The Patient Body: No Burden Too Great

 A pro-life supporter. Photo: Maisie Crow/The Last Clinic Film, LLC

A pro-life supporter.
Maisie Crow/The Last Clinic Film, LLC

By Ann Neumann

Cast thy burden upon the Lord, and he shall sustain thee: he shall never suffer the righteous to be moved.

–Psalms 55:22 KJV

The Supreme Court’s 5-3 decision in June on Whole Woman’s Health v. Hellerstedt was about many things: the fate of a recent tsunami of Targeted Regulation of Abortion Provider (TRAP) laws that have made anti-abortion activists giddy and reproductive health providers gasp; the maneuverings of a court hobbled by the death of Antonin Scalia earlier this year; and the great stakes of filling that vacant seat.

But what Whole Women’s Health most clearly displayed was how the many types of burdens that women face—the burden of birthing labor, most fundamentally, but also the burden of parenting and domestic life (bring home the bacon, fry it up in a pan) as well as the moral burden of behaving as sexual beings within socially ascribed boundaries—are very often conflated, dismissed, marginalized and obscured.

All these burdens are too often collected under an impossibly narrow definition of what work a woman must do in society, either actively or passively. A woman is supposed to be the keeper of home and hearth, to be the moral actor, responsible for her own good behavior, her spouse’s, her children’s, and really, everyone else’s (and to never let you forget you’re a man). Yet, as she is expected to take such careful and constant care, she must remain vulnerable and willing to perform her submission to protective, paternalistic laws and mores.

The Texas laws taken up by the court stipulated that physicians providing abortion must have hospital admitting privileges and that the facility in which they work must meet care standards that clearly exceed the routine and low risk nature of an abortion procedure. This guise—concern for the health of women—was particularly galling because tired decades of this particular culture war and its related issues (domestic violence inaction, employment and pay inequality, women’s health care inadequacies; reduced education and day care funding) have shown that the true concern lies elsewhere. These laws pretend to be about protecting women’s health, when really, they are about increasing control over women’s bodies while continuing to minimize the value of the work that women perform. TRAP laws are just the latest example of legislation whose pretense of concern furthers the subordination of women’s labor to decision making. According to these laws, it is more important that a woman chooses the right work than that her work is valued.

By attacking abortion safety, abortion opponents felt they had found the ideal defense of abortion restrictions. Who doesn’t want women to be safe? Yet, abortion is statistically very safe and has been shown to substantially improve women’s lives and health. Still, again and again deference to a “traditional” gender role—namely subservience to men, babies and household duties—has erased the work of women and the pain of such labor. And this gender role ideology has erased or obscured the real pain and challenge women face when they can’t plan their reproductive lives.

Women worth protecting, worth keeping safe, comply with the narrow moral code and narrow (or nonexistent) choices afforded to them. Those not willing or able to make the “right” choices, regardless of the ramifications for their personal lives, will never be safe. Either because they are exempted from participating in society (as compliant mothers, dutiful homemakers, productive workers) or because they must be reformed, controlled, and forced to do the right thing. The (non) choice has become the only acceptable women’s work; all that it entails is forgotten, disregarded, obscured.


Ultimately Whole Women’s Health acknowledges that it is indeed possible to burden a woman. This is no small thing. For decades those opposed to gender equality and reproductive justice have been perfectly happy to carry on the pretense that no type of “women’s work” is too much for women, despite the number of tasks, chores and attributes thrown into that basket.

But moral burden has always dogged and shaded women’s role in society, particularly in politics. “Women entered public affairs by way of an evangelical religious revival that emphasized their moral superiority, becoming temperance reformers and abolitionists,” Jill Lepore writes of politically minded women in the mid 1800s. This burdensome responsibility to act as moral arbiter for society and its lawmakers has always played a role in the anti-abortion debate — “What kind of woman could kill her own baby?” opponents of legal abortion ask.

When the movement’s focus on fetuses instead of women’s health came under direct criticism from reproductive justice supporters, the “pro-life” movement shifted its tactics (or more accurately, added a new regiment to their forces), heavily relying on a persistent form of paternalism and the same old gender roles: women are delicate and must be protected from unsafe “abortion mills.” If women (including minority women, the anti-abortion movement finally realized) knew what they needed, female “pro-life” activists would be brought to the front as the moral voice of all women. Real women take pride and pleasure in raising happy healthy babies, in providing for those babies, no matter the cost, in using sexual abstinence as birth control, in keeping their men around by balancing sexiness with domestic capabilities, in accepting any and every burden God gives them.


This focus on women’s morality assumes that all labor associated with “traditionally” gendered domestic work is noble nonlabor—because anyone other than a loyal, dutiful wife and mother is an immoral slut, a destroyer of the social fabric of the country. This position held by the anti-abortion movement is on full display in Maisie Crow’s new documentary, Jackson, which chronicles the trials of women in Mississippi’s capital, site of the state’s last abortion clinic, the Jackson Women’s Health Organization.*

The film follows April Jackson, who is 24, and expecting her fifth child. April has very little money, no high school degree or GED, and works several part time jobs just to keep her children in clothes and food. There are no men in her picture, unless you count those who make the punishing laws of her state (regarding social services, sex education, contraception and abortion access) or yell excruciatingly shaming/shameful things at anyone who goes near the women’s clinic. No matter what April does, it’s never enough.

Yet April’s taken in by Barbara Beaver, who runs the local Crisis Pregnancy Center, a busy and vocal anti-abortion evangelical who is allied with the state’s governor, other local politicians, and wealthy donors willing to support her center which exists solely to divert women from the choice of abortion.

