“I’m terrified. Trying to start a family with my hubby and our first pregnancy was ectopic,” one user on threads wrote. 

“I’m a Black woman in TX where it’s being shown that these health professionals don’t & won’t give af about me if I’m in pain & very well may provide substandard treatment for asinine reasons,” another user wrote. 

“We have two kids and wanted one more. But with the ban we didn’t want to risk my life or having to travel if something went wrong,” yet another woman wrote. 

Last month, Texan after Texan, hundreds of them, shared concerns on a Threads post from The Barbed Wired that asked how they felt about desired pregnancies in the state. 

The emotions shared on the thread is an indication of a larger trend we’re seeing: People in Texas are scared of getting pregnant because of the state’s abortion bans and correlated declines in reproductive health. 

Texas is home to more than 6.3 million women of reproductive age and 94% of births were to women 20 years old and older, according to the March of Dimes. Sure, not all of them will want to get pregnant at any given time (or at all), but for those that do want to expand their families, fear beyond the typical risks associated with pregnancy have crept up.

Already, 8% of all pregnancies face complications, and 10-20% of pregnancies will end in miscarriage, according to the Mayo Clinic. In September, the Gender Equity Policy Institute and NBC News found Texas’ maternal mortality cases rose by 56%, compared with just 11% nationally, after the state’s abortion ban went into effect. At The Barbed Wire, we’ve rounded up some of the reporting and data available since the abortion bans went into effect, and found that rates of infant mortality, sepsis and STDs are up. 

On Monday, the Texas House will hold a public hearing on House Bill 44, a companion bill to Senate Bill 31, that its author’s claim will “remove any question and hesitation” when it comes to doctors concerns on whether or not to carry out life-saving abortions for pregnant people, according to the Texas Tribune. Some reproductive advocates caution that this bill and it’s companion are a “trojan horse” that does not really clarify exceptions for life-saving abortions, revives a 1925 Texas abortion law that would allow the state to prosecute patients (like in Georgia) and does not account for fatal fetal anomalies or cases of rape or incest.   

As the Legislature considers those bills, and others that would further restrict reproductive healthcare, we asked doctors what can be done to stay safe and sane if you are pregnant or are planning on getting pregnant. How can you take steps to focus on what is in your control instead of worrying about changing state and federal laws that can impact you? The bottom line: Doctors told The Barbed Wire it’s time to stop doom-scrolling and get informed. 

“Arm yourself with knowledge before you get pregnant,” Dr. Amna Dermish, chief operating and medical services officer at Planned Parenthood Texas, told The Barbed Wire. “I say that understanding that that is a luxury, being very clear right. Not everybody has the capacity to do that.”

Dermish and other doctors we spoke with echoed those sentiments, saying that the ability to prepare, plan and have tools is already a privilege that many pregnant people may not have access to. 

“I will preface everything that I’m about to say with the fact that I am extremely privileged. I’m a privileged Caucasian female physician who practices in a large metropolitan city with a lot of access to care,” Dr. Austin Dennard, a Dallas-based OB-GYN, told The Barbed Wire. “The patients that I serve all have commercial insurance, so right there, you’re only looking at a doctor-patient relationship that’s honestly fairly rare.”

Still, doctors separated preparedness into categories: Know your rights, know what questions to ask, know your resources. 

Know What Texas Abortion Laws Mean for You

“Although society treats abortions and miscarriages as very different pregnancy circumstances, medically they are quite similar. In fact, when someone has a miscarriage, they may receive the exact same procedure or pills that a person would use to induce an abortion,” Renee Bracey Sherman and Regina Mahone wrote in their book Liberating Abortion. 

When pregnancies fail, the standard of care in modern medicine includes using abortion care, according to Johns Hopkins Medicine and the Mayo Clinic. Medications like mifepristone and misoprostol (which Texas tried to ban) are used during miscarriage treatment to help “the uterus pass pregnancy tissue out of the body.” In cases of heavy bleeding or if there are signs of an infection, doctors may determine medicine alone is not enough. A D&C, a minor procedure called suction dilation and curettage, is another standard of care that can be performed by healthcare professionals to remove tissue from the uterus that hasn’t been expelled naturally and presents risk of infection. 

