19th reporter Amanda Becker joins Errin to talk about her new book, “You Must Stand Up: The Fight for Abortion Rights.” Amanda talks about the origins of the book, creative resistance in the wake of the Dobbs decision, IVF and fetal personhood, and the stakes of the first presidential election since the fall of Roe.
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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
Amanda Becker is The 19th’s Washington correspondent and a 2023 Nieman Fellow. She has covered the U.S. Congress, the White House, the Supreme Court and elections, including three presidential elections, for nearly two decades. Becker previously worked at Reuters and CQ Roll Call. Her work has appeared in the New York Times, Washington Post, USA Today, and Glamour magazine, among other publications. Her political coverage has also been broadcast on National Public Radio. She divides her time between Washington, D.C. and rural West Virginia. You Must Stand Up, The Fight for Abortion Rights in Post-Dobbs America, is her first book, published by Bloomsbury USA on Sept. 10, 2024.
Follow Amanda on X at @AmandaBecker and Instagram @beckernews
Episode transcript
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Amanda Becker:
I was a big Mr. Rogers watcher when I was a kid . And, you know, there’s a phrase that he would say, which was, like, “When something bad happens, look for the helpers.”
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. So the 2024 election is rapidly approaching, and one of the key issues is abortion. We’ve already seen it come up in the presidential debate between Vice President Kamala Harris and former President Donald Trump. And it was one of the issues that Harris spoke about most passionately.
Kamala Harris:
Working people, working women have to travel to another state to go and get the healthcare she needs. Barely can afford to do it, and what you are putting her through is unconscionable.
Errin:
So Democrats have been putting reproductive rights front and center in their campaign, arguing that another Trump presidency would set women’s rights back even further and endanger many, many more lives. And here at The 19th, we’ve been keeping up with the state of reproductive rights in America. Our Washington correspondent, Amanda Becker, just released a book about the fight for abortion rights post-Roe. She’s been grappling with the realtime impacts of the Dobbs decision, the nearly daily shifts in health care battles, court cases and constitutions. Today, I’m so happy to be joined by my friend and colleague, Amanda, to discuss her new book, “You Must Stand Up,” and the role of abortion rights and how they might play in the presidential election. Welcome, Amanda.
Amanda:
Thanks for having me.
Errin:
Okay, so let’s go back to the beginning. I mean, 2022, the Dobbs decision comes down. I think I remember you were on vacation, because of course breaking news is going to happen when you were on vacation. But just remind us: where were you when the Dobbs decision came in and what was your reaction?
Amanda:
You know, I was sitting up in the loft that counts as my bedroom on family vacation. And, um, my family was watching some action movie I didn’t wanna watch. So I was reading, and on my phone, and I got the alert come across my phone like everybody else that Politico had gotten ahold of the decision, and I saw the story headline that Roe was gonna fall. You know, obviously my first move even on vacation was to go into The 19th slack and just make sure people had seen it, and they had. And so I knew that was taken care of. And so then I started reading the decision myself. I was getting texts from women I’ve been friends with throughout my life, asking questions about how this was gonna affect them. You know, things like, “Do I need to move my frozen embryos out of my state?”
Amanda:
As we’ve seen abortion bans imperil IVF. I knew it was just gonna be such a period of chaos. Now I was already pitching the book at that point. I already had a proposal together at that point, you know, ’cause anyone who listened to the oral argument the December before that had a pretty good idea that either Roe was gonna fall or its protections were gonna be pretty significantly scaled back. There were some states that had bans that kicked in pretty much immediately. And so, you know, what went from being routine medical care that they were providing on a day-to-day basis, went to being illegal in the span of five or 10 minutes in some cases.
Errin:
But I wonder if you can talk, too, about just how you decided who to focus on in your book when you thought about how you were going to kind of document and chronicle that. ‘Cause who we end up hearing from are so many of the people who you were just describing: The doers, right? In the wake of this decision, the folks who were providing care and trying to figure out how they were gonna navigate this landscape. What made you focus on those folks? Why did you think that their story was the story to tell, really, in this post-Dobbs reality?
