In the summer of 2022, the Supreme Court overturned Roe v. Wade. Millions of Americans were stripped of various forms of reproductive health care. In her new book, “Undue Burden: Life and Death Decisions in Post-Roe America,” Shefali Luthra covers the experience of those impacted. *Spoiler alert: we’re all impacted*. As the gender and health care reporter for The 19th, Shefali joins the show to discuss the fallout of the Dobbs decision and what the future of reproductive health care looks like.

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On today’s episode

Our host

Errin Haines is The 19th’s editor-at-large and writer of The Amendment newsletter. An award-winning journalist with nearly two decades of experience, Errin was previously a national writer on race for the Associated Press. She’s also worked at the Los Angeles Times and the Washington Post.

Follow Errin on Instagram @emarvelous and X @errinhaines. 

Today’s guest

Shefali Luthra is The 19th’s health reporter covering the intersection of gender and health care. Prior to joining The 19th she was a correspondent at Kaiser Health News, where she spent six years covering national health care and policy. Her book Undue Burden, chronicling the impact of Roe v. Wade’s overturn on pregnant Americans, will publish May 21 through Doubleday.

Follow Shefali Luthra on X @shefalil.

Episode transcript

The Amendment podcast transcripts are automatically generated by a third-party website and may contain typos or other errors. Please consider the official record for The Amendment podcast to be the audio publicly available wherever you listen to podcasts.

Shefali Luthra:

The undoing of Roe v. Wade had massive implications. No one will be left unaffected, but at the same time, there are some people who will be more affected than others.

Errin Haines:

Hey y’all, welcome to The Amendment, a weekly conversation about gender, politics, and power from The 19th News and Wonder Media Network. I’m your host Errin Haines, today, I’m so excited. We have a very, very special episode for y’all. So when I was brainstorming guests for this show, there was one person that we knew that we had to have on, and that is The 19th’s very own Shefali Luthra. Shefali is our health reporter who covers the intersection of gender and health care. And she just published her first book. It’s called, Undue Burden: Life and Death Decisions in Post-Roe America. And it follows the harrowing experiences of people who are trying to get an abortion after the fall of Roe versus Wade in the summer of 2022. The book also covers the role of health care providers and the challenges that they face as each state navigates the fall of Roe differently.

Errin:

So what stands out to me in this excellent book is what, or rather, who is at the center of the discourse. And while much of the coverage on abortion focuses on the politics and the policies, the thing about Shefali is she centers the people, the people who these policies impact the most. So, while abortion is often used as a political palm by lawmakers, Shefali’s coverage is not about that. And during an election year where abortion is very much on the ballot, these are the stories that we need to be paying attention to. Shefali, congratulations and welcome to the show.

Shefali:

Errin. Thank you so much. I am so excited to be here.

Errin:

Well, we’re excited to have you and to get into this, how do you see your job at really the intersection of health care and gender and, and how have you seen that role evolve in your time with The 19th?

Shefali:

It’s a great question because when I came to The 19th, Roe v Wade was still law of the land. The right to an abortion was something that was protected, maybe not taken for granted, maybe something that had been weakened over time. There was obviously still a movement to eventually overturn Roe. But at the time, in the summer of 2020, it existed, and I spent a lot of time building a beat at The 19th that thought about health care as an issue of people and as an issue of inequality. And that, that touched on pregnancy a lot already. We talked about contraception, we talked about maternal health outcomes, perinatal health and, and mental health and, and all of that through the lens of people who can become pregnant.

Errin:

I think back even to, you know, you reporting on pregnant people in in the pandemic. I mean, that was really kind of where we started in terms of your approach to covering health care and gender and how the pandemic was affecting all of that. And we saw in your reporting even then, like the inequality that existed that was exacerbated by the pandemic. I feel like that probably set you up well for what you saw by the time we get to 2022. Right?

