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reproductive healthcare
Sanctions, Siege, and the Female Body
Policies of pressure and control from Iran to Gaza quietly transform women’s health into collateral damage.
May 19, 2026
A delayed shipment of medication does not make headlines.
A generator failing in a maternity ward is not breaking news.
A woman rationing insulin or postponing prenatal care is not framed as political violence.
And yet, from Iran to Gaza, these are the quiet consequences of policies described in distant capitals as “pressure,” “security,” and “strategy.”
Whether through sanctions or siege, the mechanism is different, but the message is the same: Women’s health is negotiable.
The Women, Life, Freedom movement born out of Iran has captured global attention. Women in Iran are disproportionately affected by the intensity of the Islamic Revolutionary Guard Corps, with stricter restrictions on their dress, behavior, and livelihoods. The Iran sanctions regime, beginning in 1979 following the US Embassy crisis, refers to the network of international economic, trade, and financial restrictions imposed on the Islamic Republic of Iran.
Part of these sanctions include limitations surrounding medicine and medical devices. In sanctions like those imposed on Iran, governments often default to a “humanitarian exemption.” Medical supplies can still be sold to Iran. Food and basic goods are allowed. The policy is framed as not harming ordinary people. So, while sanctions on Iran formally include humanitarian exemptions for food and medicine, these protections often collapse in practice. Banks refuse transactions, suppliers withdraw, and supply chains falter, leaving critical treatments technically permitted but effectively out of reach. Women are disproportionately affected due to their reproductive needs. While sanctions did not create gender inequality in Iran, they have intensified existing inequities in access to contraception, abortion-related care, and maternal care.
In Palestine, the long-term occupation and ongoing genocide have had their own implications for women’s health. Movement restrictions due to blockades delay care. The bombing of hospitals creates infrastructure damage, preventing people from accessing treatment within the Gaza Strip, leaving the healthcare system severely overburdened. Women in Gaza are deprived of sexual and reproductive health services and sanitary products. Women have been documented giving birth in cars, in tents, and on the side of the road. Young girls have reported using pieces of tents as menstrual cloth.
Rob Nixon describes the concept of slow violence in the context of environmental justice. The parallel to women’s health here is direct. Slow violence is gradual, invisible, and normalized. It is not dramatic like war headlines, but it is equally destructive. It is a long-term erosion of health and dignity.
Policies presented as “strategic” or “necessary” produce predictable civilian harm. This damage is not coincidental or accidental, but structurally foreseeable. In Iran, sanctions limit access to medicines and equipment. In Palestine, specifically Gaza, blockade and military conditions restrict healthcare infrastructure and mobility. The common thread is not just genderized violence; it is the collapse of mobility, supply chains, and legal access to care, with women’s reproductive health among the clearest casualties.
We should reject the notion that this harm is unavoidable and that no one is at fault. Policymakers are aware of these outcomes. Reports, data, and firsthand coverage document these consequences, yet the policies continue.
Official reports from the United Nations have documented the severe consequences of maternal malnutrition and food insecurity on infant and maternal health in Gaza. These conditions increase the risk of complications during pregnancy and childbirth, including low birth weight, premature delivery, and heightened neonatal and maternal mortality. Bombs kill people, but policy kills people too.
In Iran, internet access has been heavily restricted, resulting in limited and delayed reporting from within the country. It is important to recognize that the absence of coverage does not mean events are not occurring, but rather that information is being constrained by disrupted communications and censorship.
Predictable harm that continues becomes accepted harm. Whether through sanctions or siege, the mechanism is different, but the message is the same: Women’s health is negotiable.
Global attention is uneven and politicized, where some women’s suffering is amplified while others' is minimized or justified. There is complexity here. The task is not to reduce the rights of some women, but to uplift those who are actively pushed down. Politicians and policymakers use distant language such as “targeted sanctions” to make decisions sound precise and controlled, masking widespread civilian impact and distancing themselves from bodily consequences. The rhetoric gap remains. The reality persists. There is no true humanitarian exception.
These harms are ongoing and documented. Slow violence becomes background noise that we learn to live with. Women are often lost in this conversation despite their disproportionate burden. Their suffering is not always visible or measurable in geopolitical analysis.
If these outcomes are predictable, the question is not whether harm is occurring, but why it is so easily explained away. In reframing what is considered violence, we must account for all consequences, intended and “unintended,” because in practice they become indistinguishable. Societal acceptance of women as collateral damage should be challenged and dismantled, beginning with the recognition that no woman’s suffering is lesser than another.
