cover image Undue Burden: Life and Death Decisions in Post-Roe America

Undue Burden: Life and Death Decisions in Post-Roe America

Shefali Luthra. Doubleday, $29 (368p) ISBN 978-0-385-55008-6

Journalist Luthra debuts with an eye-opening and chilling look at the strain the U.S. reproductive healthcare system is undergoing in a “post-Roe” world. Tracking the circuitous, costly, and legally jeopardizing paths that patients seeking abortions who live in states that have imposed restrictions must take to access care across state lines, Luthra reveals that these cross-country journeys are having a “bottleneck” effect that is limiting healthcare access across America. The story of Angela, a 21-year-old San Antonio mother who can’t afford another child and makes an expensive trip to New Mexico for a dose of the abortifacient mifepristone, is juxtaposed with the plight of Jasper, a trans man who struggles to access abortion care because his local clinic in Orlando, Fla., has been overwhelmed by out-of-state patients. The healthcare providers themselves paint a dire portrait of a system in crisis (“It’s an unfolding national disaster,” says one). Luthra depicts them triaging patients (the staff at a Jacksonville, Fla., clinic routinely stays until midnight to help out-of-staters, but still has to limit services for locals), strategizing new ways of providing care (which include illegal mail-order mifepristone networks), and dealing with patients in mortal terror of jail time (one San Diego clinician describes patients anxiously discussing how best to hide where they’ve been from people back home). Luthra’s vivid and compassionate storytelling unveils an interconnected web of desperate individuals and heroic helpers who are only just barely within reach. It’s an urgent wake-up call. (May)

Correction: An earlier version of this review incorrectly stated that Jasper’s local clinic is in Jacksonville, Fla. The review has also been updated with changes made prior to the book’s publication.