Deadly Back-Alley Abortions

The New Era of Deadly Back-Alley Abortions Is Here

At events in Michigan and Georgia, Harris raises alarms about access under Trump by remembering women who died ending pregnancies.

Pema Levy

Kamala Harris‘ campaign is highlighting the preventable deaths of two women who would be alive if not for Georgia’s abortion ban. This week reporting from ProPublica proved out the warning that abortion bans could be deadly, by bringing forward the names and faces of two Georgia women, Amber Thurman and Candi Miller, who died in 2022 but would be alive today if not for the state’s ban.

“Amber’s mom shared with me that the word over and over again in her mind is ‘preventable,'” Harris said Thursday evening at a Michigan campaign forum hosted by Oprah Winfrey. Thurman’s mother and two sisters were in the audience. “This story is a story that is sadly not the only story of what has been happening since these bans have taken place.”

Amber Thurman and Candi Miller both died after medication-induced abortions failed to expel all the fetal tissue, resulting in fatal infections, ProPublica reported. They were among the first women to die from what could be called a modern back-alley abortion: abortions that have been pushed underground and exiled from the safety of expert medical supervision. 

In the days since ProPublica broke the news of these preventable deaths, anti-abortion activists have sought to blame the women. “Abortion killed Amber Thurman,” anti-abortion activist Lila Rose posted on X, shifting blame from the ban to the procedure and, implicitly, Thurman herself. The stories are complicated for advocates fighting to keep abortion medication on the market, as their stories highlight the rare times in which medication abortions require emergency follow-up care. (Such episodes are at the center of a current lawsuit to take one of the drugs, mifepristone, off the market.) But from the beginning to the end of their tragic stories, it’s clear that both women died for one reason: Georgia’s strict abortion ban. 

It’s a story the Harris campaign is continuing to tell, with a Friday rally in Atlanta, where she delivered a warning: “If [Trump] is elected again, I am certain, he will sign a national abortion ban.” And with it, more people will die. “There is a word, preventable, and there is another word, predictable,” Harris said. “And the reality is, for every story we hear of the suffering under Trump abortion bans, there are so many of the stories we’re not hearing.”

On the debate stage last week, Trump would not rule out signing a national abortion ban. And his allies who crafted Project 2025 have laid out how to ban abortion, including those conducted with medication, nationwide. It’s a message her campaign has sounded from the start, as it leans on the health crisis caused by the overturning of Roe to motivate voters. But it’s also the sad truth.

The two women’s stories are eerily reminiscent of ones from over 50 years ago, when women died either from obtaining illegal abortions from doctors or others ill equipped to perform them, or from torturous attempts to induce one at home. When the Supreme Court overturned Roe two years ago, physicians, historians, and politicians warned that women would die. We now know that it took less than two months before at least one did.

“I fear that their situations are not unique,” Dr. Daniel Grossman, the director of a research group on reproductive health at the University of California, San Francisco, posted on X. “I think it’s very likely that other women and pregnant people have died due to their care being denied or delayed or due to being too scared to seek care—all because of the bans on abortion.” As evidence, Grossman cited a new study in which patients and providers reported on the near-death scenarios they have encountered under post-Roe abortion bans, cases very similar to those of Thurman and Miller. In 86 narratives, the report describes patients whose pregnancies, miscarriages, and post-abortion complications threatened their life. And yet doctors refused to treat them. 

Soon after the Supreme Court overturned Roe v. Wade in June 2022, Georgia instituted a six-week ban. Like other draconian laws that popped up around the country that summer, its language was medically vague but legally punitive. Doctors and hospitals were left to guess what procedures were actually prohibited and when exactly exceptions for the life of the mother kicked in. If a prosecutor and jury second-guessed their decision, possible prison sentences loomed over their decisions. Almost immediately, in Thurman’s case, doctors chose a path that led to her death.

Thurman was a healthy 28-year-old single mother of a six-year-old when she learned she was pregnant with twins. Thurman wanted a surgical abortion, but as ProPublica reported, Georgia’s six-week ban had just taken effect. Thurman drove to North Carolina for the procedure, but after traffic caused her to miss her appointment, she was offered a medication abortion instead. As happens in rare instances, not all of the fetal tissue was expelled, leading to sepsis. If Thurman were in North Carolina, she could have returned to the clinic and received a dilation and curettage, a common procedure that would have saved her life. But she was stuck in Georgia. Again, the state failed her. When Thurman was admitted to an ER in Georgia, it was clear that she needed a D&C to clear away the tissue that was poisoning her. But the hospital delayed surgery for 20 hours. By then, it was too late. A statewide maternal mortality review committee, which operates on a two-year lag and is only now examining post-Roe cases, deemed her death preventable.

