Let’s talk about something we don’t say often enough: Pregnancy is not a guarantee of safe or respectful care in this country. In fact, for too many people, especially in the post-Roe reality, pregnancy can be one of the most vulnerable, surveilled, and legally precarious positions to be in.
We are taught to idealize pregnancy as a natural, joyful event. However, as a physician who has cared for thousands of pregnant patients, I know that this is not always the case. Behind the baby shower balloons and prenatal vitamins lies a harsh truth: Being pregnant in America means your health can be deprioritized, your autonomy questioned, and your dignity denied.
Consider the story of Adriana Smith, a pregnant woman who went to the hospital with a headache. She was experiencing an aneurysm. She was dismissed, misdiagnosed, and neglected until it was too late. By the time she was found unresponsive, she was nine weeks pregnant. And suddenly, her body was treated not as a person needing care, but as an incubator to preserve the pregnancy.
That’s what happens when laws prioritize fetal life over the life of the person carrying the pregnancy.
What Adriana endured is part of a larger pattern. In states where abortion is criminalized or tightly restricted, providers have become hesitant, even afraid, to treat pregnant people with standard care. They fear legal repercussions, not just from performing abortions, but from giving medications or interventions that might be construed as interfering with a pregnancy.
The result? Pregnant patients are being turned away, undertreated, or left waiting while hospital lawyers weigh the legal risks of care. This is especially dangerous in cases like ectopic pregnancies, miscarriage management, and preterm labor, where delay can mean organ failure or death.
This fear is reinforced by policies that treat pregnant bodies as sites of surveillance. Doctors and nurses are pressured to report suspected self-managed abortions, even though no state law requires such reporting. What should be a medical record becomes potential evidence. What should be care becomes interrogation.
Let’s be honest about who this impacts most. It’s Black women, Indigenous women, low-income people, and immigrants. Disproportionately, this is a threat to those already navigating a healthcare system steeped in bias and neglect. It’s people like Adriana Smith. It’s patients who show up at clinics like mine already bruised by a system that sees their pregnancies as public property.
And here’s what’s worse: many of them aren’t even trying to terminate their pregnancies. They’re trying to continue them. But the threat of criminalization doesn’t distinguish between miscarriage and abortion. It targets pregnancy itself.
Healthcare during pregnancy should be about support, not suspicion. But too often, it’s shaped by a culture that treats pregnant people as potential criminals or vessels for someone else’s political agenda. That culture gets codified into law, and then handed down to hospital administrators who’d rather protect themselves than provide care.
What You Can Do: Tips for Navigating Pregnancy Care Today
Whether you’re early in pregnancy or preparing for delivery, here’s how you can protect yourself and advocate for your health in a system that too often forgets to:
- Know your rights: Demand to be stabilized and insist on documentation if care is delayed or denied.
- Ask questions—early and often: Find out where your providers stand on abortion, emergency pregnancy care, and patient privacy. Don’t wait for a crisis to find out what their policies are.
- Bring an advocate: If you’re facing a high-risk pregnancy, bring someone you trust to appointments or the ER. A witness can ensure your voice is heard if you’re dismissed or mistreated.
- Limit what you share: If you’ve self-managed a miscarriage or abortion, know that you are not legally required to disclose that to healthcare providers. Share only what’s necessary for your care.
- Be cautious with digital data: Turn off location tracking if traveling to a clinic. Use encrypted apps like Signal for sensitive conversations. Avoid storing reproductive health info on public platforms.
- Document everything: Keep a record of your symptoms, care received, and any questionable treatment or delays. If needed, this documentation can support a complaint or legal challenge.
- Know where to turn: Identify supportive resources ahead of time—like your local abortion fund, doula collectives, or legal aid organizations—that can guide you if your care is denied or criminalized.
We Can—and Must—Do Better
First, we need to reaffirm a fundamental truth: Pregnancy should not diminish your right to healthcare. Not your access to medication. Not your right to be taken seriously in an emergency room. Not your legal protections as a patient.
Second, hospitals and clinics need to adopt and train for patient-first, trauma-informed policies. There should be no more delay because of legal confusion, and there should be no more calling the police instead of a specialist.
Third, we need to get loud. If you’re not pregnant, you might think this doesn’t affect you. But no one is truly safe if we allow a system to treat any group of people this way. Bodily autonomy is either universal or conditional.
Lastly, we need to honor the real stories. People like Adriana deserve more than a footnote. Their experiences should shape how we train providers, write laws, and build policy. Right now, pregnancy in America is a risk not just to your health but to your humanity.
We cannot accept that. Not in silence. Not in surrender.
We must do better. And we must do it now.
