When Roe. v. Wade was overturned in June 2022, the impact was immediate. In the wake of the decision, at least 16 states have ceased nearly all abortion services.
Women across the country who live in states with abortion restrictions are now forced to travel for abortion care, carry nonviable pregnancies to term or wait until they were sick enough to receive care.
In a monthslong investigation, 18 women from across 10 states shared their deeply personal stories, chronicling their heartbreaking journeys and how, in some cases, they were brought to the brink of death because they couldn't access timely care in their home states.
The women appeared in a companion broadcast, "Impact by Nightline: On the Brink," with exclusive interviews by Diane Sawyer and Rachel Scott, which looks at the hidden health care crisis playing out in clinics and exam rooms across the country. So many families posing the question: is this what lawmakers intended? "On the Brink" premieres Dec. 14 on Hulu.
These are their stories.
JENNIFER ADKINS IDAHO
Jennifer Adkins, a 31-year-old mother living in Idaho, was excited to find out she was pregnant again and began affectionately calling her baby "Spooky" after finding out that her due date was Halloween.
But at a routine 12-week ultrasound appointment, she found out her baby had a slim chance of survival and that continuing her pregnancy could put her health, or even life, in danger.
Adkins' doctors told her the scan revealed the fetus had excess fluid and skin edema -- signs of cystic hygroma -- and that her fetus likely had Turner syndrome -- a rare condition that results from one of the X chromosomes missing. Adkins' doctor told her the fetus would not survive and she was surprised Adkins hadn't miscarried already.
Adkins also was told that there was a high likelihood that she would develop Mirror syndrome, a condition where the pregnant person develops fluid buildup and can develop preeclampsia, which can result in stroke or death.
Adkins was told that if the laws in Idaho were different, she would have just been referred to an abortion clinic. But because Roe had been overturned and Idaho's near-total abortion ban was in effect, they were afraid to refer her to any clinic, even one out of state.
With financial help from family, friends and two abortion funds, Adkins was able to finance a trip to Oregon for an abortion.
Adkins is now the lead plaintiff in an ongoing lawsuit brought by the Center for Reproductive Rights against the state of Idaho over the ban.
JESSICA BERNARDO TEXAS
Jessica Bernardo and her husband spent years trying to conceive — going through extensive testing and a medical procedure to improve their chances of becoming pregnant — and were ecstatic when she got pregnant with a daughter, who she called Emma, in July 2022.
Fourteen weeks into the pregnancy, test results revealed her fetus likely had Down syndrome, but Bernardo and her husband agreed that they would love their baby no matter what. Bernardo's physician referred her to a specialist and advised her to make an appointment as soon as possible.
At the appointment, a scan revealed that the fetus had a rare, fatal disorder called fetal anasarca, which causes fluid to build up in the body. The fetus also had heart failure and kidney failure.
Bernardo's doctor warned her to watch out for high blood pressure and coughing, symptoms of Mirror syndrome, another rare condition where a mother develops similar fluid buildup to the fetus. Even though Bernardo's blood pressure numbers were climbing and she had already developed a cough, her doctor did not mention an abortion.
Bernardo later did her own research on Mirror syndrome, and learned that it could be fatal for the mother and fetus. She then called her OB-GYN to follow up and said she did not want to wait for her baby's heart to stop on its own and said she was worried about her health deteriorating. She wanted to grieve and get pregnant again.
"I was really terrified, and my husband was terrified to lose me after we already found out that we would lose our daughter," Bernardo said.
"It just felt like a dystopian nightmare that we needed to get out of the state and get the care that I needed as soon as I could," Bernardo said.
But, due to Texas' multiple abortion bans, she said she was denied an abortion. Bernardo spent $7,000 traveling to Seattle for an abortion a week later.
KIERSTEN HOGAN TEXAS
Kiersten Hogan was excited to learn that she was pregnant, despite being diagnosed with polycystic ovary syndrome, which can increase the risk of pregnancy complications, and having a history of miscarriages.
At 20 weeks of pregnancy, Hogan's water broke and she rushed to a hospital in Texas — just weeks after a Texas law prohibiting abortion care after cardiac activity can be detected — had gone into effect.
