When Georgia lawmakers passed a restrictive abortion ban in 2019, the debate at the Georgia Capitol focused heavily on abstract concepts like morality and autonomy. Who has the right to decide for a woman if or when she ends a pregnancy? How late is too late to decide? Why not just promote adoption for a woman who doesn’t want her baby?
The pro-life lawmakers seemed to assume that all women are healthy, that nobody ends a planned pregnancy and that doctors in Georgia would have a clear understanding of exactly which abortions are legal and which are not. But that’s not the way it’s turned out.
Not fully discussed was the medical and emotional toll on women, especially those trying to navigate high-risk pregnancies and the new law, which prohibits nearly all abortions after fetal cardiac activity is detected, usually around six weeks, but sometimes sooner.
Nor was the intense stress on doctors trying to weigh sick women’s health and their own careers, since violating the law could result in losing their licenses and up to a decade in prison. Those were the stories told during a Senate hearing in Atlanta on Monday. And they were hard to listen to.
The hearing was convened by U.S. Sen. Jon Ossoff, the first-term Democrat whose wife is an OB-GYN. Ossoff did not mention his wife, but he did include an OB-GYN on the panel, along with two women whose harrowing experiences should be heard by anyone who cares about the health of women and babies in Georgia. Even for those who support Georgia’s law, it’s clear many of the exceptions detailed in the legislation are not working as advertised or intended.
The first witness, Mackenzie Kulik, is a married medical researcher who told Ossoff that she and her husband were thrilled when they learned they would welcome a baby daughter last year. But they were equally devastated at one doctor’s appointment after another as they learned of their daughter’s worsening medical prognosis, as well as Mackenzie’s. Scans showed too little amniotic fluid, then a missing face, then lungs that would never function.
Now well past Georgia’s limit, but somehow not qualifying under the “fatal fetal abnormality” exception in the Georgia law, Kulik asked if she should end her pregnancy. Her doctor closed the exam room door and quietly told her “off the record” what her difficult and dangerous options were.
Knowing her baby would not survive, Kulik decided to travel to Washington, D.C., to terminate her pregnancy, a process made exponentially more difficult without a Georgia doctor’s referral that she could not get because it would have been illegal under the new law.
“I had to repeat the story of our baby girl and how she was not going to live, and how we are choosing to terminate the pregnancy because we loved her so much, how we did not want her to suffer,” Kulik said, describing her pleas to her insurance company and out-of-state doctor’s offices.
Her lowest moment came as she was laying on a dirty Washington sidewalk, in too much pain to stand, waiting for an Uber to take her to the clinic. “I felt like an animal,” she said. “Like I didn’t matter, like my baby didn’t matter.”
Yasmein Ziyad, a mother of one, had a different story, but one that went equally awry.
Ziyad described worrying early in her pregnancy that she was having a miscarriage, only to be told by her doctor that she was not — and that not hearing her baby’s heartbeat at six weeks of pregnancy was not necessarily abnormal. She was sent home and told to go on bed rest.
At eight weeks, her doctor confirmed she was experiencing a miscarriage, but he could not intervene with a procedure that could be interpreted as an abortion under the law. “He spoke around the topic, then stated, ‘These laws. I don’t want to lose my license or be arrested,’” she said.
Ziyad was prescribed medication to speed the miscarriage, but after two and a half weeks of what she called excruciating pain, her doctor eventually needed to extract more from her uterus, which he did without pain medication.
“I couldn’t get the care I needed, that would have spared me so much pain and suffering,” she said. “As a result of what I went through, we have given up on hopes of ever being pregnant again,” she said.
The third witness at the hearing, Emory University professor and OB-GYN Dr. Carrie Cwiak, said Georgia emergency rooms are seeing more pregnant women coming in with life-threatening conditions, precisely because that’s what Georgia law requires. Doctors are waiting until their patients are in grave medical danger to end a pregnancy, she said, instead of preventing the grave danger in the first place.
“Make no mistake,” she said. “This restrictive ban has increased maternal mortality and poor health outcomes.”
For all of the talk in 2019 about Georgia’s abortion ban being meant to save babies’ lives, it only endangered life for these two Georgia women. They wanted their babies desperately, but were among the countless who learned through life’s worst experience that pregnancy can be as tragic as it can be joyful, as life-threatening as it is life-affirming.
And they showed again there is no law tidy enough to account for all that can go wrong in pregnancies, especially when doctors have to choose between pregnant women’s lives and their own livelihoods.
A key part of any doctor’s training is to first do no harm — whatever the outcome you want, make sure you don’t make a situation worse as you’re trying to make it better. The Georgia abortion ban did not prevent these two women from seeking the abortions they wanted and eventually needed. It only put them in more danger in the end.