Amanda:
It all started with I knew I wanted some people working in clinics because I knew they were going to be the ones who were, you know, preparing for this, who saw it coming, who were getting ready. And the way I was thinking about it and talking about it with my agent, who was helping me with the proposal, was, you know, I was a big Mr. Rogers watcher when I was a kid. And, you know, there’s a phrase that he would say, which was, like, “When something bad happens, look for the helpers.” And so I was looking for the helpers. And, you know, the first woman who, kind of, I knew would be a main part of the book was Robin Marty in Tuscaloosa, Alabama. She’s not a healthcare provider. She actually came up in kind of the liberal blogosphere space, then was working at a news organization that only covers reproductive health and rights.
Amanda:
And then she realized in the few years before Dobbs that Roe was gonna fall. And she thought, like, “I can’t even waste any more time writing about this. I need to get involved in a direct capacity to facilitate care.” And I think maybe because she’d worked in the media space, like, she just had a greater degree of comfort about working with a journalist at what we both knew would be one of the most stressful trying times of that clinic’s existence and for the people who work in it. And then, through Robin, I was able to be connected to other doctors such as Dr. Gabrielle Goodrich in Phoenix, and so it kind of started that way. And then, you know, as the circle kind of gets bigger around those two clinics and those two women that I consider to be the heart of the book, I realized what I was writing wasn’t just the biggest political story of my lifetime, of my career, but also a story about our democracy and how we got to a place where there’s laws in place in great parts of the country that are not supported by the general public, and kind of interrogating and examining what I consider to be democratic erosion that got us there.
Errin:
In reading your book, I was also really struck by how these physicians had to get creative in terms of how they responded and how they showed up for their patients over these past couple of years. I wanna talk about the conversations that you were having with some of these providers, and some of the biggest obstacles to providing that care, and how doctors have gotten creative in finding those kind of loopholes in the system to be able to treat people.
Amanda:
Yeah, so let’s use Arizona as the example, right? The clinic in Phoenix. So in the weeks after Dobbs, Arizona actually had three different statutes on the books related to abortion. There was a 15-week ban that they’d passed. The Republican legislature had passed relatively recently. There was kind of vague fetal personhood language that they had approved. Both of those were kind of on hold while Roe was in place, and then Roe fell. Now, there was also a complete abortion ban except for for the life of the parent from before Arizona was a state that had been on hold since Roe in the seventies. Dr. Gabrielle Goodrich, she was having to stay ahead of this. So she had set up a system during that chaotic time period where they were shipping medication abortion to post offices on the Arizona-California border.
Amanda:
And then patients were going and picking it up and bringing it back to their homes. And then they could get aftercare at the clinic. Now, once it was the 15-week ban in place, she continued to be creative. You know, they were able to do medication abortions again. You know, medication abortion is usually used through about the 11th week of pregnancy. And she is on a Signal chat of doctors all over the country. It’s a place to, kind of, share best practices, share strategy. She started talking to doctors at a clinic in California because Dr. Goodrich was actually very experienced at providing abortion later in pregnancy. She was one of the, you know, only places in the country where you could go for an intact birth experience for an abortion. And these are people who find out their fetuses have very, very severe health problems late in pregnancy, but maybe they want to have the body to bury, or for religious reasons or to take footprints to mourn.
Amanda:
So she was experienced doing that work. And so she started talking to a clinic in California and came up with a system where they do induction abortions, which are really common in Europe, but not something that is, kind of, often done here, where they start the induction in California and stop the heartbeat. And then people are able to come back to the clinic in Arizona to, kind of, complete the abortion. So, you know, they’ve had to completely rethink how they deliver care. Because not only is that now like a bifurcated medical process between two different doctors in two different clinics, they’re having to figure out, kind of, how you divide up the billing, which abortion funds and, you know, support networks will fund it in either place and just completely rethink how they deliver care to their patients based on some of these laws.
Errin:
You know, you mentioned that prior experience, you know, like somebody, like a Dr. Goodrich had. I mean, I’m also thinking about, frankly, Robin Marty and how, even in the lead up to Roe, the strategizing that they were having to do, just in anticipation of that decision, right? And trying to kind of figure out travel. It just really has been striking to watch people kind of navigating, you know, the health of these patients, but also because of the legal risks that they face depending on the laws in their state, right?