Shefali:

Absolutely. And frankly, even prior to that, because when my job at The 19th really changed was the fall of 2021, when the six week abortion ban SB 8 took effect in Texas. Yeah. It did not legally overturn Roe, but functionally it did. If you lived in Texas, the second biggest state in the country, if you were a health care provider there, you no longer had the right to an abortion guaranteed. Instead, it was functionally outlawed by the time many people don’t even realize that they’re pregnant. And this was really, really transformative. We approached it at The 19th, my editor Abby Johnston and I thinking about inequality. It was really important to us to look at who are the people who would not have options anymore. I went to the Rio Grande Valley, which is very, very much the south of Texas on the border with Mexico, to think about what it means to be in a state with a tremendous Latinx population, a large immigrant population, and to have places that are some of the poorest in the country. How are you supposed to travel for care? What does it mean to not have this right anymore, to choose when and how and under what circumstances you become pregnant? And that reporting was really important to how we continued to think about my beat at The 19th. It also laid the groundwork for this book, because the book starts with SB 8, it starts in Texas. It ends in Texas. To me, the story of Roe v. Wade and its fall and what that means is very much a Texas story.

Errin:

Yeah, absolutely. I mean, we have talked on this podcast about Texas is really kind of, you know, the testing ground for so much of the policy that happens across this country, particularly, you know, among conservatives that are looking to pass legislation that makes people less free, less fair, less equal in our democracy. So, you know, here you are two years after Dobbs, three years after SB 8. What do you feel like sets your lens and approach apart from what the mainstream approach is to abortion reporting?

Shefali:

I think part of it is what you said at The 19th, and in my work, the focus is on people, and it is on the people whose lives are affected by policy and are affected by politics. What happens in Washington is important to write about, but that to me is always an undercurrent. It is the subtext, the background, and the foreground is looking at lives that are changed, even if the laws someday change. If you could not get an abortion in this period, that’s life altering for you. The other thing that I always try and think about is inequality, right? Who is affected and who is affected differently? And a theme that I came to over and over again in reporting and writing this book is that the undoing of Roe v Wade had massive implications. No one will be left unaffected, but at the same time, there are some people who will be more affected than others. People who are lower income people who are people of color, people who are minors, all these sorts of demographics that maybe aren’t always centered in political journalism and in Washington, but are critical to how we think about who we write for at The 19th.

Errin:

Absolutely. And I mean, just the reality that there are people on the other end of policy. Right, exactly. And just never, ever forgetting that. And also the reality that without an intersectional approach, you’re, you’re really not telling the full story of the impact of these policies on, on people. So I wanna continue to kind of talk about the role of the media in covering abortion, especially since the fall of Roe. How does the media, as you see it, play a role in really kind of shaping public perception and policy discussions surrounding abortion access? Is there like a recent example that you have of how you’ve seen that play out? And what responsibility do you think journalists have in this regard?

Shefali:

I think this is one of the biggest issues of my lifetime to be sure. It just has profound implications for what it means to live in this country and what it means to live in this country if you can become pregnant, whether or not you intend to have an abortion. And I in some ways have been really heartened to see the emphasis that a lot of news outlets have begun to place on abortion in the way that they did not before the fall of Roe. You know, we have abortion reporters at major newspapers. We have some reporters who are doing really incredible work that is shaping our public discourse. What is really striking to me is this is an issue that voters clearly care about a lot more than they did before. They are saying it is shaping how they vote. And we are seeing press respond to that.

Shefali:

But what I hope for and what I think is really important to what we do at The 19th is two years out is a long time and things start to feel normal. It starts to feel like we always lived under this world order. And it starts to feel like, you know, a 15 week abortion ban was always the compromise. And that simply isn’t true. And it’s really important for us to take that long view and the short view and to remember that these are extraordinary times in which we are living, and we need to cover them with that lens. That this is, this is really drastic. It is a huge shift from where we have been as a country for the past 50 years. And it is having profound implications that are divorced from public health, divorced from science, and divorced from what other countries around the world would do. And that is a critical lens that I think is easy to lose. And I, I hope that we don’t, and I’m proud of the work we do at The 19th to make sure that that is a central theme of how we write about this.

