Are pro-life state laws killing women?

Cardiovascular surgeon Dr. Gary Ott says his pregnant patients’ medical needs rarely call for delivering a baby early. Even more rarely does he have to decide whether a woman must deliver her baby before the child can survive outside the womb. Most health problems that women experience during pregnancy can be treated while preserving the lives of both mother and unborn baby—or, in the worst cases, delivering the child early instead of actively killing him or her.

“I’ve had occasions where it truly was mother or baby,” he said. “When they do happen, we treat the mother with priority, and that’s been established medical practice.”

So Ott was skeptical when he read a ProPublica story published in January that highlighted the case of 34-year-old Ciji Graham, a pregnant woman who died while awaiting treatment for a heart condition. ProPublica claimed that intentionally killing an unborn child is sometimes the only way to save the mother’s life.

“I sensed a sort of agenda behind this article to put this in a sense of ‘This is either the child or the mother,’” Ott said.

Tens of thousands of women in the United States experience high-risk pregnancies each year due to preexisting conditions or complications that arise during pregnancy. Last month’s ProPublica article continues its series trying to blame potentially preventable maternal deaths on pro-life state laws. While people on both sides of the abortion issue agree that women need better access to maternity care, abortion advocates claim that killing unborn babies can prevent some maternal deaths. But pro-life physicians say high-risk cases highlight the importance of ensuring pregnant women have continuous, attentive care from professionals who understand what is and is not safe during pregnancy.

Avoidable death?

According to ProPublica, Ciji Graham visited a cardiologist with an irregular heartbeat in November 2023. She expected the doctor to perform a cardioversion to correct her atrial fibrillation, which she had experienced before. Instead, she learned that she was pregnant.

While atrial fibrillation itself usually does not cause death, it can lead to more serious complications and should be treated quickly. Leading medical associations say that cardioversion, either performed through IV medication or an electrical shock, is generally safe and effective in pregnancy.

According to ProPublica, though, Graham’s physician didn’t treat her but instead sent her home after giving her directions to consult with her primary care provider and other specialists. The Greensboro, N.C., police officer and mother tried another cardiologist the next day and was again discharged, this time with a prescription for blood thinners to prepare her for a cardioversion in three weeks.

The same day, Graham called an abortion facility to schedule an abortion for two weeks later. At six weeks pregnant, North Carolina law did not protect her baby from abortion.

But four days after that second cardiology appointment—before either the abortion or the cardioversion—Graham died. Without an autopsy, the medical examiner listed her cause of death as cardiac arrhythmia due to atrial fibrillation but did not pinpoint the exact complication that ended her life.

ProPublica claimed Graham’s doctors hesitated to do a cardioversion on a pregnant woman due to pro-life laws, though neither of the specialists responded to the media outlet’s questions about why they did not treat her. A representative for Cone Health, the second office Graham visited, said in a statement that the healthcare provider’s treatment was consistent with accepted regional standards.

Doctors talking to WORLD and ProPublica agreed that Graham did not receive prompt treatment in line with standard medical procedures. But ProPublica’s reporting implies that the state’s law protecting babies after 12 weeks of pregnancy—and Graham’s two-week wait for an opening at the abortion facility—factored into her death.

“They set up a false argument that, if we only had abortion, this wouldn’t have happened,” Ott said. He and his colleagues agreed that, if a pregnant woman showed up with a heart rate of 192 beats per minute, as Graham did, they would quickly perform an echocardiogram to check for blood clots before moving on to stabilize her heart. He argued that a cardioversion, the standard treatment for atrial fibrillation, would not pose any significant risk to her baby. An abortion, though—especially one in a stand-alone facility and not a hospital—would likely have put Graham’s heart under even more stress, he said.

In short, Graham shouldn’t have had to choose between saving her own life or her child’s, Ott said.

“It’s a false dichotomy,” he said. “It’s making a choice between two extremes that don’t have to exist because the obvious right thing to do here was to treat the mom properly, and mother and baby would both be healthy.”

Support team

According to one survey published in 2022 by the American Heart Association, only about half of cardiologists are comfortable managing cardiovascular disease in pregnant patients. But doctors outside of pregnancy-related specialties typically consult an OB-GYN before treating pregnant patients.

Whenever a pregnant woman is diagnosed with a serious medical condition, an OB-GYN will oversee her care whether the issue is directly tied to pregnancy or not, said Dr. Ingrid Skop, a Texas OB-GYN and vice president and director of medical affairs for the pro-life Charlotte Lozier Institute. “Often we will have a multidisciplinary conference to bring in experts to discuss treatment options,” she said. “Quality care would have looked like a doctor taking ownership of the patient and being the one to coordinate all care.”

It is not clear if Graham, the North Carolina mother, ever visited an OB-GYN or if either cardiologist she saw consulted with one.

In very rare cases, an OB-GYN may decide that, to save a woman’s life, it is necessary to end her pregnancy, often by inducing labor or performing a cesarean section. Skop said the most common situation occurs when a woman’s water breaks before her baby reaches viability, the point of being able to survive outside the womb, usually at around 22 to 23 weeks of pregnancy. In that case, her doctor may decide to save the mother from a potentially deadly infection by delivering her baby, even if the baby likely would not survive.