Despite the loss of her amniotic fluid, Kiersten says doctors seemed confused about the law and did not offer her a termination. She says she was not told that the pregnancy was likely not viable.
"I was told that if I tried to discharge myself or seek care elsewhere that I could be arrested for trying to kill my child. I [had] wanted this baby, so, of course I stayed," Hogan said.
Women in Texas cannot be prosecuted for seeking abortion care for themselves, according to Texas laws.
After four days in the hospital, Hogan delivered her son stillborn. Hogan said she wouldn't feel safe getting pregnant again in Texas.
"I wouldn't wish it on my worst enemy," Hogan said in October. "It was taking a tragedy and turning it into trauma.
Hogan said her sister was pregnant at the same time as she was and suffered a miscarriage.
"Her scenario was very different than mine being that she lived in California," Hogan said. "She didn't know how to be there for me because she didn't understand what I was going through, and I didn't know how to be there for her because of what I was going through."
Hogan's allegations about her case are part of a lawsuit against the state of Texas over its abortion bans.
LAUREN MILLER TEXAS
Lauren Miller, already mother to a 1-year-old son, was excited to learn she was pregnant again in July 2022.
Before her first scheduled prenatal visit, Miller began experiencing horrible nausea and vomiting, at one point even going to the emergency room for dehydration after 36 hours of vomiting.
At the emergency room she learned that she was pregnant with twins. She was also diagnosed with hyperemesis gravidarum, a form of severe persistent nausea that can last throughout pregnancy, and she began treatment.
At her 12-week ultrasound appointment, Miller learned that one of her babies — referred to as Baby B because of its proximity to her cervix — was not growing as fast as the other and she provided a blood sample for testing to screen for some fetal conditions.
A week later, she learned that Baby B had two fluid-filled sacs on its brain. Several days later, test results returned indicating that Baby B likely had the genetic condition trisomy 18, which is described as incompatible with life.
After getting more tests and meeting with a genetic counselor and a maternal-fetal medicine specialist, Miller learned that Baby B had multiple fetal structural abnormalities — including fluid where much of the brain should have been developing, an abnormal heart, and an incomplete abdomen.
She was told Baby B would likely not survive to birth and her Maternal Fetal Medicine specialist suggested she travel out of state for abortion care because she was at risk of dangerous complications and pre-term birth.
Texas law prohibited the termination of the nonviable twin, which doctors said was needed to protect the healthy fetus.
Miller had to travel to Colorado to get a selective fetal reduction of the nonviable fetus.
She has since given birth to her son, Henry, the surviving twin.
KRISTEN ANAYA TEXAS
After 10 months of fertility tests, procedures, surgeries, medication, shots, blood draws, ultrasounds and two egg retrievals, Kristen Anaya and her husband were elated to be pregnant.
When her water broke at four months pregnant, the couple rushed to the hospital. An ultrasound confirmed that Anaya had lost nearly all her amniotic fluid, making it virtually impossible for the fetus to survive. Heartbroken and in shock, the couple kept asking doctors if there was anything they could do to save their baby — who they named Tylee — but there was nothing to be done.
To make matters worse, because the fetus' heart was still beating, doctors could not induce labor to protect Anaya from infection because of Texas' abortion ban. Anaya says her doctors needed to be able to prove that Anaya's life was at risk before intervening.
Anaya developed sepsis and waited in the hospital for over 22 hours before she was sick enough so that the hospital's advisory board would allow doctors to give her a life-saving abortion. During that time, Anaya spiked a high fever, was shaking uncontrollably for hours and vomited at least eight times, all while taking blood tests every three hours.
She has since required multiple procedures to clear her uterus.
KRISTINA CRUICKSHANK TEXAS
Kristina Cruickshank was 12 weeks pregnant with her first child when she went to the emergency room, experiencing abdominal pain and heavy bleeding.
She was 15-weeks pregnant when she received a diagnosis: she had a partial molar pregnancy — a rare condition in which one egg is fertilized by two sperm. Her pregnancy would never develop into a fetus.
Left untreated, partial molar pregnancies can become cancerous. The treatment is an immediate abortion.
Cruickshank was getting sicker by the day: she developed an overactive thyroid, which affects hormone levels in the body, could barely walk due to severe abdominal pain, had enlarged ovaries and developed cysts around both ovaries.