Amanda:
There’s a waiting period in a lot of states, and there was a waiting period in Alabama, so they had been advised by lawyers — and, often, many types of abortions are a multi-day process. You don’t just go in and have it and leave even once you’ve completed your waiting period — so they had been advised by their attorneys that, you know, once a procedure was started, they could finish it. But what about the people that were still in their 24-48 hour waiting period, right? And so they had figured out, you know, any patient who’s able to get there, Georgia still had access at that point. And so they were sending, kind of, their files to a clinic in Atlanta that had some capacity. It’s like a two-and-a-half hour drive. And so they were having to set that all up. Now shortly after the Dobbs decision came out, there started to be, kind of, murmurs in Alabama, and it did come to fruition that the Attorney General there was going to come after potentially clinics or anyone who was sharing information about how to get an abortion.
Amanda:
Now the clinic has filed a free speech lawsuit about that. A decision is expected any day. It will likely be appealed either way it comes out. It’s another case that could end up at the Supreme Court because, you know, how can you say with the First Amendment in place that merely even telling people where they could go is no longer legal in the state of Alabama? According to the Attorney General, they were having to even think about things at clinics across this country like, “Do we need to host our website? Do we need to have our server in a state where abortion is still legal?” And so it’s just created this inner jurisdictional morass of overlapping and sometimes laws that are in conflict with one another.
Errin:
so Amanda, I would be remiss if I did not mention Amber Thurman. I know you and I have kind of talked about this, but I wanna talk about it here. ProPublica recently reported that Amber, who’s a 28-year-old medical assistant and mother to a 6-year-old, who after having to cross state lines to even attain an abortion died in her home state of Georgia when she experienced rare side complications from a procedure. These were complications that she didn’t need to die from, but the simple procedure that would’ve saved her life is now a felony and comes with up to a 10-year prison sentence for doctors. I wanna ask you what your reaction was to Amber’s story. When you saw this story, what did you think and what does her story tell us about the post-Dobbs reality that we’re in?
Amanda:
People dying is the inevitable impact of abortion bans. As you said, she crossed into North Carolina. She originally wanted to get a surgical abortion, but was unable to because they were running late because of traffic. You know, she ended up getting a medication abortion. Went back home. What happens sometimes in medication abortion procedures — which is something that also happens in miscarriages all the time — is that your body does not finish expelling all of the fetal tissue and all of the birth matter. And so you have to go in to have that removed or you become septic. And the procedure that she needed, that she was waiting to see if they would approve, is the exact same procedure that you would get if you were having a miscarriage that didn’t complete. And I have multiple, multiple friends who have experienced this. And what is happening is because it’s the same procedure as you would use for to complete an abortion, that people are showing up in emergency rooms like Amber and they’re not able to get it because the hospital staff are worried that they could face legal repercussions for providing an abortion after the, you know, weeks cutoff in whatever state they’re practicing in.
Amanda:
And so she waited and waited, and by the time they gave the procedure to her that she needed, it was too late and she died. And, you know, we’re gonna start hearing about these because this came from information from a maternal mortality review board that are in states. There’s a lag in terms of, like, when they get case information and when they review it, and then when they release the reports to the public. So I would assume we’re unfortunately going to hear about a lot more of these in the coming weeks and months as we get, kind of, the first picture of what that first year without Roe in place looked like.
Errin:
I think it’s also unsurprising that this was a Black woman. I think it’s also unsurprising that she was in the South when this happened. Just knowing everything that we know about the landscape.
Amanda:
You know, look, a lot of doctors, they know how devastating this has been and will continue to be. The American Medical Association has been very vocal and pushing back against Dobbs and its impacts and talking about how that’s going to lead to bad patient outcomes. The title of my book, “You Must Stand Up,” that was a blog that Dr. Goodrich wrote for other doctors long before Dobbs because she knew what was coming. And she was saying, “Doctors, you must stand up for our ability to treat patients, or else hospital review boards and other, you know, entities are gonna be making decisions about our patients that could have, you know, negative impacts on their health or cause them to lose their lives.” And she was saying, you know, “If we don’t stand up as physicians now, it’s gonna affect our ability to even care for our patients in basic ways.”
