‘We just have to keep fighting’: a shocking new film on the danger of US abortion laws

In August 2022, Amanda and Josh Zurawski were 18 weeks into a much-wanted pregnancy with their first child when her water broke early. The complication ended her chances of delivering a healthy baby and imperiled her health – but doctors in Austin, where the couple live, said they could not end her pregnancy under Texas law, because they could still detect fetal cardiac activity.

In the wake of the supreme court’s decision in Dobbs v Jackson Women’s Health Organization in June 2022, which reversed half a century of precedent and overturned Roe v Wade, the Texas legislature, like those in 13 other states, passed a near-total abortion ban. Though the ban allowed for medical exceptions, doctors have said that the law – written by politicians, not medical professionals – is so vaguely worded, and the criminal penalties so severe (up to 99 years in prison for violating state abortion law), that it was unworkable in practice, blocking doctors from helping patients.

So Zurawski, against her wishes and the common standard of care, remained pregnant, knowing her daughter stood no chance of survival, as she grew sicker and sicker. As she testified to the state in a lawsuit that bears her name – the first post-Roe v Wade to be filed by women who said that their health, lives or fertility had been endangered by abortion bans, and the subject of a new documentary executive produced by Hillary and Chelsea Clinton and Jennifer Lawrence – she listened to the cardiac activity with a terrible mix of love, for the child she and Josh desperately wanted, and dread, for her deteriorating health. Doctors eventually performed an emergency induction abortion – but only after she developed sepsis and nearly died. The infection kept her in the ICU for days and cost her one of her fallopian tubes, permanently compromising her future ability to have children.

Aided by the Center for Reproductive Rights, Zurawski sued the state of Texas, looking for clarity in the law as written, and responsibility for a policy that has led to a 13% increase in infant deaths, forced doctors to provide substandard care and inflicted incalculable trauma on women seeking basic healthcare.

“Somebody had to file the first suit,” Zurawski says in the film named after her lawsuit, Zurawski v Texas, released just before a pivotal election in which reproductive rights across the country are on the line.

“What we’re asking for in this lawsuit is the bare minimum human decency requires,” says Molly Duane, the Center’s leading attorney for the suit, in the film. “People are going to die. And the question is, does anyone in the state of Texas in a position of power actually care?”

The film, directed by Texas-bred film-makers Abbie Perrault and Maisie Crow, captures with journalistic clarity the chaos, uncertainty and unnecessary pain and suffering that ensues when a state bans abortion – what happens in court, in hospitals, and in the private aftermath. It is one particular slice of post-Roe America – life-saving or simply dignifying healthcare denied, because of legal uncertainty, to women who wanted to be pregnant in the first place.

“It’s like we’re in triage mode,” Crow told the Guardian. “If someone has to go septic before they can get an abortion, that means that for everyone else who needs abortion for all the reasons that women seek abortion care, they are not getting that care either. We really felt like we needed to highlight the most dire situation that was unfolding in front of us to emphasize the fact that if the women in this lawsuit aren’t getting care, then no one else is.”

And the situation, as the film-makers found, was dire. As soon as Zurawski filed her suit, dozens of women, along with their partners and families, reached out with similarly harrowing stories. In a collage of voicemails played during the film, others share similar experiences: an ectopic pregnancy denied care until her fallopian tube ruptured, another inviable pregnancy carried to term. Share my story, tell people what is happening. “The state absolutely wants to sweep their experiences under the rug,” says Duane. “They just want to pretend like real people don’t exist at all.”

Zurawski v Texas follows three of the eventual 22 plaintiffs, who provided in-person testimony on their abortion stories, something that was happening in court for the first time since the 1970s. Samantha Casiano, who lived in East Texas with her partner and their children, learned at her 20-week scan that her daughter, Halo, would be born without most of her brain – a defect called anencephaly that was incompatible with life. Unable to afford travel out of state for an abortion, she was forced to carry the pregnancy to term while planning for her daughter’s funeral, then watch as Halo gasped for air for four hours after birth. Dr Austin Dennard, an OB-GYN based in Dallas, also learned her long-awaited third child had anencephaly, and had to travel out of state for the medical care she used to be able to provide her patients in her home community. “Having these laws cripple our ability to provide care – it feels like a slap in the face,” she says. Zurawski, traumatized by her medical experience, resorts to surrogacy in another state.

The film is part behind the scenes of their court hearing – nerves, fury, pride, inexpressible pain (Casiano, recounting Halo’s short life after birth, vomited on the stand) – and part documentation of trauma, healing and action. “We didn’t want to politicize it, because this is a healthcare issue that’s been politicized, but it should be a nonpartisan issue,” said Perrault. “We really just wanted to present what’s happening to people under these laws and let the audience take that in on a very human, intimate, personal level from each of these women.”

For the participants – Zurawski, Dennard, Casiano, along with their partners and families – “the horror of what they had to experience and the impact of that on their families and their own reproductive journeys was evident throughout the film-making process,” said Crow. “But we also were just incredibly in awe of their bravery and their willingness to stand up for women across the country in filing this lawsuit and taking the stand to share their testimony.”

The state, ultimately, did not listen to them. On 31 May, the Texas supreme court unanimously rejected the women’s legal challenge, declaring that the state abortion ban could stand as is, without clarifying when medically necessary abortions can be performed. The decision barely mentioned the women. “To know that people in the position of power feel that pregnant individuals should simply be vessels,” says Dennard in the film. “We just have to keep fighting, and we have to keep talking about it, and we have to keep telling our stories, without fear.” The film will be released directly for home viewing to do just that, as an explicitly urgent call to understand the stakes of abortion bans that many who do not experience them first hand do not understand. “Twenty-five million women in America live under bans like this,” said Perrault. “It’s not only these women, it’s also their partners and their children and their parents. Understanding that this issue could affect you in your lifetime is so key.”

The landscape for reproductive rights captured in Zurawski v Texas is staggeringly bleak, even as similar lawsuits in other four other states with near-total abortion bans, including Idaho and Tennessee, remain in legal limbo. But Duane, along with Perrault and Crow, see power in what they witnessed with the lawsuit: people – such as Zurawski’s conservative family members – changing their minds and their votes through hearing the women’s experiences.

“What we’re seeing now that we didn’t see pre-Dobbs is that families are talking about this,” said Crow. “It’s going to take a lot of time before abortion is accessible again. But in a pre-Dobbs era, abortion was not accessible to so many people who needed it to begin with. If there is a restructuring of how abortion becomes more accessible, I think that that’s something to be hopeful towards.”