Skop said those situations are not the same as an elective abortion. “The intent of the doctor is to protect the mother’s life. It’s not to end the child’s life,” she said.

When one of Ott’s patients was 20 weeks pregnant, she developed a hernia that pressed her bowels against her lungs until she was unable to breathe. Doctors could not wait any longer to operate, and they delivered the tiny baby via c-section. Nurses handed him to the father while Ott fixed the mother’s hernia. “He held it till the baby stopped breathing, and I can tell you, there wasn’t a dry eye in the room,” Ott said. “There was no way you could go through that and not think that that baby meant something.”

In some situations, doctors will choose to admit a sick mother and monitor her to try and stabilize her until her baby has a better chance of surviving. “If an emergency threatens my patient’s life after the time of viability, then my job is to separate the child from the mother,” Skop said. “Ending the pregnancy will help the mother to begin to recover from this complication, and I can hand that baby to the NICU team and say, ‘Please try to save his life.’”

Fear of litigation

As a Texas OB-GYN, Skop is familiar with pro-abortion groups’ claims that pro-life laws contribute to women’s deaths. Abortion advocates claim that Texas doctors have delayed maternal care for fear of being prosecuted under state laws that protect babies. But Skop said that every state with pro-life laws includes protections for doctors in the rare circumstance in which delivering a baby early is the safest way to protect a mother.

“I practiced in a hospital where abortion was absolutely forbidden, but that didn’t keep me from being able to provide expert and qualified and good medical care,” said Dr. Jeffrey Barrows, a retired Ohio OB-GYN who previously served as the senior vice president of bioethics and public policy for the Christian Medical and Dental Associations. Most hospital systems do not perform elective abortions, Barrows said, but the majority do have clear protocols for treating women with life-threatening complications.

As medicine has become more specialized, Barrows said some doctors are becoming less willing to treat patients with conditions that fall outside their standard practice. “The reason they stay out is a fear of a lawsuit,” he said. While no doctor has ever been sued for ending a pregnancy to save a woman’s life, according to Barrows, many women have sued doctors they claim denied or delayed their care because of pro-life laws.

In Texas, Skop said doctors may not understand their protections under such laws because state and national medical boards have failed to provide continuing education for physicians. “Unfortunately, many of the large mainstream medical organizations are pro-choice, and they would like to see the laws fail,” Skop said. “When they have weighed in on the issue, it has sometimes been in order to confuse the doctors more.”

Texas passed pro-life laws in 2021 and 2025. Last summer, a bipartisan coalition of state lawmakers passed a bill that clarifies specific conditions under the state’s pro-life laws that would warrant a doctor ending a pregnancy by early delivery. It also required the Texas Medical Board to introduce training for doctors about the laws, becoming the first state to do so.

Other states with pro-life laws have also released clarifying lists, and all laws designed to protect unborn babies allow for exceptions in emergencies. “No state requires that risk to be immediate, nor does any state require a doctor to be certain that [the mother] will die,” Skop said.

Saving them both

Tammy Hanson’s doctor called on her 39th birthday to tell her she had a brain tumor. After months of pain and numbness in her face, the Florida mother of three learned that she had a tumor on the nerve leading from the ear to the brain called an acoustic neuroma, now called a vestibular schwannoma. The condition rarely appears in patients as young as Hanson, and when doctors found her tumor in 2001, surgeons had successfully removed them from only a handful of people. But that was not the family’s only surprise that year. “As we were looking for options and doctors and things, I turned up pregnant,” Hanson said.

At the time, Roe v. Wade was the law of the land, and Hanson’s doctors wanted to act quickly to remove the tumor. “The doctor looked at me and said, ‘You really need to have an abortion, we need to take care of you,’” she said.

While Hanson and her husband hadn’t planned to have another child and had recently gotten rid of all their baby gear, they knew their answer. “My husband and I totally agreed—no,” Hanson said. “If God is in control of this, we’re not going to take life away.”

Doctors agreed it was best not to operate until after Hanson delivered. Throughout her pregnancy, she had a full schedule of appointments with her regular OB-GYN, a high-risk OB-GYN, and a neurologist. “It was just like every week somebody was testing me,” she said.

While her team monitored her, they watched as the hormones that were helping grow her baby also caused the tumor to grow 2½ times as large as it had been. Hanson’s primary OB-GYN asked her again if she would consider an abortion, and again she said no.

Exactly three months after Hanson delivered her healthy baby girl, she sat in a Los Angeles hospital room waiting for surgery. The surgeon successfully removed the tumor, but Hanson was left without hearing in her right ear, partial paralysis on that side of her face, and trouble with balance. Her recovery took years. She had to relearn how to walk, eat, and process sounds while raising her four children.

But she has been able to see all four of her children grow up and follow Jesus. That, she says, is something she would not change: “It’s been well worth it.”