Errin:

Yeah. We can’t normalize what has, what has happened in the past two years as if we didn’t have the 50 years before that. And I do think that that that is reflected in kind of the sense of urgency around the work that you have been doing, not just at The 19th, but really in getting this story out in Undue Burden. So, I mean, you mentioned Texas in 2021, kind of being this, this harbinger. And something that I noticed that I wanna ask you to keep talking about throughout the book was really kind of this universal skepticism or disbelief that the Supreme Court would actually overturn Roe ever. Right. But there was also sign after sign that this was a very real possibility. This is absolutely something that a lot of women of color, particularly in the South, for example, saw coming, were trying to push back against. Why do you think it was so difficult for so much of the country though, to believe that Roe would eventually fall? Why were we so incredulous?

Shefali:

I think in part because it is so extreme, what has happened, and for a lot of people there was a real divorce from the reality of what access to abortion already looked like. You mentioned the South, there was one abortion clinic in Mississippi before Roe was overturned. There was one clinic in Missouri, which Midwest, but still that is just so, so different from where people in the media live where people who make our laws live. You don’t see that. You don’t understand that already the right to an abortion is for many people a right in name only. I remember when SB 8 was upheld by the Supreme Court, I remember when we heard the oral arguments for the Dobbs case. And to me as a listener, as a journalist, it seemed clear that this was a court that was ready to gut abortion protections.

Shefali:

And that wasn’t the consensus in Washington, I think in part because of the extremity. And because people took this for granted, they just simply could not conceive of a world in which abortion was not a protected right. In which Roe was not treated as an untouchable precedent or if not untouchable, then at least minorly touchable. And instead, when we had those oral arguments, when we had the Dobbs decision leak at the beginning of May, 2022, showing us quite clearly what this would mean, it is not as if the White House formulated a plan when the decision actually came, you know, six weeks later, they talked about how they needed more time to figure out what this meant to come up with legal strategies to respond. And a lot of folks I spoke to at the time, and people who still think about that time two years later, that was kind of shocking because they had six weeks, they had longer, if you look at oral arguments, they had even longer, if you look at the court upholding SB 8. And yet just people couldn’t truly fathom that this is where we would be

Errin:

At the highest levels of government. And all the way down to, you know, these folks who were on the ground, whose stories that you’re telling. As you’ve mentioned, one of the biggest themes in your book is that restricted access to abortion affects everybody, but it doesn’t affect everybody equally. So to start, why do you say that abortion access affects everyone, not just people who are pregnant or those who want to get pregnant.

Shefali:

What we have already is a reproductive health care system that is so fragile and so tenuous that when you put pressure on it, like the overturn of Roe v. Wade and abortion bans that are some of the strictest in the world, that breaks the system in some ways. And it means that if I live in a blue state with abortion rights, but there are many people traveling to my home state for care that they cannot get at home anymore. The clinic that I otherwise would’ve counted on can’t serve at the same capacity it used to. It means doctors have less time to provide other services as well, whether that is birth control, whether that is colonoscopies, whether that is other kinds of reproductive health care, gender affirming care. I have spoken to clinics who don’t offer it anymore because they have seen so many out-of-state abortion patients.

Shefali:

That is all they can provide at this point. We have doctors who will not be trained in the full scope of medical care because it is illegal in their state to learn how to provide abortions. And that affects their ability to provide miscarriage care. It affects whether people want to become OB-GYNs at all. And that matters for all of us, whether you want to become pregnant or not, even if you don’t ever intend to have an abortion, someone you know will someday become pregnant and will not be able to access the full scope of health care. Because we have taken steps as a country, as a society to make it illegal and in other cases protected, but functionally far harder to provide.

Errin:

Yeah. I wanna talk more about that imbalanced impact. I mean, how does restricted abortion access disproportionately affect marginalized communities, particularly people of color?

