walk in her honor every year.
“We did a lot of rituals around death and saying goodbye,” Archer said. “It felt like we were doing the right thing – at every stage, for her and for our family.”