Maternity care in the United States is in crisis. Since 2011, 217 hospitals have closed their maternity units. According to March of Dimes, more than 2.2 million women of childbearing age live in counties without obstetrical care. You would think this situation would be a major concern of abortion opponents. After all, they are the ones forcing thousands of people to continue unwanted pregnancies that have already resulted in thousands of births. Maybe make sure there’s adequate care for pregnant and delivering women and their babies before you vastly increase their numbers?

But no, anti-choicers frame abortion bans as the only protection necessary, when in fact bans interfere with the practice of medicine even in the case of wanted pregnancies. They cause patients to come close to death because doctors are afraid to treat them. They force patients to carry dying fetuses to term. They prevent doctors from helping patients with complicated risk factors. Moreover, bans are causing doctors to leave states where they can’t practice compassionate, evidence-based medicine without risking their license or worse. In Louisiana, where legislators have refused to clarify confusing medical exceptions, the penalty for violating the abortion ban is up to 15 years in prison and a fine of $5,000 to $200,000. No wonder medical students are refusing to train in abortion-ban states.

The maternal mortality rate in the US has been higher than in any other major industrialized country for more than two decades. In fact, data from UNICEF and the World Health Organization suggest that as of 2020, the United States, with 21 deaths per 100,000 live births, was on par with Malaysia and Lebanon. Since then, our maternal mortality rate has only risen: According to the CDC, the number climbed to 32.9 deaths per 100,000 births in just one year. We talk a lot about how to improve the numbers, but a new study from the University of Washington suggests the will isn’t there. In the 20 years from 1999 to 2019, maternal mortality more than doubled, with by far the worst outcomes among Black, Native American, and Alaskan Native people. In Mississippi, the state that gave us the Dobbs case, the maternal mortality rate increased from 33.2 deaths per 100,000 between 2013 and 2016 to 36 deaths between 2017 and 2019, the latest figures available. For Black women, the news was a disaster: Deaths rose from three times the rate for whites to four times, or from 51.9 to a staggering 65.1 per 100,000.

Abortion opponents love to promise that they will do all sorts of good things for pregnant women and new mothers. There will be diapers! Health care! Maternity homes like the Texas evangelical “maternity ranch” profiled in The Washington Post a while back. After all, in the 14 states where abortion is illegal, anti-choice Republicans can no longer say, “Well, having a baby was your decision, so why should I pay for it?”

Except, of course, they can and will say that. Sure, there have been some token tweaks to the cruelty and disdain long meted out to low-income mothers and fathers. In some states, disposable diapers will no longer be taxed—which they never should have been in the first place, since they are not luxuries but necessities. One calculation estimates that the exemption will save parents a big fat $76 a year. Tennessee’s Republican governor, Bill Lee, is proposing that his state, where abortion is now totally banned, will cover half the cost of diapers for the first two years.

If it doesn’t seem like they’re trying very hard, they’re not. As of this writing, 40 states (plus Washington, D.C.) have taken advantage of the expanded Medicaid coverage offered under the Affordable Care Act, and 10 haven’t bothered, despite data showing that low-income people who receive health insurance through Medicaid have better outcomes than those who are excluded from coverage. Those 10 states? Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. Nearly all are controlled by Republicans who have banned or severely restricted abortion access (or attempted to). On the plus side, several of these states have recently expanded postpartum coverage from 60 days to a full year; in Mississippi, Republican Governor Tate Reeves declared the one-year coverage part of his state’s “new pro-life agenda.” Whatever his intentions, the expanded coverage is crucial to saving lives. Many people don’t understand that the risk of maternal mortality is not just about the dangers of childbirth itself but the continuing effects of pregnancy and delivery, which may not show up till months later—high blood pressure, heart conditions, infections, hemorrhage.

The dismissal of the physical and social risks of pregnancy, childbirth, and motherhood is endemic to the anti-abortion movement. Whatever a woman’s situation, they say, it will all be fine. That 10-year-old rape victim in Ohio? She didn’t exist. (Update: Her rapist has just been sentenced to life in prison.) Savita Halappanavar, the Irish woman who died after doctors refused to complete her septic miscarriage because the fetus had a heartbeat, must have died of something else, and so did the three Polish women who died under the same circumstances. I’ve spoken to pro-life protesters on the street who dismiss the CDC’s statistics on maternal mortality because they include deaths up to one year after the end of pregnancy. If you die in a car crash, it counts, one pointed out.

I would respect abortion opponents more if they acknowledged that they expect women to endure whatever suffering comes their way due to their impregnation by some man, who, let’s not forget, suffers nothing. I wish they would just admit that having a child when your life is not in a good place might mean a lifetime of poverty and violence and struggle—not just for the mother, but for the child too. Crucial as they are, diapers are just the beginning of what children need to thrive. When that baby is toilet-trained (and seriously, Bill Lee, how many toddlers are trained by the age of 2?), she will still need clothes and shoes and healthy food and a safe and stable place to live in a safe and stable community. Where are the so-called pro-lifers when that cute little innocent baby is 10 or 12 or 20? Where are they if she gets pregnant herself?