Shefali:

There is a story in this book that I think about a lot. There is a young woman, her name is Angela. She becomes pregnant and only learns about her pregnancy after the turnover. Abortion is fully illegal in Texas by that point. She is a young mother. She is Latina, she lives in San Antonio. There are already so many systemic inequalities that disproportionately affect Latina women in this country. They make less money than White women, let alone White men. They are more likely to already have children when they’re younger. They are more likely to not have full access to the health care system. And for Angela, getting an abortion was so difficult. She had to hide this from everyone she knew, other than the man who got her pregnant. She had to come up with different excuse. She used all the money she had just to travel one state over for an abortion.

Shefali:

And there are other people in the book who make those same kinds of trips, but they have the money to do it. And it is emotionally grueling, but it is not financially terrifying. And I think often about Angela because she tells a story of who are the people most likely to get abortions, young mothers, often young mothers of color. And she reminds us that this is not technically life or death. She will live if she has this second child, but her life as she knows it will be over. And she knows that she be the kind of person she wants to be, be the mom she wants to be, live the life she has dreamed for her family if she does not have access to this choice.

Errin:

You mentioned Angela. I wanna talk about some of the individual stories that you highlighted. Uh, there was also Tiff, Darlene and Jasper. Can you just share a little bit about each of them and how you chose to focus on these folks specifically?

Shefali:

It was very important to me that the four central characters of the book represent different narrative experiences of abortion and different reasons people get abortion. Tiff is the main character of the first part of the book. She’s a teenager when she gets pregnant. She wants an abortion, but abortion is functionally outlawed in Texas at that point. And she has no options. Her parents, she knows, would not support this if it’s what she pursued. She doesn’t think about abortion because why should she? She is just a kid. And so she does not know how to circumvent Texas’ draconian laws as a minor. She would need either parental consent or the intervention of a judge to bypass that parental consent. She would need her own income. If she was hoping to travel out of state, she would need a car. She would need money. She would need some way to convince her parents that there’s a reason she’s leaving.

Shefali:

And she didn’t know how to order pills and get them discreetly mailed to her house. And what this that meant is Tiff had a child and she is living a life very different from what she imagined for herself. She got her GED, she’s figuring out, hoping to have a career someday, hoping to give her son everything she can. But it isn’t going to be easy for her because she didn’t have this option. There is, there’s Angela who also lives in Texas. Darlene, Darlene is in some ways the closest to what we have already seen, often portrayed in the press. She is a little older. She is White. She would love to become pregnant, but the time that she discovers she is pregnant is one that is medically very fraught for her. And doctors are afraid that if she continues with this pregnancy, she’ll die. But they don’t feel safe enough within Texas’s laws to give her adequate advice.

Shefali:

The only option they can really recommend is you should go somewhere where abortion is protected. And there are great doctors who will talk to you about your options. She flies to California and that is just an insane thing to ask of someone. And she knew that she could afford it, but she also knew that if she did not have that option, that she very well could be risking her life to stay pregnant, even though this is something that she wanted. And the last story that you mentioned, Jasper is someone I think about often, and I think his story is so critical because he’s a trans man in Florida. He becomes pregnant. He is 14 weeks along when he finds out he is pregnant. And no one had ever thought to test him for pregnancy because he is a man. And his story is important because it shows, it is not only women who have abortions who get pregnant, it talks about what it means to be living under dual and connected attacks on reproductive autonomy.

Shefali:

Someone who’s seeking abortion, who has also sought gender affirming care in a state that has restricted access to both. And it speaks to something else, which is that a 15 week ban may sound very reasonable and like a, a compromised position compared to the total bans we have seen enacted in so many states. But it left him with one week to make his decision. He had to make two visits to an abortion clinic separated by 24 hours. He had to figure out what he was going to do. And after that trip was over, he wondered, he knew in some ways that he could not be a parent, but he never felt like he got to make peace with that decision and to have the time to think it all through.

