"Personhood" is Coming

Your medical care and rights are at risk

Guy Smallman / Getty Images

Everyone needs to prepare for the attempt and potential success of the Trump administration to implement “personhood.”

The writing is on the wall in flashing neon, so we need to talk about it.

What is Personhood?

Personhood, from a forced birth perspective, means every fertilized egg, even before implantation, should be treated as a person. Consequently, abortion–or even anything preventing implantation– should be treated as murder.

Whether forced birthers really believe this or if it’s simply a weapon of control or a way to make money is an entirely different matter. For example, this week, during Robert F. Kennedy Jr’s confirmation hearing for Secretary of Health and Human Services (I just threw up in my mouth thinking of the potential carnage that awaits us if he is confirmed), we heard how when he was running for president, he was vehemently pro-choice, but now that he is trying to get confirmed as a Trump appointee, he believes that “every abortion is a tragedy.” Look, he is salivating about the money to be made with Make America Health Again supplements and merch and by making it easier to sue vaccine manufacturers, so he’s happy to lick some boots.

I know that part about Kennedy making money from MAHA™ supplements and merch sounds like a joke I made up, but it’s not. In December, Kennedy apparently transferred ownership of a trademark application for Make American Healthy Again and MAHA to an LLC managed by Del Bigtree, the CEO of an anti-vaccination group and producer of the film “Vaxxed: From Cover-Up to Catastrophe.” No, really. The trademark could be used for supplements, compounded medications, vaccine detox programs, or maybe even MAHA onesies. After all, the Children’s Health Defense, an anti-science propaganda organization that Kennedy recently chaired, sells anti-vaccine onesies. Senator Bernie Sanders grilled him about this with a photo of the merchandise, and now the website sells them with the discount code “Bernie.”

We are in the most fucking dystopian timeline.

Why Do I Think Personhood Is Coming?

Because they told us in black and white in Project 2025. Repeatedly.

For anyone still clinging to the idea that Project 2025 is a distinct entity from Trump, CNN looked at 53 executive orders and actions from Trump’s first week and found that “more than two-thirds – 36 – evoke proposals outlined in “Mandate for Leadership,” Project 2025’s 922-page blueprint for the next Republican president.”

Project 2025 is filled with personhood language, such as, “Abortion pills pose the single greatest threat to unborn children in a post-Roe world.” Regarding mifepristone, “The FDA is statutorily charged with guaranteeing the safety and efficacy of drugs and therefore should withdraw this drug that is proven to be dangerous to women and by definition fatally unsafe for unborn children.” (Note: that last sentence is a lie. It is very safe, even safer than Viagra.) Several sections use the term “person” or “patients” to describe a fertilized egg/embryo/fetus, like this one:

A barrage of executive orders these past two weeks has been especially harmful for transgender and nonbinary people. To comply with the executive order from January 20 that is supposed to be about "defending women from gender ideology extremism," the CDC removed the pages for a document known as the “Medical Eligibility Requirement for Contraception,” which was an invaluable repository of information about contraception efficacy and safety. They also gutted the NIH Office of Research on Women’s Health website. This is apparently because everything with the word “gender” has been flagged for removal, which ranges from standard warnings about gender discrimination to crucial data about HIV surveillance. As I predicted in my previous post, they will comb through everything and remove what doesn’t comply with Project 2025.

Which leads to personhood.

The executive order “defending women” that is being acted upon as we speak (ironically removing crucial information for providing health care for women), includes personhood language:

Female’ means a person belonging, at conception, to the sex that produces the large reproductive cell. ‘Male’ means a person belonging, at conception, to the sex that produces the small reproductive cell.

Trump’s Project 2025 told us they want personhood. They are making good on other promises, so it’s only a matter of time before they move to personhood. It would not surprise me if the documents that have been pulled offline are also being rewritten to suit this purpose, for example, reclassifying IUDs as abortifacients.

What Does Personhood Mean?

Really bad shit.

Personhood, or the way it is interpreted by the evangelical fascists in power, means a fertilized egg has more rights than a living, breathing, pregnant person. It reduces people with a uterus to incubator status. In the United States, if someone broke into your home and were shooting at you, killing them in self-defense would be legal. After all, they are invading your home and actively trying to kill you. With personhood, if you are pregnant and pre-viability but have a severe infection and need delivery, meaning the pregnancy is effectively trying to kill you, you do not get to protect yourself against that threat.

We know this because interpreting the legislation in states where abortion is illegal but with a medically nonsensical “life of the mother” exemption is impossible. Who decides when the life of the mother is at risk? In medicine, we prefer to intervene to prevent critical illness, but when abortion is illegal, AND the judicial system is frothing at the mouth to charge those involved (back to control), it’s a different story. I started my OB/GYN training in 1990 and spent a lot of time with doctors in Canada who knew the history all too well of when abortion was illegal. No one was concerned about helping a woman who needed an abortion because she was sick.