Errin:
You’re talking about providers that had to get more creative, but providers also getting more activist, which is also something that you write about in the book. Right? And this is not just even around reproductive care. I mean, you had providers during the pandemic, during the racial reckoning, really understanding that there was kind of a different role that they had to play — a role that maybe they didn’t intend to play, right? As physicians, as caregivers. But understanding that the politics that are involved in the care that they’re trying to provide, that there was maybe a different way that they needed to show up, to stand up, right? Around this issue.
Amanda:
Yeah. I follow a medical student in Wisconsin who started school, you know, six weeks after Dobbs. And Wisconsin at that point had a full ban in place, also from the 1800s. She was wanting to go into women’s healthcare. And so she’s showing up for medical school in her home state of Wisconsin, where she was excited to be back after doing undergrad out of state, and thinking to herself, “How exactly am I gonna be a women’s healthcare provider in a state where I can’t provide abortion and miscarriage care?” Medical students tend to practice and build their practices in where they do their residencies. Where you do your residency is where you get a lot of, like, your on-the-ground clinical training. If you cannot do a residency where you learn abortion care and you’re wanting to be an OBGYN, that’s problematic. We’ve already seen in the first, kind of, two cycles after Dobbs, in terms of applications to medical school, applications have dropped in states with abortion bans.
Amanda:
Now Wisconsin already had a maternal health care desert, um, large portions of the state. And so this was going to have cascading impacts on care. The South already has abysmal maternal health outcomes in terms of birth. We’re gonna see that get exacerbated and worse because doctors are gonna not be training in that specialty in those states, and then it’s gonna make that healthcare desert even worse. And so the student that I followed, you know, got involved in a group that was working ahead of a Supreme Court election there to get the word out because the State Supreme Court election was widely seen as a referendum on that abortion ban. And, uh, you know, we saw record turnout — including among students, including among young women in particular — in that state of Wisconsin. And, you know, they’re fighting to learn how to care for their patients in the future.
Amanda:
And medical schools don’t have any sort of, like…abortion care is not part of the core curriculum in medical schools. So if you’re wanting to learn that, and you’re in a state that has a ban, you’re having to go to great lengths to, kind of, set up externships and stuff out of state to shadow at clinics out of state. And all of this has a cumulative impact on accessing healthcare in large portions of this country now. And so she, you know, had come from kind of a public health background, and so I think she felt a little bit more comfortable, you know, being an activist ’cause that’s not something that a lot of doctors feel comfortable doing. But we’ve seen it get more and more common. White coats for Black lives during Black Lives Matter. We certainly saw medicine get politicized during the COVID-19 pandemic farther. Doctors, I think, are realizing that being politically active it’s not just an extra thing they need to consider doing on top of all their other, you know, responsibilities as a physician. It’s something that needs to be a part of their practice or they’re not going to be able to take care of their patients.
Errin:
A consequence that maybe some people did not anticipate, but certainly something that you predicted based on your reporting, the next frontier of the anti-abortion movement: The idea of fetal personhood. And we actually got into this in our recent poll we have at the 19th that found that 81% of Democrats and 55% of independents expressed opposition to fetal personhood, compared with only 28% of Republicans. I just wanna take a minute to get you to explain the concept of fetal personhood and why that is critical to understanding the future of abortion rights in America.
Amanda:
Yeah. So fetal personhood is the idea that a fetus, or even an embryo, or even a zygote, or in some, you know, on the farthest extreme of the anti-abortion movement, even a what they would call a “pre fertilized egg” — any of that would have the same legal rights as you or I. And you will hear it referenced in different ways. It’s not… people aren’t always saying the phrase “fetal personhood” when they talk about it. It’s often presented as “14th Amendment rights for fetuses.” And that is what you saw, kind of, a year after Dobbs when the anti-abortion movement rallied in DC. It was called, like, “14th Amendment rights” was part of, kind of, their programming, and it was on all their flyers. In the Republican official party platform, at their convention that they adopted this year, it says that they’re going to encourage states and support states that adopt laws and policies that create 14th Amendment rights for everyone.