Right now in the state of Texas, the right to such care is unclear. Texans can not get abortions unless there is a “life-threatening condition,” according to the Center for Reproductive Rights, a global human rights organization. But even that is murky. A group of 111 OB-GYNs in Texas sent a letter to state leaders in November, saying the law prevents them from providing lifesaving care to pregnant women.

Reproductive rights advocates say pregnant Texans have to show “how dead they are” before they can receive care, if they get to that at all. It’s why reproductive justice advocates continue sounding the alarm that abortion bans don’t just impact people who want abortions, it trickles down to anyone who may need access to reproductive healthcare. 

“Texans, you may never want an abortion, but you may find yourself in my situation. You may need one to save yourself or to save a healthy, wanted baby.”

Lauren Miller, Mother

“Texans, you may never want an abortion, but you may find yourself in my situation. You may need one to save yourself or to save a healthy, wanted baby,” Lauren Miller, a reproductive rights advocate and one of the original plaintiffs who sued the state for access to abortion care, said during a legislative hearing for more abortion bills in March. In 2023, Miller needed an abortion to save the life of one of her unborn twins after the second one was diagnosed with a fatal fetal anomaly. Miller said she had to flee the state to save her second baby’s life. Miller spoke out against Senate Bill 31, a sister bill to House Bill 44, that claims it will clarify when doctors can provide abortion care to save a mother’s life. 

“These politicians insist they know better than you what is right for your family. They would criminalize you for making the right decision for your family. That is not freedom, that is not independence, that is anti-Texan,” Miller implored during the hearing. 

Under Texas’ current abortion bans, dozens of women with wanted pregnancies who have experienced terrifying miscarriages, fetal anomalies, or other life-altering pregnancy complications, say they have not gotten the care they need, and three Texas women that we know of have died. Doctors say Lauren’s case, along with the more than 20 other plaintiffs in Zurawsky vs. Texas, proves that abortion is healthcare and that right is being denied to all people. 

Doctors say you could be in one of those scenarios if you experience a miscarriage develop sepsis — which may require an abortion to save your life. That option was denied to 28-year-old Josseli Barnica who ProPublica found died after doctors delayed treating her miscarriage because of the laws Texas lawmakers put in place.

“Medicine is complicated. Medicine is messy. It’s not a black or white situation. There are so many clinical scenarios where a patient needs to be able to have an open and honest communication between their doctor over whether or not it is safe for them to continue pregnancy or whether or not they want to continue a pregnancy,” Dennard told The Barbed Wire. “You can’t just write a list of exceptions to medical scenarios. There is no end to the real life situations that occur where patients need to be able to have these open, honest communication moments with their providers. So there’s no list that lawyers could write down that are exceptions.” 

That’s why it’s important to ask questions and know what treatments are available to you. 

Know What Questions to Ask Your Healthcare Team 

“We can’t expect our patients to get a secondary degree in obstetrics in order to have a safe pregnancy,” Dermish said. “This person who might be hemorrhaging in the delivery room, how do they know how much blood is too much blood? How do they know when we need to be worried? How can they understand what’s going on? It’s a completely unrealistic expectation.” 

While getting a medical degree to go through a pregnancy journey in Texas may be an unrealistic expectation, doctors Dermish and Dennard say there are still ways Texans can advocate for a safer pregnancy journey. They recommend saving the following questions to take to exams, or put in your hospital bag.