Errin:

Yeah. I wanna talk a little bit more about Jasper because stories like Jasper’s are not really the stories that we’re hearing a lot in this conversation about the post-Dobbs reality in this country. So advocacy for abortion rights often does focus on cisgender women, potentially leaving out, the voices and experiences of transgender individuals. Talk a little bit more about just what Jasper’s story tells us about reproductive health care that we don’t get from stories about cisgender women.

Shefali:

It is very, very obvious. If you look at the states that have restricted abortion and that are restricting gender affirming care, that Venn diagram is a circle. They are the same states. They are the same lawmakers. They are attacking in some places, these same clinics. The parallels are just so striking. The laws that have gone after gender affirming care are the laws that were used to restrict abortion very early on, limiting care for minors, limiting insurance’s ability to cover it, building a public relations strategy that demonizes medical providers because it is more politically sympathetic than demonizing patients. The experience of someone like Jasper underscores the relationship not only between these political attacks and legal attacks, but of what this kind of care means for people. It is, it can be lifesaving. It is at the very least life affirming for someone like Jasper. He could not be the person he is. He could not have the life that he hopes for without access to both of these forms of health care.

Errin:

Yeah. And also places where people are able to get access to reproductive care are are places where a lot of folks have been getting gender affirming care. So with the disappearance of those places, you have, you know, kind of the erosion of that network of health care as well, which you have written about.

Shefali:

Exactly. When you shut down an abortion clinic, you shut down a health care center that in some cases provides only abortion, but in others provides a lot of other services. Whether that is birth control, whether that is pap smears, whether that is gender affirming care. Again, because these are both forms of health care that have been siloed and stigmatized by parts of the medical system, even though it requires intense expertise and medical training and all the evidence that backs up the provision of these, it’s just so much harder to find them because of politics, not because of science.

Errin:

Another common thing throughout the book is this universal sentiment that getting an abortion shouldn’t be so hard. And because it was so hard and so limited, it made people feel like less of a person. And, and so this is really, I mean, your reporting is is not just about, you know, the the loss of a right, but the loss people feeling a sense of a loss of their humanity, of their dignity. How did you see the structural realities of abortion access really chipping away at people’s fundamental sense of self?

Shefali:

It was so striking to me over and over again. I heard people who had thought so deeply about what was the best decision for them, who knew that this was something that they needed and then came up against a health care system that told them that what they thought did not matter, that they actually could not be taken seriously, and that they deserved a level of intervention that frankly doesn’t exist for other kinds of health care. And just the phrase that you picked up on is something I heard over and over again. I feel like I am less of a person. I feel like I matter less because of my gender. And I feel like my country does not consider me to be treated as a free and equal citizen. And I mean, after hearing all these people reiterate this point, I can’t blame them.

Shefali:

Because when you step away and think about what is happening, like if I decided I need this kind of health care, let’s say I don’t know why I hurt my ankle and I need physical therapy to heal my ankle, the state would not step in and say, hold on. Let’s first make sure that you really know what you’re thinking about. Let’s take 24 hours, let’s make sure you make two visits to the physical therapist before you get your ankle healing underway. We only do this for health care that is related to gender, and that’s really important and it is something that we need to sit with as we write about this. 

Errin:

Yeah. Absolutely. You talk about autonomy and people being able to make decisions. This book also features the stories of providers and what they’ve been wrestling with in the days following Dobbs. What strategies have you seen abortion providers employing to continue to offer services and support patients in regions that have these restrictive abortion laws?

Shefali:

I recently described this as an escalating battle of who can be more ingenious between anti-abortion folks and folks who are trying to expand access. There have been really striking compelling efforts underway for physicians who live in states with protective laws to mail abortion pills, to people in states where the procedure is banned. New York, Massachusetts, California, et cetera. They have laws that, you know, protect physicians as long as they are within their state and are prescribing pills and sending them to people in Texas or Louisiana or what have you. And this, I think, is so interesting ’cause it really does speak to the efforts to which people are going to try and circumvent these bans. It also is a strategy that brings some legal risk to it, because if I am a physician in California and I take on this task, and then let’s say I go on a trip and my flight has a layover at Dallas-Fort Worth and I sent abortion pills to someone in Texas.