The Obvious Ramifications of Personhood

The Turnaway Study tells us that when women are denied an abortion, they are four times more likely to live in poverty, more likely to be tied to an abusive partner, and more likely to experience serious complications in pregnancy, like preeclampsia or even in pregnancy. Given the alarming maternal mortality in the United States and the extreme safety of abortion, it is always safer to have an abortion than to be pregnant. Whether we can count on maternal mortality reporting going forward is an entirely different matter.

Those with wanted pregnancies will also suffer. There will be no state to fly to for someone with a viable pregnancy with a serious complication that is best treated with abortion (although it’s important to acknowledge that many women are too sick to leave for care or can’t afford it). I have personally saved lives doing abortions for women with infections or catastrophic bleeding but who still have fetal cardiac activity. We are already seeing the consequences at the state level, so we don’t need to imagine what it will be like; we know. In Texas, at least three women, and in Georgia, at least two have died because they were denied appropriate care for miscarriage/pregnancy complications.

People sometimes wonder why doctors can’t just do the abortion and risk the consequences. When someone is sick, we need an anesthesiologist, an OR nurse, and an OR tech just to do the procedure. There are also recovery room nurses, ICU nurses, lab technicians, central supply, and scheduling. Even if everyone involved with the care was pro-choice and willing to look the other way, what if a forced birther hears about it? It isn’t a stretch that reporting a suspected abortion will become an executive order; after all, federal workers have been told they need to report on suspected DEI programs or hires or risk “adverse consequences.” Regardless, if abortion is illegal, most hospital administrators wouldn’t allow the procedure. It isn’t a stretch that Medicaid or Medicare funds could be withheld from hospitals suspected of doing abortions. And yeah, I said suspected because that creates the most chaos and will lead to more delays. How many people will need to look at an ultrasound to confirm a fetus has no cardiac activity before we will even be able to treat people who are bleeding or have an infection and have a missed abortion or a fetal demise?

With personhood, we can count on the federal government to criminally prosecute anyone involved. The state of Louisiana has just charged Dr. Margaret Carpenter and her practice, Nightingale Medical, with criminal abortion by means of abortion-inducting drugs. This is the first time a doctor has been charged with a felony for providing medication abortion. New York has a shield law, which protects Dr. Carpenter, but if abortion becomes illegal on a federal level, then a state shield law will offer no protection. If the shield law is challenged and goes to the Supreme Court, it could be over turned. If Louisiana is willing to file criminal charges for abortion, so will a Project 2025 run “Justice” Department. Medical malpractice doesn’t cover criminal litigation, so doctors and anyone working for the practice will go bankrupt defending themselves. Whether they would even get a fair trial is an entirely different matter.

Criminalization of Pregnancy Complications and Substance Use During Pregnancy

If someone shows up in the emergency room bleeding heavily with a miscarriage and isn’t “sad enough” or is vaguely ambivalent about being pregnant, they could be reported for a suspected home abortion. In the year after Roe fell, more than 200 women were prosecuted after pregnancy loss, abortion, or birth in the United States. This is where personhood hits another layer of hell. In 2019, Lauren Smith delivered her baby Audrey in South Carolina. Lauren used cannabis during pregnancy to treat nausea, and she and her baby tested positive at delivery, despite the hospital not having permission to do the tests. Her baby was apprehended by the state and six months later Audrey was arrested and charged with felony child neglect. When PBS reported on her case in late 2024 she had been waiting five years for her trial and faces up to 10 years in prison. Her daughter has been living with her grandmother (yes, she has not has custody of her baby for five years). She has struggled to find work because she can’t pass a background check.

Delayed Cancer Care During a Wanted Pregnancy.

When pregnancy loss is criminalized, that means chemotherapy and radiation, both therapies that can harm a developing fetus, will almost certainly halt. This isn't me being an abortion hysteric; this is already happening in states where abortion is illegal. Cancer affects about 1 in 1000 pregnancies, and every month that cancer therapy is delayed, the risk of dying increases by 13%.

Inability to Access or Restricted Access to Misoprostol

When there is severe bleeding after a delivery, we often use the drug misoprostol, which can also be used for medication abortions. Imagine a world where it’s locked up like opioids because the law requires it or because hospitals can’t risk it being stolen, and instead of the medication being available in about 30 seconds on a hemorrhage cart, it could take 7 or 8 minutes, or more, and a lot of badness can happen in a few minutes with uncontrolled bleeding from a uterus. This isn’t some far-fetched idea, because Louisiana passed a law in 2024 reclassifying misoprostol as a dangerous controlled substance and now hospitals are locking it up.

