Sehfali Luthra and Undue Burden

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Undue Burden: Life and Death Decisions in Post-Roe America by Shefali Luthra humanizes the human costs in a post-Roe America. After Roe v. Wade fell, I had a lot of feelings about it, so I jumped at the opportunity to cover this book. In 10 chapters, Shefali (we’re on a first name basis) examines stories ranging from a teenager in Texas who found herself pregnant to the actual doctors who are drinking from a firehose, trying to provide necessary care but live in states where laws change sometimes from one day to the next.

As part of our sponsorship, I had the opportunity to sit with Shefali and talk to her about the book. Knowing that this was coming on the blog, I opted for a format which still allowed us the ability for real time discussions. I decided to chat with her over text and give you all the screenshots of our conversation. For our readers who utilize a screen reading tool – the text is for each image is located in the alternative text description.

Natalia - Hi Shefali
Shefali - Hello!
Natalia -Thanks so much to agreeing to this weird format,
Shefali - Of course!
Natalia - I wanted to get your real time answers in a way that's optimized for text. And wasn't just me going "ARE YOU JOKING?!" In progressively higher pitches on audio.
Shefali - No, this is perfect. Truly.
Natalia - Ok! So let's talk Undue Burden.
Shefali - My favorite topic!

Natalia: I suppose my first question is - why does the United States hate women? (No pressure).
Shefali: Ha! I think that is a bigger question than I can answer but I do like the theme that you are pointing to — the history of abortion restrictions originating from an effort to disempower women (in that case, the midwives who provided them). It’s important for me to note that abortion bans affect more than just women — trans men and non-binary people get abortions too, and can face greater barriers to care — but there is a very clear element of stigmatizing and policing health care in a way that is unique to reproductive health care generally and abortion specifically. And that does predominantly affect women and exacerbates inequality.
Natalia - You're absolutely right. I find myself reading lots of texts lately regarding the power that the patriarchal structures have on bodies of women and marginalized genders and the two that come to might right now are Birth Control by Allison Yarrow and Vagina Obscura by Rachel E. Gross. It seems like the one narrative thread that everyone is writing about is about how much of this is rooted in taking control from the group of people with the bodies and moving it towards the men/state/etc.

Shefali: There is something so striking there — in writing this book, I would pause and process that people seeking health care faced a level of second guessing from their governments that they simply would not for other forms of care. Which is in some ways an obvious point but one that I think really deserves repeating and processing.
Natalia: Absolutely! One of my favorite aphorisms is that certain political groups want a government that's so small that it fits inside your uterus. Is it an aphorism? Maybe metaphor? Regardless, it hits me time and time again. Like when my partner got a vasectomy and there was no discussion about whether or not he wanted more children, or wanted to give himself "options" in case our marriage didn't work out. Both things that have been asked of me in a gynecological setting while discussing permanent forms of birth control.
Shefali - There is a narrative that for women motherhood is so essential and pure, which can frame how we talk about “good” and “bad” abortions — and motherhood is a very powerful role for many women but is not for everyone!
Natalia: Right!

Natalia: There is a quote from your introduction that I want to pull out. I underlined it in what looks to be orange glitter pen (lol). The context is that you're talking to readers about the Dobbs decision which overturned Roe v. Wade and you write "Weeks after the decision came down, officials in President Joe Biden's administration continued to protest that they needed more time to figure out what came next, arguing that a ruling overturning Roe had been impossible to foresee." (emphasis mine). My note next to this sentence says "come the fuck on" and I think is a notion that is worth exploring a bit. As you were researching this book and talking to people - did you find that any of them thought that abortion rights were safe and truly untouchable?
Shefali - It’s very clear that there was a real sense in Washington that Roe was not going to fall, which I attribute to a few things. In part, this was a very radical decision! There is no precedent for eliminating a right that had been protected for almost 50 years. And also — abortion rights had been largely eliminated in Texas already, thanks to SB8, the six-week bounty hunter ban. This was a big sign to many of us that Roe would not make it; the court had indicated to states a roadmap to ban abortion. But for many journalists, politicians and policymakers, Texas is far away. The erosion of abortion rights felt theoretical. Those of us who had seen this happen (and I’m lucky to work at a newsroom where people live around the country, including Texas!) and seen the impact understood what was bound to happen — but the perspective we often hear from the most is sequestered from that.

Shefali - Does that make sense?
Natalia: It does, but it points to what I think is the biggest concern of all - how do we (as activists) bridge the distance between the federal government and people who are living day-to-day in America? One thing that struck me throughout your book are these people on the ground providing the necessary work of abortion care who could tell that this was not going to end well for folks and what I read as their sheer frustration with the larger political apparatus that didn't safeguard this.
Shefali - You’re totally right about the disconnect.
Natalia: I myself have been a solidly progressive voter for 17 years. I've done my part right? And when Dobbs came out all I could think was "If the Democratic National Committee sends me one email fundraising off of this, I'm going to lose it. They knew it was going to happen!"
Shefali - And I think it’s something the reporters covering this issue are trying to bridge — and something I attempt to bridge in this book, by focusing on so many states. But I think the answer is just telling stories as much as possible. People understand human stories in a way they understand little else. It makes abstract policy feel real. Abortion totally was a political talking point for Democrats but one where there was little policy making priority.

Shefali - Perhaps because the political reality didn’t allow it — there were a lot of abortion opposing Democrats the last time they had a trifecta, and even getting birth control in the ACA was tough!

Shefali - Please!
Natalia - How'd you do it? How'd you collect all these stories?

