In most cases, we would never have learned her name. Kate Cox, a Texas woman, is in a sadly common set of circumstances: a 31-year-old mother of two, Cox was pregnant with her third child when doctors informed her that something was wrong. Pregnancy complications are common, but in a state like Texas, they have become newly dangerous, threatening women with potentially disfiguring health complications, along with unimaginable heartbreak, as the state’s multiple bans have mandated grotesque and inhumane treatment of doomed pregnancies.
Cox’s fetus had trisomy 18, a chromosomal disorder. Trisomy 18 is a devastating diagnosis. Most pregnancies end in stillbirths; those infants born alive with the disorder live anguished, short and painful lives. Cox was informed that her fetus, in the sterile medical parlance, “could not sustain life”. The fetus had malformations of the spine, heart, brain and limbs. The pregnancy also posed dire threats to Cox’s health; most significantly, she was at risk of losing her future fertility if she remained pregnant.
If Cox made it to delivery – a big if – the child would live for perhaps an hour, perhaps a week. It would have to be treated with pain medications for the entirety of its brief life. None of these were cognizable concerns under Texas’s abortion ban. The law said that she would have to remain pregnant – would have to get sicker, have to endure greater and greater pain and grief, and then would have to labor and give birth to a daughter, who she would watch suffer and die.
There are hundreds of women like Cox living in Republican-controlled states, women carrying pregnancies in which there is no hope that a living baby will result at the end of nine months. These are pregnancies that – because of abortion bans that provide no actionable exemptions for medically futile pregnancies or maternal health – women are forced to keep carrying anyway.
Most people in this situation suffer in private; they endure the cooing at their bellies from oblivious strangers while they remain pregnant, and they purchase tiny urns in the brutal days after. Cox is different only because she made the decision to share her situation publicly. As her health deteriorated and she made multiple visits to the emergency room, she published an op-ed in the Dallas Morning News, and petitioned Texas courts for an abortion. It is the first recorded instance of an adult woman having to ask for government permission to end her pregnancy since Roe. On Friday night, the Texas supreme court refused. On Monday, Cox left the state, seeking an abortion elsewhere.
There is a tendency, in coverage of abortion law, for writers to try and discipline their language. The issue is fraught and passionate enough, the thinking goes, surrounded as it is by stigma, ignorance and misinformation. There is one line of journalistic thought that holds that the best way to serve one’s readers, and to maintain their trust, is to write with as strict neutrality as the facts will allow. If I were to follow that line, I would tell you that the case raises vexed and unresolved legal questions about the extent of medical exemptions to abortion bans, and that the actions of Ken Paxton, the Texas attorney general, whose office intervened to prevent Cox from receiving an abortion, is signaling a maximalist view. I might not mention, in the interest of neutrality, that among the Texas supreme court justices who denied Cox her abortion was John Devine, an extremist Christian conservative with a long history of anti-choice activism, including, according to his boast at a campaign event, being arrested 37 times in harassment actions outside abortion clinics.
But there is another line of thought that holds that euphemism is dishonesty, and that the effort to maintain journalistic neutrality in situations of grave injustice winds up obscuring more than it reveals. If I were to follow this latter method, I would tell you plainly that, by refusing to let her end this pregnancy, Paxton and the state of Texas in effect allowed Kate Cox to be tortured, and that she was forced to flee to escape that torture.
Cox will not be the last woman in this position. She will not be the last woman to make a public plea to be permitted an abortion for a dangerous and non-viable pregnancy; she will not be the last one who is denied. She is part of a growing cast of abortion rights plaintiffs, a product of Dobbs’s cruelties and of the shifting strategic posture of the reproductive rights movement. These new claimants are not the traditional pro-choice litigators – clinics or doctors – but prospective patients themselves. In particular, the new plaintiffs are women who are seeking medical exemptions to terminate wanted but dangerous pregnancies. (In her op-ed, Cox referenced Zurwaski v Texas, a lawsuit in which 20 such women are suing to clarify and expand medical exemptions to Texas’s abortion ban.)
Think of it as a crusade of the medically endangered: women who are faced with tragic, dangerous and heartbreaking circumstances in their pregnancies are emerging as a new face of the pro-choice legal movement. Like the anti-choice movement spent decades chipping away at the abortion rights and expanding restrictions, these women’s lawsuits seek to expand access in the most sympathetic of cases – those of medical emergencies – to carve out slightly larger loopholes for more women to access abortion through.
It’s an incrementalistic strategy, one that assumes that legal abortion bans like those in Texas are here to stay for the foreseeable future. And it is also a strategy that makes some concessions to the bigotries and biases of the Texas court, to say nothing of American public opinion. Like many of the medically endangered plaintiffs, Cox is white and married. She is already a mother, and wants to be pregnant – she speaks extensively, and movingly, of desiring more children, and of wishing that she could have this one. Unlike many in her shoes, when faced with a horrible consequence of a sadistic law, she was able to seek both publicity and legal help. Unlike many in her shoes, when she was denied an abortion, she was able to flee.
None of these things about Cox – neither her privilege not her palatability – make her a bad person, or make her suffering any less horrific. But they do make her an appealing face for a movement that is seeking to reason with a rabid and revanchist cadre of judges. There is nothing the right can object to in her, the thinking goes, and there is nothing they can get from making her suffer: her child will die. And yet her plea was rejected by the Texas courts, which suggests that the anti-choice movement does feel that they can get something out of Kate Cox. They get the ability to make her beg. Then, they get the satisfaction of saying no.
The way we talk about abortion has warped in the wake of Dobbs. We use bloodless language of gestational limits; we may even be tempted to describe once-unheard of 15 week bans as comparatively “moderate”. We look on the bright side, like to the fact that Cox, denied the care that will keep her healthy and alive in Texas, was able to go elsewhere. Amid these adjusted expectations it is easy to lose track of how far we’ve fallen in our standards for women’s dignity and freedom. Two years ago, a woman in Cox’s shoes was able to control her own body and life on her own terms; now, she has to go before a court, all her virtues on display, and beg not to be maimed. “I am a Texan,” Cox said in her op-ed. “Why should I or any other woman have to drive or fly hundreds of miles to do what we feel is best for ourselves and our families, to determine our own futures?” It was an appeal to her dignity as a citizen. But Texas only saw her as a woman.
Moira Donegan is a Guardian US columnist
