News of the tragic abortion-related deaths of Amber Thurman and Candi Miller brought to mind my public health experiences in Kenya. In the 1990s, I helped the Kenyan government roll out health survey data to district teams eager to assess and refine their HIV prevention efforts. As our first session began, protesters disrupted the meeting, shouting about evil and sin and that condoms kill people.
At subsequent sessions, religious extremists repeatedly tried to derail our HIV prevention efforts. During this time, access to effective treatment was still years away. Prevention was critical to halting the spread of a disease turning vibrant Kenyans into walking skeletons. But this vocal minority preferred to condemn others to death for perceived “immorality” rather than to save lives and reduce suffering.
Credit: Handout
Credit: Handout
In Georgia, anti-abortion groups succeeded in securing an abortion ban that led to the deaths of Amber Thurman and Candi Miller. Anti-abortion activists deny and deflect responsibility for these deaths. But deaths among women from unsafe abortion occur everywhere in the world bans are enacted. Even before the Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision, maternal mortality was higher in U.S. states with more restrictive abortion policies than less restrictive settings.
Georgia lawmakers were warned about the ban’s potential for disaster and that Black people, like the two women who died, would be among those to suffer most. Throughout the United States, lawmakers have passed bans or near bans over the strong objections of the country’s leading health and medical associations. The number of prominent U.S. professional associations, religious organizations and businesses objecting to abortion restrictions now exceeds 270. The World Health Organization classifies abortion as essential health care.
No defensible public health, medical or human rights rationale exists for abortion bans or near-bans. Since the Supreme Court’s Dobbs decision, U.S. abortion rates have risen, reaching their highest level in 2023 in more than a decade. Globally, no evidence links legal restrictions to lower abortion rates. Plenty of evidence suggests bans inflict maximum harm on low-income, young, Black and other vulnerable people.
Georgia’s ban is also designed to hit lower-income people the hardest. The six-week cut off comes before most people realize they’re pregnant. Thus, lawmakers would anticipate that many people would be illegally self-managing abortions at home or, if they could afford it, traveling out of state for care.
While medication abortion is generally highly effective, it doesn’t always work. Some people require timely follow-up and in-office clinical procedures. Yet the ban would not seem to offer a clear legal path for prompt care of incomplete induced abortions.
People with money could leave Georgia for timely follow-up care, becoming “abortion tourists” in the derisive “pro life” lexicon. Travel for high-quality care, however, would be out of reach for many. In the United States, about 4 in 10 women and girls receiving abortions fall under the federal poverty line. Those unable to travel, like Amber Thurman, would likely need to meet the Georgia ban’s vague emergency care standard to secure treatment. And, as Georgia’s “pro life” lawmakers and activists surely knew, this might be a low standard of care indeed.
In other ban states, patients have had to become severely ill before health professionals, hobbled by fear of prosecution and ambiguous legal restrictions, intervene. Providers have reported many instances where bans have “dangerously warped” clinical care standards. Readily treatable conditions have been left to fester into life-threatening infections, ICU stays and astronomical medical bills. A woman’s life might have to be at immediate risk before doctors intervene when a fetal heartbeat is still detectable, even when the fetus isn’t viable.
With politicians usurping the authority of doctors, is the exodus of obstetricians and gynecologists from ban states any surprise? In Georgia, more OB-GYNs left the state from 2022 through the first half of 2024 (153), than did from 2010 to 2021 combined (107). These departures will make pregnancy less safe for everyone in the state.
By conferring personhood on a fetus, Georgia’s “Living Infants Fairness and Equality Act,” also violates international human rights standards. These standards do not grant a zygote, embryo or fetus rights as people, moves that would undermine a pregnant person’s fundamental rights and agency. Fetal personhood is a religious idea, not a scientific one. Further, agreement on this concept doesn’t exist within or between religions.
In enshrining fetal personhood in legislation, a vocal religious minority in Georgia hijacked the power of government to impose their beliefs on other Americans. These beliefs, which put fetal life on equal footing with the mother’s life, can dangerously undermine care when put into practice. Some of the many pregnancy horror stories of delayed emergency care in the United States echo the longtime charges the ACLU has leveled against Catholic hospitals, which follow U.S. Conference of Catholic Bishops guidelines.
Rather than turning to religion, lawmakers might better consider when a pregnant person is no longer a full human being. Right now, in Georgia, the answer is chillingly clear. A Florida man, former speaker of the state’s House of Representatives, got to the heart of the matter when he referred to pregnant women as “host bodies.”
In Kenya, an estimated seven women and girls die every day from unsafe abortion. Thousands more land in hospitals with abortion-related complications. Some of these people likely would have qualified for safe abortions under the health exceptions in the country’s 2010 Constitution. Legal ambiguity, fear of prosecution, and other factors continue to deter providers and patients. These types of factors also reportedly deterred Candi Miller from seeking care in Georgia.
U.S. activists help fund anti-abortion efforts in Kenya. Kenyan “pro life” activists, not surprisingly, oppose critical public health initiatives such as guidance and trainings for health workers on safe abortion. They would rather see women and girls die.
Is this the direction we want to go in Georgia? Will we continue to condemn pregnant people to die and suffer needlessly?
Whether it’s the United States or Kenya, HIV or abortion care, crusaders in love with their own righteousness are the same. They worship power and control above all, no matter the harm they inflict. It’s high time we eliminate these indefensible abortion policies and make women’s health care safe again.
Dara Carr is a global health consultant. She has worked with numerous governments and civil society organizations to improve policies and programs in HIV, family planning and maternal health.
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