Shefali - It took a lot of time. I traveled a lot. I relied on a pretty extensive network of sourcing. And I really leveraged the work I had done at The 19th — which has treated abortion and the human impact of abortion bans as a front page issue well before Dobbs. I don’t think this book would exist without them!
Natalia - It seems like climate change and abortion are very similar issues. In both instances people have been sounding the alarm for years, and government always finds an excuse to not implement changes in a timely manner.
Shefali - And I think there will be many books written about what could have been done, it’s a question I think is worth examining — but it’s ultimately less interesting to me than what it means to live in this reality now.

Natalia - Do you know what happened to the people who you featured in the book? I don't want to give too much away, but I almost wish I could read a "where are they now" feature.
Shefali - I’m still in touch with a few of them.
Natalia - Oh that's awesome.
Shefali - And what I will say — which I think is a spoiler free way to answer this question — is that staying in touch has helped me understand that I met them at one of the worst moments of their lives. And yet people are so resilient, learning that from this reporting has really changed how I think about people and how we respond to hardship.
Natalia - Tell me a little bit more about that.

Shefali - Angela, one of the main characters, has started planning a future for her family — she’s moved into a bigger home, planning to return to school, getting married. She’s in a wonderful place made possible for her by overcoming her state’s abortion ban. Darlene has two beautiful children whom she loves. These are people who have been through something so hard — and yet they kept going, and life kept going. We are so much more than the hard things we navigate, and they’ve really reminded me of that — which, when covering something as difficult as this, is a really powerful lesson for me.
Natalia - How do you ensure your own mental health when you're in the thick of it with someone?
Shefali - In part by remembering that!
Natalia - Hahaha of course.
Shefali - In part by having great mental health care and a strong support network. I think being able to relate to the people I write about makes this more difficult but it is also an asset - we can trust and understand each other more when we know we could so easily be in each other's shoes.

Natalia - So much of everything could be ameliorated if we had that empathy with each other.
Shefali - Empathy is powerful!
Natalia - Pulling on that thread a little bit - one of the other things that stood out to me in this book is something that I truly appreciated. You didn't focus solely on people who needed an abortion for what certain folks would deem "immoral" reasons. You also focused on those who needed abortions for absolutely heat breaking reasons, or who didn't get abortions at all but couldn't access the necessary care that they needed to. Did you go into writing this book with that idea in mind? Almost like a checklist? Or was it more organic than that?
Shefali - The story is in part informed by the reporting, of course — whose stories i found, who was willing to spend time with me on the phone. But it was important to me to capture the full range of who gets abortions and why which means thinking about people who get abortions because they can’t have a child, for whom abortion bans were insurmountable, and who faced medical complexity in wanted pregnancies.
Natalia - I was pregnant with my third child in 2022 and COVID-19 and pregnancies wasn't well understood. I live in Georgia and just getting information and care was so hard. I didn't know if I needed an abortion, if I wanted an abortion, if I wasn't even going to have the choice of an abortion because the virus would do the work for me. I felt...almost claustrophobic in my own skin. I wasn't a person anymore, I wasn't Natalia - instead I was this other being. One who existed solely for her incubation properties.

Natalia - When I was reading about women who had pregnancies they really wanted but who's care dipped into uncertain legal territory, I was so angry because I felt like I was being brought back to the worst time of my life. (I'm having a hard time articulating my question!)
Shefali - I didn’t want to presume!
Natalia - How do I - as an activist - get lawmakers to care about the real life impacts their decisions have on my life from your perspective as a professional story teller?
Shefali - This is such a hard question because of what I think the answer is which is - I think the emergency of so many abortion stories has changed our political discourse. So many Americans did not understand this issue, or thought it was something that would never affect them. But with every story they hear, the more they - and eventually lawmakers - do in fact care, and our dialogue changes.

Natalia - How do you overcome people like me who think that I shouldn't have to share my very personal story with someone to see me as a human being deserving of her own rights?
Shefali - All that to say: the answer, I think, it to keep telling stories. And know that someday they will make a difference - even if the impact takes time for us to see.
Shefali - It's a reasonable feeling to have! And it's one I respect. No one owes anyone their story.
Natalia - This is something I struggle with all the time. So I'm very interested to hear your perspective.
Shefali - As a reporter, I can promise to do my best to write with care and compassion and due diligence. And if that is enough for people to trust me, I'll do my best to honor their trust. But if they don't - it's a very reasonable and fair choice on their part.
Natalia - Have you met anyone while promoting this book, or during any of your times reporting on abortion access and care, who was not swayed by one of the stories you've told?

Shefali - Not in person but virtually for course. I think a lot about a wise colleague who told me we tell these stories and do this work knowing we won't see change right away - but someday it will happen. Even if we don't live to see it, we know our work matters in getting there.
Natalia - Everyone's so tough when they're hidden behind a keyboard. But I love that thought and what a good note to end our time together on. I could talk about this for forever. Hahahahaha but you have a life.
Shefali - Same! Thank you for doing this!

Natalia - Thank YOU for being brave enough to take this work on, hear about a person's worst moments, and bring them to light in a loving and compassionate way. Where can our readers keep up with you?
Shefali - I appreciate that. and email - sbluthra at 19thnews dot org - and I occassionally stilll post on Twitter at Shefalil.
Natalia - Ugh! The downfall of twitter must hurt as a reporter.
Shefali - It's a bummer, but we persist!
Natalia - Right on.

Thank you so much to Shefali for talking about Undue Burden with us. In addition to her email and Twitter, you can keep up with her reporting featured in The 19th here!

Natalia Santana

Natalia Santana is a compliance professional by day, and an activist, student and parent...also by day. Interested in the intersection of activism and education, her joy in life is taking complicated concepts and distilling them into easy to understand Twitter rants. Favorite genres: science fiction, fantasy, and non-fiction books.

Sehfali Luthra and Undue Burden

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