How the War on Women’s Health Is Bringing ‘The Handmaid’s Tale’ to Life

The documentary ‘Birthright: A War Story’ (in theaters July 14) tells of a world in which women’s wombs are controlled by governments and ideologies instead of individuals.


Here’s a decidedly un-fun fact: The U.S. currently has the worst maternal death rate in the developed world. According to a joint NPR and ProPublica investigation on maternal mortality, “More American women are dying of pregnancy-related complications than any other developed country.” So why, as maternal mortality declines around the world, are American mothers dying at an alarming, rising rate? Birthright: A War Story, a timely new documentary from director Civia Tamarkin, shows that these stats are just another symptom of the ongoing war to take control of and restrict reproductive health care, in which women and would-be mothers have become collateral damage.

As Tarah Demant, a senior director at Amnesty International USA, explains in the documentary, “While every death is a personal tragedy for a community or a family, a preventable death means that a government or a state is not meeting its human rights obligations... A maternal health crisis does not somehow magically appear in a country. It appears when you have a confluence of restrictions on women’s health and information and choices, where you have a lack of accountability for when there is pregnancy-related preventable death, and when you have a culture which disregards the lives of women.”

Birthright is astutely marketing itself as a real-life Handmaid’s Tale—an allusion to the Margaret Atwood novel turned Hulu series in which women are routinely raped and reduced, as a matter of policy, to their wombs. The dystopian world of The Handmaid’s Tale is differentiated from our own by crimson cloaks, but the notion of a womb controlled by governments and ideologies and opposed to individuals is not a foreign one. In fact, as American state legislatures have continued to pass laws establishing “personhood” for unborn fetuses and restricting citizens’ access to information, contraception, and legal abortions, the lives of pregnant women have become increasingly dystopian. While Birthright attempts to offer comprehensive histories and expert commentaries, it primarily deals in the stories of real American women, who have been shocked to find that their desires to order an abortion pill online or take half a Valium while pregnant have been criminalized, or that their local hospital has refused to terminate their non-viable pregnancy or offer them the sterilization services that they desire.

The brutal thrust of the documentary is best articulated by Andrea Friedman, a reproductive rights policy strategist who summarizes the aims and consequences of the prolific “pro-life” movement, explaining, “The ultimate goal, of course, is to overturn Roe. But doing so means that you are taking away a whole series of other rights from women. So women who want to carry a pregnancy to term, want to make choices about how they give birth, might lose those rights, because the court may be able to decide that what they’ve chosen for their birth, for their pregnancy, is not in the best interest of the fetus.”

Tamarkin’s film persuasively argues that women’s autonomy has become increasingly policed by state legislatures taking anti-abortion ideology to punishing new heights. While the broader history of abortion access and reproductive justice in America has its own milestones, from Griswold v. Connecticut to Roe v. Wade, Birthright’s most compelling timeline—that of the rapidly growing, radical anti-abortion movement—really picks up around 2010. That’s when the Tea Party came to power, ushering in a wealth of conservative legislation across the country. Between 2010 and 2015, state legislatures passed 388 abortion restrictions. As Birthright points out, the Tea Party was something of a Trojan horse on this issue, with many candidates primarily running on economic platforms, only to push aggressively ideological agendas once instated. This narrative—Americans vote on economic concerns, only to elect politicians with ambitious, hyper-conservative cultural agendas—should ring a warning bell under the current administration.

We’ve all read about increasingly cruel-sounding anti-abortion legislation; laws that close clinics, mandate the spread of scientifically unsound misinformation, and subject women to unnecessary and invasive procedures. What Birthright does so well is place these laws within a larger context, shedding light on the passionate activists who pressure politicians and picket clinics. The anti-abortion movement in this country is only growing stronger, with a multi-pronged approach that paves the way for a near-future dystopia in which “pro-life” activists who purport to protect children and mothers betray a pervasive disregard for maternal life.

Birthright methodically cycles through various victims of ideological agendas and punishing legal precedents. One of the film’s most thorough and stunning indictments is of the Catholic hospital system that forcibly filters the medical care of an increasing number of Americans through their own ethical and religious directives. According to the Catholic Health Association of the United States’ website, the system is “comprised of more than 600 hospitals and 1,400 long-term care and other health facilities in all 50 states,” making the Catholic health ministry “the largest group of nonprofit health care providers in the nation.” One in six hospitalized patients in America receives care in a Catholic facility.

Birthright explores religiously motivated hospital policies, such as an inability to terminate even in the event of a non-viable pregnancy. Through multiple examples, the film reveals the disturbing practice of sending women home to get sicker or potentially die, rather than providing them with an emergency abortion. One woman who was interviewed for the film was sent home from a Catholic hospital even though her doctors were fairly confident she was having a miscarriage. She was told, “Your fetus stopped growing regularly a couple of weeks ago, but we can’t do anything for you, because there’s still a heartbeat.” Within a few hours of being released, she fainted and went into shock, and had to be rushed back to the emergency room. The documentary argues that fetuses that cannot survive outside the womb are being prioritized over women. Those women are being denied potentially life-saving procedures and instead are being left to carry around dying children and monitor their own escalating medical crises. Additionally, hospitals being absorbed into the Catholic system can no longer offer abortions or sterilizations—essentially making legal medical procedures inaccessible to huge swaths of Americans.