Shefali:

I don’t know if I could be arrested. That is an open question that has not been tested yet. We have a lot of ingenuity coming from health care providers trying to figure out ways to make sure people can get care. Some getting dual licensed in states that also see a lot out-of-state patients. I’ve spoken to doctors from California who travel to Kansas every month to see as many patients there as they can. But over time, as more bans take effect, as the impact of Dobbs spreads further and further, I think it’s an open question as to whether this response, this creativity and often courage from physicians will be enough to blunt the impact of something this seismic.

Errin:

And I mean, to your mind, why is it important for us to know the stories of these providers to know what their experience has been in this post-Dobbs reality?

Shefali:

They are people who have gone to school for this. They know the science, they know what they are doing, and their expertise has been completely delegitimized in a way that simply would not happen. Part of that is because they are operating under laws that were written or passed without anyone ever thinking that they would be enacted and would be enforced. And therefore, were not written with a lot of research, with a lot of care, with a lot of scrutiny. And now you have people who have gone to school for a decade to become very good at what they do, and someone who hasn’t taken a biology class in 30 years is telling them, actually, you can’t do that.

Errin:

Yeah it really is stunning when you, when you put it in those terms. Well I wanna look ahead because yes, you have written this book that is fantastic. But you are continuing to cover abortion and the changing landscape of abortion in America. So I wanna look ahead a little bit in terms of what’s happening with abortion. Currently, we see that Florida, which was supposed to be a compromise state, just had their six week abortion ban go into effect. Can you talk about the impact that will have within that state and externally for those neighboring states?

Shefali:

I think this is the biggest abortion ban to take effect. Since Wade was overturned, and that’s true for two reasons. One is that Florida is the third biggest state in the country. It is home to dozens of abortion clinics. 85,000 abortions took place last year there. That is a lot of people who will not be able to access care if they are past six weeks, which as we’ve discussed is so early that people often don’t realize they are pregnant. Florida is important for Floridians. It is also important if we look at the South, because when you pull up a map of the U.S., Florida was the only state on the eastern seaboard, south of North Carolina to allow abortion past six weeks. Some, you had a couple of Southern states that allowed abortion at six weeks. Georgia, South Carolina. North Carolina allowed it up to 12. Everyone else had banned it. So you had a lot of people traveling to Florida because it was their only option. It is no longer an option. You will now have people traveling from Georgia, maybe to North Carolina where there is a two visit requirement separated by three days or more likely to Virginia or Illinois or New York. You’ll have people from Miami either, you know, flying to Puerto Rico or flying to Cuba or flying to Illinois for an abortion. And that is just a tremendous shift and something we would not really accept in this country for any other form of health care.

Errin:

Yeah. And particularly, I mean, I’m thinking about just, you know, in this region of the country, I mean, we can’t talk about the impact without talking about the impact on Latinx and Black folks. Can you, I guess even expand a a little bit about the intersectionality of and the inequality of the impact of this?

Shefali:

Absolutely. If you look at the states that have banned abortion, they are more often home to Latinx people. They are more often home to Black people, like Black women of reproductive age are more likely to live in a state with an abortion ban than not. We have tremendous shares of states that have some of the biggest Latinx populations in the country, Texas, Florida, Arizona, et cetera, that have very strict bans in place that is going to have really substantial and unequal impact, especially when we consider that as a country. We already had unequal pregnancy related outcomes, especially for Black women. When you compare them to the treatment, the care that White women would receive. What happens then is we are putting Black women in particular in a situation where they know that it is more dangerous to be pregnant in this country. And they also know that they do not have a choice unless they are able to leave their state or find a way to circumvent their state bans. And oh, by the way, you also probably earn less money because of systemic inequality in how we pay people.

Errin:

Exactly. Well, I know that you are also continuing to keep an eye on the Supreme Court. There are currently two pending U.S. Supreme Court cases on abortion. Can you explain what those are and the impact that those decisions could have?