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A Public Health Emergency: How Abortion Bans Are Fueling Maternal Deaths in America
People living in states that have banned abortion are nearly twice as likely to die during pregnancy, childbirth, or soon after compared with those in states where abortion remains legal and accessible.
Apr 10, 2026
The maternal mortality crisis in the United States is a national embarrassment, and it’s unfolding in real time. The US continues to have one of the highest maternal death rates among high-income countries, and the situation is getting worse, not better. Behind this trend is a growing body of research showing that state abortion bans directly contribute to increased maternal mortality, especially in communities already burdened by systemic inequities.
Maternal mortality has traditionally reflected deep structural problems in a healthcare system that fails to serve all people equally. In 2024, the US maternal mortality rate ticked upward again, reversing a brief decline and demonstrating that the crisis is far from over. Experts point to a range of causes, including reduced access to prenatal care, maternity care deserts, and strained hospital systems, all problems intensified in states with abortion restrictions and in states with increased Immigration and Customs Enforcement (ICE) agents.
A comprehensive analysis from the most recent Centers for Disease Control and Prevention (CDC) mortality figures shows that people living in states that have banned abortion are nearly twice as likely to die during pregnancy, childbirth, or soon after compared with those in states where abortion remains legal and accessible. What’s more, in supportive states where abortion has remained legal, maternal mortality has declined by about 21% since 2022, suggesting that access to comprehensive reproductive care saves lives.
Restricting abortion does more than eliminate a medical procedure; it forces people to carry pregnancies that pose very real health risks. Childbirth has inherent dangers from hemorrhage and infection to hypertensive disorders and cardiac events, and the risk of death from pregnancy is at least 44 times higher than from abortion. When abortion is inaccessible, people are compelled to continue unwanted or medically unsafe pregnancies. That dynamic alone drives increased deaths that could otherwise have been prevented.
Bans do not reduce the prevalence of abortion; they reduce its safety, push people into riskier medical scenarios, and leave pregnant people with fewer options even when their health is at stake.
Racial and socioeconomic disparities in maternal mortality did not begin with the reversal of Roe v. Wade. Black birthing people in the US have long faced significantly higher death rates than white birthing people, a symptom of deep structural racism in healthcare, poverty, and chronic stress. But abortion bans have exacerbated these inequities.
In states with abortion bans, Black birthing people are more than three times as likely as white birthing people in those same states to die from pregnancy-related causes. Those figures make crystal clear that when we talk about maternal mortality, we are talking about a crisis of racial inequity, class inequity, and political neglect. States with the worst maternal health outcomes, including Louisiana, Mississippi, and Texas, are predominantly in the South and have enacted some of the most restrictive reproductive laws.
These disparities compound with other conditions such as limited access to early prenatal care—which the CDC reports has declined across the country, with the steepest drops among Black mothers. Delays in early care are associated with worse outcomes for both mother and baby and are worsened by the closure of maternity care facilities in rural and under-resourced areas.
For undocumented and immigrant communities, the maternal mortality crisis is layered with additional barriers. Fear of immigration enforcement, including ICE, deters people from seeking care, even in emergencies. Clinics in border states with large immigrant populations were already medically underserved before Dobbs, and abortion bans have deepened that inaccessibility. Many undocumented people lack insurance, fear reporting, or face economic barriers that make traveling for care impossible. These structural obstacles do not just delay care, they can literally cost lives.
Immigrant and mixed-status families are disproportionately concentrated in states with abortion bans, like Texas, Arizona, and Florida, meaning that people who already face the greatest systemic barriers to healthcare are also the most likely to lack access to safe abortion or comprehensive maternal services. This intersection of racist policy, reproductive restriction, and anti-immigrant enforcement creates a perfect storm that pushes already vulnerable people further to the margins and deeper toward harm.
Critics of abortion argue from moral or ideological positions, but the evidence shows that access to abortion care is fundamentally a matter of public health. Bans do not reduce the prevalence of abortion; they reduce its safety, push people into riskier medical scenarios, and leave pregnant people with fewer options even when their health is at stake.
We are now witnessing a preventable loss of life, and the window to act is closing.
We know how to prevent many maternal deaths: Expand access to comprehensive reproductive care (including abortion), strengthen prenatal and postpartum support, increase Medicaid coverage, invest in maternity care infrastructure, and dismantle the historic and systemic inequities that predict who lives and who dies. We know these interventions work because states that have protected reproductive rights are already seeing declines in maternal mortality.