Or perhaps someone has an incomplete abortion of a wanted pregnancy, and has been prescribed misoprostol to complete the abortion. Pharmacies may refuse to dispense it, because how do they know it’s not for an abortion? They don’t want to hassle of being reported. This happened in 2022 after Roe fell, but the Federal Government stepped in and reminded pharmacies they were in danger of violating civil rights. The Trump/2025 administration is not concerned about your civil rights. The consequences here are more women will need surgical procedures for an incomplete abortion or will just suffer with far more protracted duration of bleeding, increasing their risk of complications.

Protecting the Potential Incubator from “Harmful” Medications

Perhaps you are 46 years old woman with rheumatoid arthritis and have been prescribed methotrexate, which has previously been used for medical abortions but is no longer in use for that reason. You don't care because this medication treats your rheumatoid arthritis, and you are a grown-ass woman who knows how not to get pregnant. Heck, maybe you don’t have sex with men. After Roe fell there were reports of pharmacies refusing to fill methotrexate, and it’s not a stretch to think this could be extended to any *potentially* embryotoxic medication. After all, you could just be a crafty woman who is deep in a multi-year elaborate ruse to convince your doctor that you have an autoimmune condition so you can be prescribed an embryotoxic medication for a clandestine medical abortion that you may one day need (and yes, this is how they think women think).

Say Goodbye to Birth Control

This may take some time, but then again given the shit show, who knows? Team Project 2025 have stated they have contraception in their crosshairs, and one lesson from these past two weeks that felt like two years is that we should take them at their word. It’s only a matter of time before the administration trots out the lie that birth control pills and IUDs can prevent a fertilized embryo from attaching. No evidence supports that this effect exists, but the truth didn't work the last time contraception was in front of the Supreme Court, which ruled that believing a medication was an abortifacient was proof enough of the claim. If anyone is counting on a hormonal IUD or a birth control pill to manage their heavy bleeding, hot flashes, or PMDD symptoms in menopause, too bad!

Say Goodbye to hormonal IUDs for Menopause

But wait, if I can’t get pregnant, why would they care? It is highly likely that the manufacturers who make these products will not want to continue selling them in the United States if they are reclassified as abortifacients. One, because the market for their use will be so low, and two, they don’t want to risk litigation if someone uses an IUD for contraception.

Women’s Health Research and Medical Care Will Be Devastated.

The NIH Office of Women’s Research is largely offline, so that’s not exactly a good sign.

New drugs may have unknown embryotoxic effects, so women may not be eligible for clinical trials, which could limit our knowledge about medications and our ability to treat countless medical conditions. Why would a pharmaceutical company want to include women in a study if they could get pregnant while taking their new medication and had a miscarriage? Whether it’s due to the new medication or not would likely be immaterial. In this situation, if a new drug gets approved, we will know less about its effects on women or it may not even be approved for women. If a drug isn’t FDA-approved for women, good luck getting the holy trifecta of a doctor to prescribe it, a pharmacist to dispense it, and an insurance company to pay for it.

Being an Women’s Health Cassandra

In Greek mythology, Cassandra was fated to give true prophecies that were never believed. I feel this in my bones.

Perhaps you are thinking, Jen, you are way too apocalyptic here. I’ve been been warning people since 1998 that women would die if abortions were banned and we were left to navigate a useless “life of the mother exemption,” and yet here we are. In 1998, I was in the position of pleading with a state legislator who knew fuck all about pregnancy or abortion in order to get permission to do a “life of the mother” abortion.

When Savita Halappanavar died in 2012 because she needed an abortion that she couldn’t get, I kept reminding people it could happen here. I’ve done plenty of abortions for people with serious infections, and her death was preventable.

I’ve been writing about abortion since I started blogging and even wrote about my 1998 experience in the New York Times in 2019 (gift link). At that time it never occurred to me that I could have been arrested because I had received his “permission” to help my patient. If that same scenario were to happen today, his assurances would not be enough.

We’re squarely in “the cruelty is the point” territory, and it’s all be sadly predictable.

What Can We Do Now?

Chaos is the goal and you can’t possible focus on every awful thing. Pick one or two issues and try to get as informed as possible and keep talking about them. For example, the environment, health care, gender equality, and immigration. I will do my best to keep you updated on health care, especially as it pertains to women.

The impact of propaganda is real, and not everyone in your circle may be as informed as you, so give them a good place to turn. The truth matters, commit to spreading it.

If you are still on Twitter (I’m not calling it by it’s stupid name), get off. You are only helping Musk, who is an agent of chaos. Stop posting there! It’s a dead site anyway.

Block people on social media who are willfully spreading disinformation.

If you use a period app and if you were pregnant and would want an abortion, understand with that in may cases your data can be used against you. Here is some information to consider about privacy (from Consumer Reports). If people are interested in hearing more about this, I can put up a post.

Harass your Senators and Representatives.

Protect people who need protection.