  1. Preconception and early pregnancy questions:
    • What medications are safe in pregnancy that I may need to stop taking?
    • How many times will I come see you during pregnancy?
    • What are reasons to call (my doctor) if I’m concerned?
    • What does my medical history mean for my pregnancy? 
    • Can you explain the 20% miscarriage risk in pregnancy?
  1. Specific scenario questions:
    • If I were to experience this complication, if I had a miscarriage, what would happen? What would my options be?
    • What would you do? Would you treat it? Would you refer me out?
    • If I have an ectopic pregnancy, how soon will I be able to talk to my provider? What’s the protocol in this hospital?
    • If I think my water has broken early, how will you counsel me on active versus expected management?
    • What’s the relationship between you as the OB-GYN and emergency department physicians? 
    • How will you keep me safe if something goes wrong?
    • If I need an abortion to save my life, will you do it?
    • What is your comfort level and protocol for performing life-saving procedures?
    • How are the other partners in your practice feeling about counseling on abortion management?
  1. Additional advice:
    • Ask what information doctors are allowed to provide versus not allowed
    • If you’re not satisfied with their answer, ask more questions
    • Be direct and upfront in your questioning
    • Request a copy of your medical practices’s list of patient rights

“If your provider honestly does not know the answer or is not willing to find out the answer, or if your provider does not have the hospital lawyer’s cell phone number in their phone, you should be asking more questions or potentially finding a different provider,” Dennard said. 

Know Your Resources

Navigating healthcare in Texas can be challenging. In July, the Commonwealth Fund, a foundation focused on promoting an equitable health care system, released a report naming Texas the second-worst state for women’s health outcomes. Texas had the highest uninsured rates among women of reproductive age (15–44), and 46.5% of Texas counties are defined as maternity care deserts, according to the March of Dimes. 

The good news is that there are organizations in the state that help advocate for reproductive rights. 

“We may not have clinics in Texas, but we have not abandoned Texans. We are still very much committed to helping our people however we can,” Andrea Ferrigno, vice president of Whole Woman’s Health, told The Barbed Wire. The abortion and reproductive care provider announced it was shutting down all its Texas clinics in 2022, after the abortion bans went in place. However, Ferrigno says they’re still seeing Texans and providing care. 

Here are some categories of resources healthcare providers recommend getting familiar with: 

  1. Medical organizations that sift the misinformation from the real information
  2. Mutual Aid Organizations
    • Texas Equal Access Fund: Offers financial and emotional support to people in North & East Texas who lack the means to access abortion and other reproductive care
    • Fund Texas Choice: Helps people with abortion care out of state and other reproductive care
    • Sueños Sin Fronteras: Aims to improve pregnancy, birth, and postpartum outcomes for undocumented people in San Antonio, Texas, through direct support, education, and advocacy
    • South Texans for Reproductive Justice: Serving the Rio Grande Valley
    • Indigenous Women Rising: Serving Native and Indigenous people
    • Lilith Fund: Provides direct financial and emotional support to those needing out of state abortion care and in state reproductive care
    • Frontera Fund: Provides financial support to those needing reproductive care near the border and Rio Grande Valley
    • Elevated Access: Volunteer pilots help get people to the healthcare access they need
  3. Online Resources

Don’t Let Texas Lawmakers Control You 

Doctors who spoke with The Barbed Wire said there are thousands of healthy pregnancies happening across Texas. In 2023, there were 387,945 live births in Texas, according to the March of Dimes. 

“My wish is not for people to get so lost in the fear of what could happen that they don’t stop to experience the joy of their pregnancy and their birth and that to me, is just another thing that’s sort of been stolen from people in Texas,” Dermish said. “My plea to people is don’t get so lost in this, in this potential, that you lose sight of that miracle and don’t let them steal your joy, because that is, that is so important.” 

Dermish said it’s important to have a healthy understanding that risks are possible and people should be prepared but know that “the odds are in our favor.” 

Dennard said, bottom line, don’t let Texas lawmakers control you. 

“I understand that it is significantly more dangerous for the average woman to be pregnant in Texas versus New York or California, but I refuse to let the state of Texas dictate when and how many times I attempt to become pregnant, and how many children I want to have with my with my partner,” Dennard said. “The power of a woman is unstoppable. Women are incredible and incredibly resourceful. So I just encourage women to just very much advocate for themselves and feel empowered and not let these restrictions dictate how they want to live their lives.”

Leslie Rangel, a first generation daughter of Mexican and Guatemalan immigrants, is deputy managing editor for The Barbed Wire. Her award-winning journalism is focused on issues of health, mental wellness,...