When we ignore women’s pain, we put their lives in danger

In August, abortion advocates in Texas celebrated a significant victory in a lawsuit challenging Texas’s ban of the procedure. (Dreamstime/TNS)

In August, abortion advocates in Texas celebrated a significant victory in a lawsuit challenging Texas’s ban of the procedure. The Texas law, like nearly all current statewide bans, includes an exception for abortions that are necessary to save the life of the pregnant person or protect them from serious injury. This means that, in theory, a person experiencing a miscarriage or another serious problem with their pregnancy can receive an abortion even if the state in which they live has banned it.

In practice, however, doctors are only willing to perform an abortion if it’s clear that the pregnant person is at significant risk. Often, in Texas and elsewhere, they are confused about which practices are legal and which aren’t. As a result, women like Amanda Zurawski, the lead plaintiff in the Texas lawsuit, have been denied care, and face serious medical consequences. The judge agreed that the exception written into the Texas abortion ban was too unclear and issued a temporary injunction against it. This ruling, however, was immediately blocked when the attorney general filed an appeal to the state supreme court.


One reason that the exception cannot be reliably applied reaches far beyond the context of abortion: Doctors too often do not believe women who say they are in pain.

One particularly horrifying example is described in a recent podcast series from The New York Times about a nurse working at Yale’s fertility center who stole vials of fentanyl, concealing her theft by replacing the fentanyl solution with saline. As a result, dozens of women underwent egg retrieval (an invasive procedure) without any pain medication. Each woman was supposed to receive both fentanyl for pain relief and a sedative to keep them calm. Instead, the women whose fentanyl vials had been stolen received nothing to block the pain.

Multiple women alerted their doctors that the anesthetic was not working. The women used terms like “excruciating,” “nightmarish,” and “horrific” to describe their pain and said that it felt like the doctors were “ripping something from the inside of [their] body.” When one woman tried multiple times to speak with the doctor who performed the retrieval, he told her that he was “perplexed” by her experience, but “not alarmed.”

Assessment of pain is often key to evaluating the health risks of a miscarriage or other problems with a pregnancy. If the doctors and hospital administrators do not trust a woman who says that she is experiencing severe abdominal pain, they are less likely to believe that her health is seriously threatened and thus less likely to approve an abortion. The result will be more women like Zurawski, whose water broke at 18 weeks and was denied an abortion by a Catholic hospital. Days later, she was diagnosed with sepsis, a life-threatening infection caused by her water breaking. She spent three days in the ICU and the disease caused one of her fallopian tubes to be permanently blocked.

These severe health risks are even worse for women who also experience discrimination for other reasons, from women suffering chronic pain who are labeled malingerers and drug-seekers to women of color (especially Black women) whose descriptions of pain are believed even less than white women’s.

The Texas Supreme Court justices, as well as any other court hearing similar challenges, should take the experiences of women into account and strike down abortion bans with narrow exceptions that rely on physicians believing women who say they are in pain. And until doctors, legislators and judges take women’s pain seriously, women will be forced to suffer in silence.


Dara E. Purvis is a professor and associate dean at Penn State Law who writes about how the law reinforces gender stereotypes and reforms that would treat people more equally. This column was produced for Progressive Perspectives, a project of The Progressive magazine, and distributed by Tribune News Service.