In the fall of 2022, Candi Miller discovered she was pregnant. Because the 41-year-old mother of three had diabetes, hypertension, and lupus, doctors warned that another pregnancy might kill her. But Georgia’s abortion ban made no exceptions for people whose chronic conditions made pregnancy a deadly proposition. Abandoned by her state, Miller ordered abortion pills online and took them at home. As with Thurman, her body did not expel all the tissue, spawning an infection. She suffered for days until her husband found her unresponsive in bed, her three year old daughter by her side.

She hadn’t sought out a doctor, her family said, “due to the current legislation on pregnancies and abortions.” Tragically, as Thurman’s death suggests, it’s not clear that it would have helped if she had.

“It is exactly like what it was before it was made, open, available and legal,” says Leslie Reagan, a historian at the University of Illinois, Urbana-Champaign and the author of the book When Abortion Was a Crime. Reagan recalls reading coroner reports of women just like Miller, only decades earlier, who died because they were afraid of being arrested or prosecuted if they went to the hospital.

If Roe were still in place, Miller could have sought a surgical abortion or taken the pills under supervision of a doctor, who could have intervened when she needed further care. But that’s not how it works in Georgia anymore. Again, the same panel, which finally reviewed her case last month, immediately deemed her death preventable. ProPublica reported that the panel is reviewing additional deaths involving abortions after the ban was passed.

History seems to be repeating itself. Both Thurman and Miller were Black, and both died of sepsis. 

When doctors and historians warned that people would die from post-Dobbs abortion bans, they weren’t being hyperbolic, they were looking at the facts. In one study, economists found that maternal death rates for nonwhite women plummeted after states began legalizing the procedure in the late 1960s and early 1970s, leading up to Roe in January 1973. ​​Legal abortion reduced non-white abortion-related mortality by 30-60 percent.

“These are two black women,” says Reagan, noting that before Roe, Black women were far more likely to die trying to obtain an abortion. “This just, again, accentuates and replicates the past. And you know, frankly, the people passing these laws do not care about that.”

Further, deaths due to abortion-related infection were the most common fatal complication. “Over 1960 to 1980, legal abortion has been suggested as a major contributor to the decline in maternal deaths, primarily from abortion-related sepsis,” according to the report. In an account quoted in the study, an obstetrician from the period recalls that “complications of illegal abortion were so common that a septic ward was set aside for the infections. Surgery for hemorrhage was a common night duty.”

But for all the historical echoes, there are key differences. Rather than an abortion from an unqualified doctor or an attempt to induce an abortion by harming themselves, both Thurman and Miller took safe medication greenlit by the Food and Drug Administration. Both had the rare occurrence of failure to expel all fetal tissue, resulting in the need for medical attention.

While it’s clear that poor women and women of color will bear the brunt of the new wave of abortion-related fatalities, hospitals’ refusal to treat women suffering complications from abortion and miscarriage jeopardize women from all walks of life. Just ask Amanda Zurawski, a white woman from Texas who faced the imminent loss of her pregnancy but was told to go home and wait for the onset of sepsis. She ended up fighting for her life in the ICU. Indeed, it appears that under today’s abortion bans, doctors and hospitals are forcing women into septic shock and, in some cases, even delaying care once sepsis has already arrived.

This is not an accident. In fact, the lawsuit against mifepristone launched by the hard right Christian group Alliance Defending Freedom was premised on the idea that doctors should be able to refuse to treat patients in the exact position as Thurman and Miller. Their lawyers argued that the doctors’ personal opposition to abortion meant they should never have to save a woman’s life if she was suffering complications from taking mifepristone, even if the fetus was not living. As the group’s attorney, Erin Hawley, said during oral arguments before the Supreme Court, an anti-abortion doctor’s conscience is harmed by “completing an elective abortion,” meaning “removing an embryo, a fetus, whether or not they’re alive, as well as placental tissue.”

It was a shocking courtroom moment, but also a revealing one. The Alliance Defending Freedom doesn’t just represent doctors—it has also been instrumental in crafting and defending state abortion bans. They are not only willing to let women die, but it is in keeping with their beliefs. The lawmakers who wrote laws like Georgia’s—and refused to amend them despite warnings—seem similarly inclined to allow preventable deaths. Louisiana is about to limit access to misoprostol, a drug that is part of the medication abortion regimen but is also a life-saving anti-hemorrhage drug used in postpartum care, by categorizing it as a controlled substance. Again, people could die.

Just as the pre-Roe era saw unnecessary death, so now are we. And it’s easy to see, from the vague yet strict laws to the fear instilled in both doctors and patients, that it’s all by design. 

In Atlanta, Harris presented a stark choice. She would restore Roe, he would usher in more bans. “He brags about overturning Roe v Wade,” Harris said of Trump on Friday. “He says he is proud. Proud that women are dying?”