Amanda:
And you know that they’re talking about fetuses and embryos potentially because they reference, you know, “After 51 years we’re finally able to do this.” You mentioned the party breakdowns. I will just say a majority of Americans overall oppose fetal personhood. And so this is something that would have impacts far beyond abortion care. It’s just, it’s truly a Pandora’s box. We saw the Alabama Supreme Court say that their fetal personhood law prevented IVF in the state because IVF you create, usually, multiple embryos, and then they’re, you know, stored and frozen in a lab. And under fetal personhood, those embryos are people. And so, you know, IVF is wildly popular with the American public. And so you saw the Republican legislature there, you know, scramble to try and fix that situation because they know that IVF is very popular, even in the Republican platform.
Amanda:
It says, “Oh, we also, you know, support IVF.” The problem is, if you talk to most any legal expert, they will tell you that fetal personhood and IVF are in direct conflict. And so, you know, this is a situation where I do think that the anti-abortion movement — and even more specifically, the Republican Party with which they’ve aligned themselves — is a dog that has caught the car. And now they’ve caught the car, they realize that the majority of Americans don’t want what they’re, you know, implementing in terms of abortion reproductive health. They’re not only trying to have it both ways right now, they’re trying to have it all ways.
Errin:
Former President Trump certainly recognizes that this is an issue. He actually has said, you know, just recently that either his administration or insurance companies would have to cover IVF services should he become president again, even though it’s not clear, you know, what, what the specifics are on how that would work. But I’m wondering, you know, how do you see former President Trump and his running mate also, JD Vance, talking about IVF?
Amanda:
You know, that was kind of an off-the-cuff remark that the former president made when he was asked in Florida. You know, it’s unclear to me from what he said about IVF whether he has an understanding of how IVF works. He may. I just haven’t heard him say anything that would indicate that. But his party stances are in direct conflict with IVF. I mean, the Republicans in the Senate have now twice blocked an IVF bill from going forward. And this is a bill that would, you know, state that you have the right to IVF and it would do some other things in terms of increasing access, particularly for members of the military. I would love to hear more details about this from, you know, former President Trump and his running mate, JD Vance, who did not show up for the second IVF vote. He was campaigning. He voted against it the first time. If you say that you support IVF, I would love to hear specifics. And frankly, I would love to hear, you know, the members of our profession who are asking these questions, when they get an answer, like, that follow-up and just say exactly how is that going to work, given that your party platform supports 14th Amendment rights for fetuses.
Errin:
Well, as we sit here today, former President Trump says he will not be doing another presidential debate with Vice President Harris. But, JD Vance and Vice President Harris’ running mate, Minnesota Governor Tim Walz, are scheduled to have a debate here coming up next month. I’m wondering if we might, or if you are hopeful that we might, hear these vice presidential nominees talking about IVF in their upcoming debate.
Amanda:
I sure hope so. I mean, this is an issue that’s gaining on the economy as a top issue among voters, particularly in swing states. If you look at women under 45, some polling shows that it’s already the top issue for them. This is an incredibly important issue. I was glad it was given time in the first and potentially only debate between Vice President Harris and Trump. But, you know, I would love to hear from them more specifically. I feel like the question is often put to the candidates as, “Would you sign federal legislation either protecting or banning abortion?” And the one accurate statement Trump made about abortion in that debate was that neither one of them was probably gonna have the numbers in the Senate to get it done, which is absolutely true unless there’s some sort of outcome that just we aren’t even seeing on the radar in terms of Senate races.
Amanda:
So beyond that, though, there’s many things that an administration could do related to abortion, related to the regulatory climate, related to the FDA’s approval of medication abortion, related to how you deploy the Justice Department. Is this dashboard that Republicans want to create related to pregnancy simply a way to surveil women in their pregnancy outcomes, for example? Because another thing about fetal personhood is it criminalizes bad pregnancy outcomes. So if you are giving birth, and let’s say, you know, you’re a Black woman and you’ve had bad experiences with the healthcare system, you may live in a maternal healthcare desert in the South and you decide to deliver at home with a doula or a midwife. You know, there are already cases where something goes wrong in the delivery — the baby does not survive — and because that baby was a human being with rights under fetal personhood even before it was born, the, you know, mother in that situation, in some cases, has been charged with, you know, negligence. Could even potentially be charged with homicide in some cases.