Shefali:

These are both really important cases. They are also interesting to me because they show that the overturning of Roe v. Wade created a large array of legal questions that we will spend years trying to figure out. The first case is about one of the two pills used in a medication abortion mifepristone. And a group of anti-abortion doctors filed suit in Texas saying that actually they think the Food and Drug Administration made a mistake more than 20 years ago when they approved this pill. They think they, they acted too fast. They didn’t consider the evidence. And I wanna be clear that this is a pill that actually the FDA studied for a very long time before it approved. And it is known from pages and pages and pages of research to be very safe and very effective. The Supreme Court is not considering whether to take the pill off the market, but they are considering restricting the circumstances under which it is prescribed.

Shefali:

They would consider no longer allowing it to be dispensed through the mail over telehealth, even though that is very effective and also very safe, they would change who is allowed to prescribe it. So it would not be nurses, even though they can very easily be trained how to do this. And it would only be allowed to be used up to seven weeks of pregnancy even though it is currently approved through 10 weeks. And a lot of doctors honestly think it is fine to use in the first trimester of pregnancy. This would be a really big deal because it would throw into disarray the systems that are in place for people seeking medication, abortion insights with bans, but also those who aren’t, like many abortion clinics only provide medication abortions if they can no longer give the standard option of care. They will have to give different options that are less effective and that are more painful.

Shefali:

And I’ve heard doctors say to me that they worry that patients’ health will really, really suffer if they cannot use mifepristone in particular for medication abortions. The other case that I’m so glad you mentioned, because it is just so striking, is about emergency medicine law. And the federal government has said that the emergency room medical law, a federal law that supersedes abortion bans in cases where they conflict. So if someone comes to the ER in a medical emergency, they have to be treated with the appropriate care. And sometimes that care is abortion. And they have specifically challenged Idaho’s ban, which would not allow abortions even in medical emergencies when they are the appropriate lifesaving treatment. So the Supreme Court is now considering, does Tala protect the right to an abortion in this, again, very, very narrow circumstance when it would be the thing that makes sure a patient is stable, that makes sure they don’t die. And if they do uphold the Idaho law over this, it would have drastic implications for how emergency rooms practices across the country. It also could suggest that many patients would no longer be able to access even the very, very limited exceptions that exist in their state’s abortion bans.

Errin:

And I mean, some people may read your book and feel a sense of hopelessness about the state of abortion in this country. Is that how you felt after you wrote this book? Uh, what would you say to people who read your book and maybe are feeling this way?

Shefali:

I would say I’m very grateful to my therapist. But really, I think there are some things that are really striking about this. And the first is to me, what was very powerful about writing this book and staying with patients in particular for a long time, was the fact that they are willing to share their stories at all is a really big shift from what would’ve existed even a few years ago. They wanted to share their stories because they hope it makes the world better, and because they wanted others to feel less alone. I think that is so powerful. It is so moving. It is really beautiful. They also have taught me over and over again that all of us are more than the worst things that ever happened to us. And I met all these people when they’re experiencing one of the worst things in their lives and now, like they’re still going. And I, I am so moved by that. I think it is something that we should all carry. That people are complex, they are resilient, they are really incredible, and even in the face of tremendous adversity, they can keep going.

Shefali:

On the politics front, I should note that there has been a real shift in how lawmakers talk about abortion. Democrats are much more willing to talk proudly and loudly about it. We have a president explicitly campaigning on abortion rights, which has never really been done before. And that is something that marks just where we are headed as a country in terms of how we talk about this, how we consider this. And I think it does suggest a world in which if our political systems work as they’re supposed to, it is something that can actually be addressed by lawmakers and policy.

Errin:

Yeah. I mean, to your point, what do you think the levers of power, the impact abortion access are that we should be paying attention to right now? And also leading up to the election and beyond?