To ignore this crisis is to ignore evidence, dignity, and the lives of pregnant people, especially those in Black, Indigenous, immigrant, and economically disadvantaged communities.
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Separating Abortion and Pregnancy-Loss Care Harms Everyone
New bills seek to reinforce a false binary between abortion care and care for pregnancy loss, but this will only harm pregnant patients and further restrict access to comprehensive sexual and reproductive healthcare.
Mar 29, 2026
People experiencing pregnancy complications in states that restrict abortion have died preventable deaths; others have been forced to bleed out while waiting for providers to deem their conditions were life-threatening enough to receive care under narrow legal exceptions or had to travel out of state for emergency abortion care. Meanwhile survivors of rape and incest have been denied care, despite exceptions that supposedly permitted abortion in those circumstances.
This is the new reality of seeking pregnancy-loss care and abortion care post-Dobbs. But instead of addressing the root issue—abortion bans and restrictions—policymakers are advancing a new strategy: redefining abortion itself. These new bills seek to reinforce a false binary between abortion care and care for pregnancy loss, but this will only harm pregnant patients and further restrict access to comprehensive sexual and reproductive healthcare.
For example, a bill in Utah would allow people who have obtained abortion care for certain reasons (such as treating an ectopic pregnancy; removing a dead fetus; or in the cases of fetal anomaly, rape, or incest) to request that their medical record state that the abortion was “involuntary.” The proposed legislation attempts to legally codify the distinction between “elective” abortions and those obtained for medical reasons to further stigmatize abortion care. The bill’s sponsor has been at the forefront of restricting abortion in Utah, and claims this bill is for medical records and to prevent patient “distress.” However, there is no need for legislators to define medical care for the sake of providers or patients. People’s reproductive experiences are highly personal, and the language they use to describe them should be up to them—not politicians.
In other states, attempts to omit care for pregnancy loss from the legal definition of abortion opens the door for abortion to be further restricted. In Missouri, Wisconsin, and South Dakota, bills are being pushed that change the definition of abortion to exclude a range of pregnancy-loss care. Wisconsin’s bill, for example, aims to “exempt [this care] from abortion restrictions,” implying that there is some reproductive healthcare that should be protected, while some should not.
The only way to ensure that people in medical emergencies or who have experienced violence can get the care they need is expanding and protecting abortion care for all.
These bills all also rely on language that personifies the fetus or embryo, advancing the long-held anti-abortion goal of granting full legal rights to embryos and fetuses. Fetal personhood directly undercuts pregnant people’s rights and can be used to target other reproductive healthcare such as forms of contraception and IVF. While this language was eventually removed from the South Dakota bill, its inclusion when it was first introduced exposes the policymakers' intention: to carve out some forms of pregnancy care and use that as a foundation to attack abortion care.
The push to “clarify” exceptions, or what care can be provided under abortion bans, stems from understandable public outrage—outrage we share. The horrific outcomes for pregnant people who have died preventable deaths are the direct result of abortion bans--but adding legal carve outs designed by the same policymakers who champion draconian abortion laws is not the way to ensure that everyone has access to essential pregnancy-loss care.
The truth is, it’s impossible to silo abortion care from the rest of reproductive healthcare through medical or legal frameworks. Abortion, pregnancy-loss care, and pregnancy care are interconnected by their practices, medications, and the people that provide and obtain them. The only way to ensure that people in medical emergencies or who have experienced violence can get the care they need is expanding and protecting abortion care for all.
Separating abortion care from pregnancy-loss care also does not align with many people's lived experiences. Guttmacher research shows that people’s understanding of the boundaries between reproductive experiences are deeply nuanced. The author and model Chrissy Tiegen, for example, has been public about redefining her own pregnancy loss as an abortion, which she proceeded with after learning she would not survive the pregnancy without medical intervention. Ultimately, how someone defines their pregnancy outcome and the care they receive is subjective, and policymakers’ efforts to establish clear legal distinctions ignore the frequently blurred boundaries between these experiences.
Categorizing abortions as elective or "involuntary” is not only stigmatizing and medically unnecessary but ignores the complexities of people’s reproductive lives. Likewise, “clarifying” exceptions is simply another tool of the anti-abortion movement to further restrict and stigmatize abortion. What pregnant people need is compassionate and personalized care, not further state involvement in their bodies and decisions.
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