To tell new abortion stories, find the unexpected — and everyday — impacts

The news made national headlines when it was announced last spring: Bonner General Health, a hospital in rural northern Idaho, was closing its maternity ward due to the state’s “legal and political climate,” which includes some of the most stringent abortion restrictions nationwide. As a result, pregnant women in Bonner County would have to drive more than 40 miles to reach the closest in-state hospital where they could receive prenatal care and give birth. 

Many journalists covering maternal health and the impacts of abortion restrictions, including me, saw the broader significance of this news in light of the overlap between increasing abortion restrictions and the growth of maternity care deserts nationwide. Given that I planned to use the USC Annenberg’s Center for Health Journalism National Fellowship to explore the lesser-covered ripple effects of abortion restrictions, it seemed worth following up to find out how local pregnant women in northern Idaho were faring in light of the maternity ward closure — and what we could learn from their experiences about how abortion restrictions are impacting people who aren’t seeking abortions. 

This is the first takeaway from my project I’d point out to other reporters on the abortion beat: follow up on previously published predictions of what the future will bring. There are lots of stories speculating about the impacts that various abortion restrictions could have for people in the long-term — and in those can lie future story ideas. Make it your mission to find out how people are actually faring while living under new laws or policies after other reporters have made their predictions and moved on. 

After I connected with half a dozen local pregnant women in Bonner County — plus the hospital’s four former OB-GYNs, midwives, and several other relevant sources — I identified a few main themes: They were facing logistical and financial burdens incurred by longer travel times to the hospital. Some people who lived five minutes from Bonner General were now driving over an hour to get hospital maternity care, for example, as well as increased stress and anxiety as a result. 

One source described having to drive 90 minutes to Spokane, Washington for prenatal appointments, and packing “shower curtains and some rubber gloves for the car” given that she was due to deliver in the notoriously snowy winter and feared giving birth en route. Early in her pregnancy, she also had to pay $475 for an ultrasound scan and exam at the Bonner General emergency room, because her OB-GYN’s office, where it would’ve only cost $23, was too far away for what she thought might be an emergency situation. 

Another source with a high-risk pregnancy discussed the emotional impacts of having to drive from Sandpoint, the city where Bonner General is located, to Coeur d’Alene, a city nearly 50 miles away, for her prenatal appointments, leaving her unable to shake a persistent worry: “In case of an emergency, what do I do?” 

Another pregnant mom faced similar fears: when she didn’t feel fetal movement for a few days, she had to make the 45-minute drive to the hospital in Coeur d’Alene. During the ride, which would’ve been five minutes if she could still go to Bonner General, she wondered: “Is my baby still alive?” (Thankfully, she and her pregnancy were fine.) Part of preparing for her at-home birth with a midwife, she added, was getting “comfortable in the discomfort in having a ‘riskier’ birth at home,” given the longer travel time to the hospital if something went wrong. 

As I gathered these stories, I was also aware of what I wasn’t hearing: a dramatic story of severe suffering or loss experienced by a pregnant person or their baby as a result of the maternity ward closure. I thought I’d need this (and, initially, I assumed I’d find it) to illustrate the harms of maternity care deserts under Dobbs, and to convince readers that this was a real problem worth caring about. These types of stories — about medical emergencies or lives turned upside down as a result of abortion bans — are the ones that tend to dominate the abortion beat. And while they are indeed important to tell, they can sometimes have the unintended consequence of obscuring the more common, quotidian challenges people face as a result of abortion bans: the inability to easily access affordable and reliable reproductive health care that allows them to control their futures. (Financial and logistical barriers are some of the key factors that lead people to have abortions later in their pregnancies, according to the Turnaway Study.) I often think of an excellent essay Maggie Doherty wrote on this topic for the Yale Review just after the Dobbs decision came down, critiquing the preponderance of abortion stories that focus on “a maximally sympathetic figure” and seek “to evoke the reader’s sympathy and to justify the patient’s decision to get an abortion.” These stories, Doherty argued, can imply that only certain “abortion stories”— the most catastrophic and heartbreaking — are worth telling.

My reporting wasn’t about people choosing to terminate a pregnancy; it was about the ways abortion restrictions were unexpectedly impacting maternity care for people with wanted pregnancies. But still, I found in Doherty’s essay a useful framework that I, and other reporters, could use to unpack what I initially saw as the challenges of my own reporting: I didn’t have a dramatic tale of death or suffering out of Bonner County—but I did have details of the daily, unexpected challenges facing local pregnant women, and those were enough. I also had several of these stories, which helped paint a picture of the community’s struggles, rather than solely focusing on an individual’s unique experience. The local context also made the significance of the women’s challenges clear: Sandpoint has a poverty rate of 14%, which is higher than both state and national averages, and a couple of Bonner General’s former OB-GYNs recounted stories of some patients who had to strategize whose car they would borrow or how they’d pay for gas to travel to prenatal appointments after the maternity ward closed, given that the rural area lacks public transportation. 

When you’re reporting stories about impacts of abortion restrictions, centering these everyday impacts that affect many people, rather than only a select few, can effectively highlight the stakes of anti-abortion policy, and expand readers’ understandings of who is impacted. And bringing in the local context of the community you’re covering is also key to helping readers understand the magnitude of your sources’ challenges. What might be a major hurdle for people in a rural region, for example, could be far less of a challenge for people in a city. 

The stories I heard from the pregnant women of Sandpoint, it turned out, were the tales of suffering and loss that most mattered to local pregnant women—they just didn’t necessarily sound how I imagined they might. In seeking to disrupt readers’ assumptions about the ripple effects of abortion restrictions, I also confronted some of my own assumptions about what kinds of stories were worth telling. If you want to report better and more unique stories about the myriad realities of post-Roe America, I suggest you strive to do the same.