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“She Had a Heartbeat Too”: Waiting for One Dead Woman

In Ireland, the death of Savita Halappanavar, who developed sepsis after being denied an abortion, catalyzed a revolution in the country’s abortion laws. Will the same happen here?

Amy Littlefield

March 14, 2023

Protesters in Dublin mourn Savita Halappanavar, who died on October 28, 2012, after developing sepsis after being denied an abortion when she miscarried 17 weeks into her pregnancy.(Julien Behal / PA Images via Getty Images)

Before a speaking event last week, I memorized as much as I could about the near-death experience Amanda Zurawski endured while losing her pregnancy. From the lawsuit Zurawski filed with four other women over the abortion bans in Texas, I learned that doctors, fearful of breaking the law, refused to end Zurawski’s pregnancy when her water broke at 18 weeks. Days later, as she was miscarrying, her fever spiked to 103.2 degrees. Zurawski’s family members flew in to see her in the ICU because they believed she was dying.

As I recounted the details to the audience, I could see people shake their heads at how the state of Texas almost killed that woman.

It has become a disturbing ritual of my profession, this chronicling of the travails of the almost-dead woman. My notebooks are full of the measures of their suffering: the peak of the fever, the pain of the infected uterus—pain severe enough to send you arching off the bed like in The Exorcist, as another almost-dead woman described it to me. How old is the almost-dead woman, and is she a mother, and could we get a picture? For generations, the almost-dead woman has been the archetypal deserving abortion patient. That archetype has roots in the late 19th century, when doctors who wanted to demonstrate their superiority over lay healers advocated for abortion to be illegal unless a patient was close enough to death—a determination that varied widely and could be made only by a doctor. Today, in the post-Roe landscape, the 12 states that ban abortion all make an exception if you are, to varying degrees, almost dead. As the Texas lawsuit shows, these exceptions, when interpreted by medical providers with the threat of prison hanging over their heads, are not enough to protect even almost-dead patients from ending up in the ICU or having to flee the state.

Of course, generating enough almost-dead people will inevitably lead to some number of dead ones.

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I wonder who she will be, our dead woman.

In Ireland, her name was Savita Halappanavar. She was a dentist. Her water broke at 17 weeks, like Amanda Zurawski’s. Doctors in Ireland told her that they could not end her pregnancy because the fetus was protected under Ireland’s Eighth Amendment as long as it still had a heartbeat. She begged for an abortion. Like Zurawski, she developed sepsis. Then she died. She was 31. Her death ignited a political revolution that liberalized Ireland’s abortion laws. Thousands of people rallied in the streets holding banners with Savita’s portrait that read “Never again.” Six years later, Irish voters repealed the Eighth Amendment in a referendum. Under the right circumstances, one death is enough.

I wonder if our dead woman is reading Good Night, Moon to her toddler after a long day at work. I wonder if she is logging into online night classes with her feet in a pair of fuzzy slippers. I wonder if she will rage and weep against the injustice of it all, when she learns that the doctors in her state will not help her unless she becomes almost dead. She may not be a woman at all, but a trans man or a nonbinary person who has already faced medical professionals inclined to discriminate against their very being. In a country where Black women seek abortions at higher rates and die far more commonly from maternal health complications, our dead woman is likely to be Black, and therefore, she is likely to know that her death will be worth less.

In 1977, Rosie Jimenez died in a hospital in McAllen, Tex., from a policy called the Hyde Amendment. The Hyde Amendment cut off most Medicaid funding of abortion. Jimenez had had a previous abortion paid for by Medicaid. After the ban passed, she resorted to an unsafe provider. Like Zurawski and Halappanavar, she developed an infection, then sepsis. A journalist named Ellen Frankfort wrote about Rosie’s final moments. She turned a “dark greenish-brown color.” Blood came out of her eyes. She had an undeposited scholarship check in her purse at the time of her death. Yet some abortion rights activists were hesitant to rally around Rosie.

“Traditional abortion groups—essentially white and middle-class—learned that she might not be a sympathetic figure,” the veteran abortion rights activist Frances Kissling, who tipped off Frankfort about Rosie’s death, wrote in the book she authored with Frankfort, Rosie: The Investigation of a Wrongful Death. “She was a Mexican-American, an unwed mother in a border town noted for illegal drug traffic, and she apparently had been pregnant several times before.” Plus, activists had predicted many deaths from the Medicaid ban. “But all we could point to was a single death,” Kissling wrote. The Hyde Amendment endures to this day.

It is not new, this search for a dead woman. As journalists, we are taught to go after the most extreme examples of a policy’s impact. For years, with Roe v. Wade intact, I wrote about how Catholic hospitals that follow religious directives and even public hospitals in states like Texas put patients through near-death ordeals because of restrictions on abortion. I wrote about Alison in Washington state, the woman who arched off her bed from the pain of an infected uterus. I wrote about a Texas woman so sick she could not walk, who was denied an abortion on the grounds that she was not dead enough. I sat across from women and asked them to recount their suffering in minute detail. How dead were you? The deader the better, for my purposes; I am trying to get people to care about you.

I wish I had only non-dead women, vibrant women, to write about, women like Angel Kai, a mother of three and storyteller with the reproductive-justice group WeTestify. She told me about how her abortion allowed her to escape an abusive relationship. Now she supports her three daughters in a house that she is proud of. She makes her daughters flashcards; she makes them handmade bows. A pregnant person’s safety, her dreams, her plans, put away or brought to life, these details matter, too, not just whether she is dead.

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Let us return to the almost-dead women.

At a news conference in front of the Texas State Capitol in Austin, the plaintiffs laid out their ordeals with simmering dignity.

“I cannot adequately put into words the trauma and despair that comes with waiting to either lose your own life, your child’s life, or both,” Amanda Zurawski said. “For days I was locked in this bizarre and avoidable hell.”

She stood beside Lauren Hall, who is 28 and lives outside of Dallas. Hall was carrying a fetus with no skull. She had to fly to Seattle for an abortion. Lauren Miller is 35 years old and lives in Dallas. She was carrying twins but one fetus could not survive because it had fluid-filled sacs where its brain should have been. She had to fly to Colorado for an abortion. Anna Zargarian is 33 years old and lives in Austin. Her water broke at 19 and a half weeks, and by the time she got her abortion in Colorado, her fever was 101. Fearing prison and civil lawsuits, providers in Texas had refused to provide abortions for all of these women, even though the state’s bans have an exception to protect a pregnant person’s life or health in medical emergencies.

In an article about the lawsuit, The New York Times wrote that these women “contradict stereotypes about who receives abortions and why. Married, and some with children already, the women rejoiced at their pregnancies, only to discover that their fetuses had no chance of survival.” Most people who have abortions are mothers. But this line seems to allude to the fact that these women, most of whom appear to be white, fall into the general category of people who can expect the world to care when the state almost kills them.

I wonder who she will be, our dead woman.

When we find her, I will tell you everything I can about her. How her family gathered around her, or if she was alone. How high the fever got, how bad was the pain, if there was blood in her eyes. I’ll tell you the details that will make her feel like your sister, or your daughter—if she had a lisp or a dimple on one side, or if she loved dogs, and how she loved her children, and how much they will miss her. I am sure that when we find her, our dead woman, she will not be the first one who has died, but only the first one we have found.

I only hope she is enough.

Amy LittlefieldAmy Littlefield is The Nation’s abortion access correspondent and a journalist who focuses on reproductive rights, healthcare, and religion. She is the author of the forthcoming book American Crusaders, a history of the anti-abortion movement over the last fifty years, to be published in 2026.


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