A Woman Says She Was Denied Prenatal Care For Being Unmarried
At a town hall earlier this month, the 35-year-old woman said she's been with her partner for 15 years, though they're not married. When she had her first visit with her provider after she found out she was pregnant, she recalled, the provider said 'they were not comfortable treating me because I am an unwed mother and that goes against their Christian values.'
'I'm traveling to Virginia for my prenatal care, scared out of my mind that I will go into labor and have to deliver in this state with a provider who feels that that child's life is more valuable than mine,' she said. 'While we do love and want this child, I also have a 13-year-old and I can't leave her behind.'
The woman, whose remarks at the town hall can be seen in a widely shared video, later spoke with TN Repro News on the condition of anonymity due to concerns of retaliation, saying that she fears being pregnant in her home state because of its near-total ban on abortion. She also told the outlet that she has filed complaints regarding the provider who denied her care with the Department of Commerce and Insurance and the American Medical Association.
Tennessee's Medical Ethics Defense Act went into effect in April. The law 'prohibits a healthcare provider from being required to participate in, or pay for, a healthcare procedure, treatment, or service that violates the conscience of the healthcare provider.' It applies to doctors, health care institutions, and insurance companies, among others.
So-called 'conscience' clauses have been considered or enacted in a number of U.S. states. These clauses have typically been quite narrow and tended to focus on a specific service, like abortion. But health law experts say that some states have, in recent years, been passing what they call very broad conscience laws, like the one in Tennessee, which they warn could lead to care denials for a wide range of health care services.
'It was exactly what I feared,' Valarie Blake, a professor at the University of Tennessee Winston College of Law, says about the story of the woman being denied prenatal care. 'Because what the law does is it essentially allows any health care professional, very broadly defined, to refuse care based on their ethical or moral beliefs for any kind of service, and there's really no limitations to that,' with very narrow exceptions.
Blake says that 'there is nothing to stop a health care professional from denying care on any basis at all that they see as conflicting with their moral or ethical beliefs' under this new law—whether that be objections to providing reproductive care, or other factors, such as marital status, obesity, poverty, diet, cigarette use, or vaccination status.
The law stipulates that a patient can't be denied care for services mandated under federal law, such as the Emergency Medical Treatment and Labor Act (EMTALA), which requires hospitals that receive Medicare dollars to provide stabilizing treatment to patients who are experiencing medical emergencies or transfer them to a hospital that can provide that care.
But Blake says that's a narrow exception, since EMTALA only applies to patients in those emergency situations. Reproductive rights experts have also criticized the effectiveness of exceptions of this kind; many people have filed complaints against hospitals in states with abortion bans, alleging that they were denied care even while experiencing pregnancy complications, in violation of EMTALA.
The Tennessee law was backed by the Alliance Defending Freedom (ADF), a conservative Christian and anti-abortion legal advocacy group. After Tennessee Gov. Bill Lee signed the bill into law, ADF Senior Counsel Greg Chafuen praised the move, saying in a statement that 'doctors and nurses have been targeted for caring for their patients by refraining from harmful and dangerous procedures' and claiming that the Act 'ensures that health care professionals are not forced to participate in procedures that violate their ethical, moral, or religious beliefs.'
Mary Ziegler, a professor at the University of California, Davis School of Law, says she doesn't think the people behind the Tennessee law intended for it to be so far-reaching, but 'if you write a law this broad, you will discover lots of people who are involved in health care have all kinds of objections to all kinds of things.'
Experts fear that the Medical Ethics Defense Act will make it even more difficult to access care at a time when the health care system is already facing a number of challenges. Many pregnant people living under abortion restrictions have been forced to travel across state lines to access care since Roe v. Wade was overturned in 2022. President Donald Trump's 'Big Beautiful Bill,' which he signed into law on July 4, includes sweeping cuts to Medicaid and is projected to cause millions of people to become uninsured by 2034. Rural hospitals across the country have been shutting down or fighting to stay open, leaving many community members struggling to access care.
Read More: 'An Exodus of OB-GYNs': How the Dobbs Decision Has Shaken the Reproductive Health Landscape
'Tennessee is a place that has already banned abortion. There have been hospital closures. It ranks as one of the highest states with maternal mortality in the country,' says Israel Cook, legislative counsel at the Center for Reproductive Rights. 'I think [the law] is just pushing health care out of reach for so many people. Abortion care, prenatal care, postpartum care, all of these reproductive health care [services] are standard health care that should be accessible and available for everyone.'
Health law experts say the 35-year-old woman's story was the first example they've heard of a care denial under the new law—but that they fear there may be more.
'I do think that it's only a matter of time before we hear more and more of these stories,' Blake says.
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