A patient at Jackson Women's Health Organization. Photo: Maisie Crow/The Last Clinic Film, LLC

A patient at Jackson Women’s Health Organization.
Photo: Maisie Crow/The Last Clinic Film, LLC

What’s most moving about the film—and it is moving, staggering and painful to watch—is April’s relentless plight and how it’s parsed, justified, moralized, and exacerbated by Beaver and state laws. Not to mention local attitudes of shame and righteousness. No burden is too great for April, through Barbara’s rose-colored lens. Beaver promises all kinds of support to April—counseling, baby clothing, other supplies—so long as April defers to the center’s religiously motivated teachings. To Beaver, April’s children and the challenge of supporting them are a gift from God, one that she is blessed to be saddled with and one that He will help her carry. The excruciating tax on April is, according to Beaver, the price she must pay for being black, poor and sexually promiscuous (never mind that this configuration of promiscuity includes any kind of sex outside of procreative and marital).

April’s burden is erased by Beaver and like minded anti-abortion activists because it is both punishment for amoral behavior (Beaver is an accepted model of the moral woman) and because it’s domestic, not a burden at all because it involves the home and mothering, well within the purview of real women’s roles.

Those in Mississippi have been closely watching the Supreme Court case in Texas, Whole Woman’s Health v. Hellerstedt, because like Texas and three other states, there is only one clinic there where women can choose their futures by choosing how many children they will bear. Because the court decision struck down the TRAP laws in Texas, it could prevent clinic closures in other states where women are desperately limited in their reproductive options (although the ruling in Texas will not end unconstitutional TRAP laws in other states, it opens them up to challenge).


Mothering, in this cosmology, is God’s plan (or biology’s, if the proponent is avoiding overt “religious” valuations). It’s as natural as breathing for women; and therefor so are the tasks that come with it.

Ultimately, Whole Woman’s Health v. Hellerstedt determined that it is possible to unnecessarily burden a woman’s life by making access to abortion more difficult or even impossible. The decision rightly deemed claims of women’s health (as a rationale for encumbering abortion access) as disingenuous coverage for an ulterior motive: ending abortion. Physical safety was never a sincere claim on the part of antiabortion activists; it was always a cover for social or moral safety. It was always a pseudo scientific/medical way to denounce women’s behavior outside of deeply entrenched and misogynistic parameters of what work women must do or how they must behave.

Jackson, Mississippi. Photo: Maisie Crow/The Last Clinic Film, LLC

Jackson, Mississippi.
Photo: Maisie Crow/The Last Clinic Film, LLC

While the “undue burden test” has been used by the Supreme Court since the 19th century, for all sorts of cases, it has seldom fully acknowledged women’s burdens when applied to reproductive justice. If, as Barbara Beaver and other anti-abortion activists believe, women are blessed by domestic and parenting labor and have abstinence (the only unquestionably moral choice, in this construct) as an option for avoiding pregnancy, April’s life is one of her own making. If it’s difficult, she should have made other decisions about her sexual activity, her education, her employment. After all, is it easier to be poor than get a job? To make an immoral decision like abortion than to be a mother?

The Court’s decision also addressed an issue inherent in the laws’ passage: that abortion is unsafe, despite any proof of this fact, and must be very tightly regulated. As Linda Hirshman writes for The Washington Post, Justice Ruth Bader Ginsburg’s seemingly unnecessary concurrence to Stephen Breyer’s decision puts in place the assertion that abortion *is* safe for women, thus eliminating any justifiable reason—or state imposed burden like traveling impossible distances—for encumbering it. In short, Ginsburg eliminates any future argument that women’s health must be balanced with burden, that any labor asked of a woman is justifiable so long as it supposedly protects her safety. Hirshman writes:

[Ginsburg] dismisses Texas’s argument about its interest in protecting “the health of women who experience complications from abortions,” by countering that “complications from an abortion are both rare and rarely dangerous.” She recites a laundry list of studies of how safe abortion is, and then she delivers the message: “So long as this Court adheres to Roe v. Wade, 410 U. S. 113 (1973), and Planned Parenthood of Southeastern Pa. v. Casey, 505 U. S. 833 (1992), Targeted Regulation of Abortion Providers laws like H. B. 2 that ‘do little or nothing for health, but rather strew impediments to abortion,’ Planned Parenthood of Wis., 806 F. 3d, at 921, cannot survive judicial inspection.” [Emphasis added.]

Protecting women—one would like to extrapolate: protecting their moral and sexual lives as well as their physical health—can no longer be an excuse to belabor them.

It may be a new day for women’s labor in Supreme Court jurisprudence, but a woman living in Mississippi, Missouri, North Dakota, South Dakota, or Wyoming has only one abortion clinic in her state. April Jackson, at the close of the film Jackson, is again pregnant, this time with twins. The “pro-life” movement will find new ways to work around Whole Woman’s Health v. Hellerstedt. And every day the burden of poor, struggling women will be rationalized as the result of their poor decision-making or their gender.

Pro-choice advocates may have won the biggest Supreme Court abortion case in decades but women everywhere continue to be unjustifiably overworked and overburdened for no reason other than that they are women.


*Full Disclosure: I did some editing/copywriting work on Jackson’s press kit.


Past “The Patient Body” columns can be found here.


Ann Neumann is a contributing editor at The Revealer and Guernica magazine and a visiting scholar at The Center for Religion and Media, NYU. Neumann is the author of The Good Death: An Exploration of Dying in America (Beacon Press, 2016).

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