An Open Letter to Iowa’s State Legislators Concerning Abortion and Women’s Healthcare

In late 2022, just two states away from Iowa’s border, thirty-three year old Christina Zielke stumbled out of Ohio’s University Hospitals TriPoint Medical Center, blood trickling down her legs and puddling into her shoes. Overjoyed to learn of her pregnancy, she and her husband were devastated to discover her fetus had no heartbeat at an ultrasound appointment. While at the ER, Christina bled through diapers of blood, but was not offered pain relief or a Dilation & Curettage (D&C) procedure commonly used to stop bleeding from miscarriages. Eventually, against Christina’s wishes, she was discharged from the ER – putting her life at risk for a pregnancy she had already lost. Upon returning home, she climbed into her empty bathtub until the bottom was filled with her blood and eventually lost consciousness due to a massive amount of blood loss. This horrific, bloody, and preventable scene is women’s reality in states with strict anti-abortion legislation. Only when Christina’s life was at serious risk did she receive the care she so desperately needed.

Iowa is at a crossroads. As a state we can decide to endanger the lives of thousands of women, like Ohio has done, or protect the lives of our sisters, wives, mothers, aunts, cousins, friends, coworkers, and classmates.

Laws like SB 23 in Ohio, which ban abortion at six weeks of pregnancy and threaten healthcare providers with hefty fines and jail time for performing abortions, are replicated across nearly twenty-four U.S. states, creating fear and confusion among doctors regarding when they can carry out medical procedures related to abortion. Although the intentions of these laws may not be to endanger women’s lives, the harsh reality is these bans endanger the lives of women. States with abortion bans experience higher maternal death rates compared to states that protect abortion. To compare Iowa to Ohio, Iowa’s maternal death rate is 9.4 per 100,000 live births under the current law which protects abortion up to 20 weeks of pregnancy. Ohio, under SB 23, experiences a maternal death rate of 24.7 per 100,000 live births. According to a brief submitted to the Supreme Court by 547 public health professionals, scholars, the American Public Health Association, and the Center for US Policy, fourteen US states with the most restrictive abortion laws suffer from the country’s worst rates of maternal and child health outcomes as well as low infant birth weights, infant mortality, child poverty, and adverse childhood experiences. This data presents a paradox; are these pro-life states really concerned about protecting the lives of children? Or are they only concerned with using women’s lives as political leverage? 

Iowa is on the brink of becoming the twenty-fifth state to enact anti-abortion legislation since the Supreme Court ruled in Dobbs v Jackson, which overturned Roe v Wade and thus gave individual states the power to determine abortion’s legality. This past February, twenty GOP Iowa lawmakers filed a bill to ban all abortions within the state of Iowa with no exceptions creating conditions where women like Zielke will be denied care. Proponents of such bills wrongfully believe bans will stop all abortions. Data published by the World Health Organization proves the opposite. The rates of abortion among countries where abortion are legal and accessible compared to countries where it is banned is about the same, with a slight increase in countries where it is illegal. Quite simply, outlawing abortion does not decrease its incidence.

If the goal is to decrease the number of abortions, then the Iowa State Legislature needs to protect the lives of Iowa women by passing a law modeled after our neighboring state of Illinois that “allows women to make autonomous decisions about one’s own reproductive health,” effectively leaving the government out of private reproductive health decisions. Illinois’s maternal death rate is 12.9 per 100,000 live births, (nearly 50% less than Ohio) and their infant mortality rate decreased after passing this piece of legislation by 3%. With America’s maternal mortality rates higher than they have ever been since 1965, we do not need to guess at what the effects of different laws will be; empirical evidence proves laws protecting abortion care save lives.

Iowa is at a crossroads. As a state we can decide to endanger the lives of thousands of women, like Ohio has done, or protect the lives of our sisters, wives, mothers, aunts, cousins, friends, coworkers, and classmates. Christina Zielke is not the only woman in America who has suffered life-threatening consequences as a result of staunchly restrictive abortion legislation, and certainly will not be the last. If you choose to join the ranks of America’s twenty four states with abortion bans, their blood will be on your hands.