‘Sometimes It Was Easier to Say I Delivered a Stillborn’: Termination for Medical Reasons Post-Roe

As we approach the one-year anniversary of Dobbs v. Jackson, the Supreme Court decision that marked the fall of Roe and the end of federal protections for abortion, Vogue is taking a look at the landscape surrounding reproductive rights.

“It was the most twisted feeling, hoping that my daughter wouldn’t have a heartbeat,” says Dani Mathisen, MD, a 26-year-old ob-gyn resident. At the time, Mathisen was 18 weeks along and an anatomy scan had just revealed that the fetus had multiple anatomical defects: problems with the heart, kidneys, spine, and brain.

When Mathisen found out her baby would not survive, she was living in Texas, which has some of the most restrictive abortion laws in the country. SB 8, the so-called Texas Heartbeat Act that took effect on September 1, 2021, and holds even in cases of rape and incest, bans abortions after about six weeks—before many women know they are pregnant—once cardiac activity is detected. (It’s not until roughly 17 to 20 weeks, when the four chambers of the heart have developed, that the term heartbeat is medically accurate, according to the American College of Obstetricians and Gynecologists.)

Mathisen says that she knew her “daughter would ultimately die, whether it was in utero or shortly after birth.” However, because the fetus still had a strong heartbeat, her doctor and maternal fetal-medicine specialist were not only unable to provide care, they were “unable to recommend where to go, what to do, or who to call to terminate the pregnancy,” she says. “I turned to Google because I knew no doctor in Texas would talk to me.”

Mathisen’s experience is not unique. Though it is difficult to quantify how many women terminate for medical reasons (TFMR), the number who have had to deal with complex situations has almost certainly increased since the fall of Roe. (Approximately 1 in 4 pregnancies results in miscarriage and 1 in 100 in stillbirth; it’s estimated that less than 1% of pregnancies lead to conditions that might be considered incompatible with life, however there are no recent statistics on the frequency of TFMR due to a lack of nuanced reporting (and now, post-Roe, fear of legal consequences). TFMR is always a heartbreaking choice—an experience too often shrouded in silence, stigma, and shame. But recent political changes have only intensified the trauma associated with this experience.