Shefali:

I think realistically, we need to be looking at the White House. The President has tremendous executive power to shape what abortion could look like, even within the confines of not being able to overturn state bans. There are existing laws on the books that could be used and enforced to further limit abortion, even in states where it is legal. I’m talking of course about The 19th Century Comstock Act, which, you know, it’s an anti obscenity law. It was passed to ban books and ban porn and, and all of that. But it also has anti-abortion language in it that many advisors to former President Trump would like to see used. And they have been pretty clear that they viewed this law as a potential national abortion ban, or the very least significant national abortion restriction. Those are clear stakes. There is also the fact that we have seen from the Biden administration some efforts to try and on the margins protect access to abortion, whether that is making sure service members or people in the VA can access care. Whether that is something like asserting that emergency room medical laws do protect the right to an abortion in narrow circumstances. Those are things that could go away if we saw an anti-abortion administration. And I think it is just so important that if you are a voter and if you care about this, no matter your politics, that you think about what the person in the White House and what their team and their advisors could do with the tremendous power that the executive office has.

Errin:

Well, we know at The 19th that abortion is on the ballot. Undue Burden shows us what that means in real life on the ground. So Shefali, thank you so much for this book. Thank you so much for your work on this issue, which I know will continue. Uh, before I let you go though, Shefali, as some of you may not know, is quite active in our work Slack channel. So since around the office you are somewhat known for your hot takes. I gotta ask you a few questions.

Shefali:

Alright.

Errin:

One, are you Team Kendrick or Team Drake?

Shefali:

Kendrick

Errin:

That was a very fast answer that requires no additional explanation. All right. I don’t know if you saw this, but I was horrified. I had to post this in the Slack channel last week. Bumble’s founder, the dating app, talked about using AI in dating, specifically AI dating concierges that are gonna be stand-ins for people when they’re contacting potential partners online. Um, okay. Is it just me or have we gone too far?

Shefali:

We have absolutely gone too far. I feel very lucky to not be on dating apps anymore. And I think yes, the people in Silicon Valley who do not understand how real humans actually work need to be like sent out into the field to, to meet some real people and then go back once they have learned where we actually are.

Errin:

Agree. “Challengers” taking over the cultural zeitgeist a little bit. Any hot takes on that?

Shefali:

You know, it has me thinking a lot about the difference between sexiness – which this is a very sexy movie – and sexual tension. I wanted more sexual tension between our boys. I thought that would’ve been very important to me as a viewer. Like I want us to lean even further into the churro and the banana and all of that. My other big takeaway from this movie is god, Zendaya, because what is worse than being a woman knowing you are better than two men and having to settle for living out your dreams through people who are inferior to you.

Errin:

That’s a good note to end on. That is the real challenge indeed. Shefali, thank you for joining me on The Amendment. Thank you for your work and we look forward to continuing to read your coverage and your hot takes.

Shefali:

Thank you so much, Errin. This was really fun.

Errin:

One reminder before we say goodbye, applications for The 19th’s third class of Francis Ellen Watkins Harper Fellows are officially open. This is a year-long program expressly for HBCU alums or former students and in particular those who are interested in a year long reporting audience engagement or product and technology track. I’ve said it before and I’ll say it again. This program is near and dear to my heart and it’s the real deal. Hands-on crucial journalism experience, access to training and mentorship, and a competitive salary with excellent benefits. Tell your mama. I highly, highly encourage everybody who fits the application requirements to apply at 19thnews.org/fellowship2024 or share the link with someone in your network. The window closes May 31st, so don’t wait. 

The Amendment is a co-production of The 19th News and Wonder Media Network. It is executive produced by Jenny Kaplan, Terri Rupar and Faith Smith. Wonder Media Network’s head of development is Emily Rudder. Julia B. Chan is The 19th editor-in-chief. The Amendment is edited by Jenny Kaplan, Grace Lynch and Emily Rudder, and it’s produced by Adesuwa Agbonile, Grace Lynch, Brittany Martinez and Taylor Williamson with production assistance from Lucy Jones and post-production support from Julie Bogan, Victoria Clark, Lance Dixon, and Wynton Wong. Artwork by Aria Goodman. And our theme music was composed by Jlin.

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