In 2008, Keith Mason started the personhood movement in Colorado, the first state to consider an amendment saying that life begins at conception. It’s easy to draw a line between a religious medical practice that allegedly prioritizes a fetal heartbeat with fatal results, and a growing movement that fights for fetal personhood. One Birthright interviewee argues that personhood laws represent a potential “intrusion in the life of an individual that should shock every true conservative in this country.”

The most compelling insight into the “other side” comes courtesy of an interview with Mason himself. In the midst of explaining his growing movement, Mason candidly admits, “It’s not our goal to overturn Roe v. Wade. I don’t think it will ever be overturned. We don’t need it to be.”

The documentary proceeds to show just how far-reaching the effects of personhood really are; how these laws have already been used to police, punish, and even imprison women and would-be mothers. Two mothers interviewed for Birthright describe being non-consensually drug tested after giving birth to healthy children. One of the women explains that during her pregnancy, she took half a Valium in order to calm down during a panic attack. After returning home with her newborn, she was understandably shocked and upset when police officers showed up at her place of work, accusing her of “chemical endangerment of a child.” The second interviewee faced the same charge; a young woman who stopped taking her epilepsy medicine after her first pregnancy ended in a miscarriage, and instead used marijuana to limit her seizures. After giving birth and testing positive for cannabis, she was physically removed from her hospital bed, handcuffed, arrested, and taken to jail while still lactating and bleeding.

These instances of the “chemical endangerment of a child” charge being wielded against new mothers can and do deter other women from seeking necessary medical attention. Birthright cites many cases of women who refused to go to the hospital or bring their newborn children, for fear of being drug tested and arrested. And that’s not the only potential charge keeping women out of emergency rooms. As the alarming case of Purvi Patel in Indiana showed, women are now being charged with “fetal homicide” and being treated as potential suspects in their own miscarriages and abortions. Birthright interviews another woman whose case was treated as a homicide after she induced an abortion with a pill (she couldn’t afford to travel to and pay for a provider).

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These instances harken back to a pre-Roe v. Wade era in which women underwent medically risky procedures, often dying as a result of unsafe abortions. If a woman experiences complications from an at-home or illegal abortion or even a miscarriage, the threat of these charges may very well keep her from seeking medical care for fear of arrest and incarceration. In other words, overturning Roe v. Wade is not the only way to plunge our country backward into a dark age of risky childbirth and fatal abortions.

Birthright’s discussion of the “chemical endangerment of a child” charge lends itself to one particularly fascinating moment in the film. In 1997, South Carolina became the first state to rule that a viable fetus is a “person” under the state’s child abuse laws. As Birthright points out, this ideological strain has historical roots; in 1989, the Medical University of South Carolina began secretly drug testing pregnant women, predominately black women, during the height of the crack epidemic, often leading to arrests and prosecution. Michele Goodwin, professor of law and global health policy at the University of California, Irvine, elaborates: “There were dozens of women who were dragged out of the Medical University of South Carolina hospital, dragged out bloodied, in bloody gowns, and tossed in the back of police cars. These were women who were left out on their own. It wasn’t part of a narrative about choice. And so there were organizations that didn’t come to the aid of these women, and I think they didn’t see that that was the start.”

Historically, women of color have been the first targets of reproductive injustice, from the Puerto Rican women subjected to high dosages of birth control during contraceptive trials in the 1950s, to the victims of compulsory sterilization programs in the U.S. Had the fight for reproductive justice in this country ever been truly intersectional, with the rights of women of color being taken as seriously as those of their white counterparts, perhaps we would all be better prepared for these most recent outrages.

Birthright attempts to emphasize the complacency of generations that have grown up in a post-Roe v. Wade world; liberal teens are portrayed in sharp contrast to their politically active, mobilized “pro-life” peers. With apathetic citizens like these, the film seems to argue, what’s to stop the anti-abortion movement from continuing its already-successful campaign, particularly under our new Republican president? We’ve already seen the current administration throw its weight behind an unusually cruel health care bill that would bar Planned Parenthood from accepting Medicaid patients, make way for potential “pre-existing conditions” like Cesarean sections and sexual assault, and allow states to rule on whether or not insurance companies should be forced to cover maternity care.

While Birthright isn’t actually about drawing connections between the dire state of reproductive health care in America and a fictional Hulu series, it does begin to trace the outline of a dystopia that’s already begun: a world where you can order an abortion pill on your smartphone, but be arrested for ingesting it, and where you can be punished for being a bad mother from the moment of conception onward. A world in which poor women of color are targeted first, but the rest of us are quick to follow. There’s a Handmaid’s Tale quote that has gotten a lot of play, particularly amongst the so-called Resistance—the observation, from a female character, that, “We didn’t look up from our phones until it was too late.” Being too distracted to fight back is already a painfully relatable concept—especially if the source of your mindless entertainment is a terrifyingly prescient television series about a dystopian world that’s already coming to fruition.

BIRTHRIGHT: A WAR STORY will be released in theaters starting July 14th in New York and July 28th in Los Angeles, with additional cities around the country.