Errin:
We said, going into this election – I mean obviously we said, you know, from the time that the Dobbs decision came down — that abortion was on the ballot, literally in some cases headed into this presidential election. Talk to me about how the end of Roe, how do you see that impacting this presidential election?
Amanda:
Well, there are 10 states that are gonna have the chance to vote directly on whether they wanna add abortion protections to their state constitutions. These are in states that have bans. These are also in states where abortion is legislatively protected right now, because what voters are realizing is legislation can be overturned, legislation can be repealed depending on who’s in power in terms of your governor, your state house. Things can change. And so it’s much more protective to get it into the constitution because it’s a much higher bar to change state constitutions. And so we are seeing that as a motivator for voters. And in terms of how that will trickle down to candidate races, I think that’s still an open question. But when abortion rights have been put before voters, to date abortion rights are undefeated. The American people have backed protecting abortion every single time so far.
Amanda:
There is a ballot measure in Arizona that’s currently polling, as of a couple days ago, at 74%. So this is a state where 30% are Democrats, 30% are Republicans, 30% are independents. So that means that even if, you know, all of the Democrats support it and all of the independents support it, there’s a pretty substantial number of Republicans who do too according to that polling. And what we’re seeing is, you know, especially in a place like Florida is another great example. That ballot amendment effort there sees their coalition as having a lot of Republicans in it, and including, and especially, Republican women. And that’s why, you know, they have declined help in a couple of cases from high profile Democrats. ‘Cause they’re saying, like, “Our job is to get the amendment passed. It’s not necessarily to help the Democratic party. And, you know, we don’t wanna alienate parts of our coalition.”
Amanda:
And so I truly believe we’re at the beginning of a political realignment, again, around abortion, and we don’t know where it’s gonna end up. Right? It could drive, you know, even more women into the Democratic party and more young people into the Democratic Party. That’s one way it could, it could completely realign. It could realign as we’re also seeing a lot of Republican House members in competitive districts, in places like New York and California, come out with ads saying they support abortion rights and that they would never, you know, vote for a ban. Maybe in 10 years we’re gonna be back to a situation where because you’re an elected lawmaker in one party or another, you don’t automatically oppose or support abortion. Maybe there will be more room for nuance ’cause we’ve gotten to the point where it’s impossible for Republicans in particular to get through their primaries without opposing abortion. And what they’re realizing now is they’re not gonna be able to win general elections like that in any sort of swing state or district. And so, you know, I think there’s multiple ways this realignment could play out, but I do think it’s happening.
Errin:
Amanda, this book, as I said, is phenomenal. Where can people get it? How can they get it?
Amanda:
Pretty much wherever you would buy books online. It’s on Amazon, it’s on Bookshop, and bookshop is great ’cause you can actually, within Bookshop, order it from your favorite local independent bookstore. So they kind of get that sale. You can also ask your independent bookstore if they don’t have it to order it. And it’s called, “You Must Stand Up: The Fight for Abortion Rights in Post-Dobbs America.” And it is available pretty much wherever you would buy books.
Errin:
Well, Amanda, this was great. I’m really happy that we finally got you on The Amendment, and I could not think of a better reason for your debut. So thank you so much.
Amanda:
Thank you, Errin.
Errin:
And, listeners, if you want to read a free excerpt of Amanda Becker’s new book, “You Must Stand Up,” you can head over to 19th news.org/youmuststandup.
The Amendment is a co-production of the 19th News and Wonder Media Network. Our executive producers are Jenny Kaplan, Terri Rupar, Faith Smith and Emily Rudder. The show is edited by Grace Lynch and Julia B Chan, produced by Brittany Martinez, Grace Lynch and Luci Jones, and post-production support from Julie Bogen, Lance Dixon and Wynton Wong. Artwork by Aria Goodman. And our theme music is composed by Jlin.