When a second doctor saw how sick Cruickshank had become, he admitted her to the hospital immediately.
Still, she sat in the hospital for three days in pain while they tried to find a hospital that could perform the kind of abortion procedure she needed and convene a committee to approve an abortion. Hospitals in states with abortion bans often have committees of physicians and lawyers that need to approve care due to the bans, which threaten doctors' medical licenses and, in some cases, prosecution of doctors. Texas had already started to implement a near total abortion ban before Roe v. Wade was overturned.
Cruickshank now has regular checkups to check for evidence of cancer.
BLAIR NELSON TEXAS
Blair Nelson and her husband started trying to conceive in 2018 after getting married. Since then, Nelson has undergone five rounds of in vitro fertilization, seven embryo transfers, multiple surgeries and had an early miscarriage.
But Nelson says it was all worth it -- she got pregnant and gave birth to her daughter in May 2021 on her fifth embryo transfer.
The couple was excited when Nelson got pregnant again on her sixth embryo transfer. But, at a routine 12-week appointment, they received heartbreaking news — the fetus had limb body defect, a rare anomaly that can cause defects in the belly, limbs and some organs.
Nelson said all of the fetus' organs were growing outside of his body, including the heart.
But Texas' multiple bans prohibit nearly all abortions, with no exceptions for cases of fatal fetal anomalies, and Nelson wasn't able to get care in her state.
Nelson traveled to Colorado for care, but during her procedure she began bleeding and doctors suspected she had a placenta accreta — a potentially deadly complication in which the placenta passes through the lining of the uterus and can attach to the mother's organs.
Nelson's OB-GYN Dr. John Thoppil later said that the placenta accreta likely developed in the month-long delay it took for Nelson to find care out of state. He says if she had been able to have a termination upon diagnosis at 12 weeks, this complication would not have happened.
At the hospital she had to choose between removing her uterus through a hysterectomy or a uterine artery embolism — in which doctors put particles into the main blood source for the uterus in hopes that it triggers clotting and stops her bleeding. She chose the UAB and the procedure worked, but doctors say future pregnancies are at a high risk for complications.
The couple plans to have another embryo transfer in February 2024.
Elizabeth Weller TEXAS
Elizabeth Weller and her husband were excited when she got pregnant in the beginning of 2022.
When her water broke at 19 weeks of pregnancy, she rushed to the emergency room where she was also diagnosed with PPROM. When Weller felt she was not getting enough information about her health, she called her OB-GYN, who explained that the baby was not viable at 19 weeks and had no chance of survival.
Weller's physician requested an abortion from the hospital's medical board, but she was denied because Weller wasn't sick enough yet. She had been started on antibiotics and her vitals were stable. And her fetus still had a heartbeat.
A nurse told Weller she had to wait until she was showing signs of a worsening infection before she could be approved for the termination of her pregnancy, telling her the symptoms of a serious infection would include vaginal discharge that released a strong odor.
"It has to be so strong that you can smell it in a room and wretch, that's what they said; that's what they were looking for," Weller said. "When I took that sample, I smelled it and almost threw up and went, 'Oh there it is, that's the key to me saving my life,'" Weller said.
She was diagnosed with chorioamnionitis, an infection of the amniotic fluid and tissue surrounding the fetus. A medical board approved her abortion.
NANCY DAVIS LOUISIANA
Ten weeks into her pregnancy, Nancy Davis was told her baby had a rare, fatal abnormality called acrania — in which the fetus does not have a skull.
Davis' doctors encouraged her to terminate the pregnancy, but after she agreed they said they would not be able to help her in Louisiana because there was still fetal cardiac activity.
"They said I had to carry my baby to bury my baby," Davis said at a press conference in August 2022.
Davis had to carry her baby for another six weeks before she was able to fly to New York and get abortion care.
Although Louisiana's abortion ban had exceptions for "medically futile" pregnancies that cannot survive outside the womb, the hospital where Davis sought care still denied her request for an abortion. In addition, Davis was also told that the procedure was not covered by Medicaid in Louisiana and would cost thousands of dollars.
When she first received the diagnosis at 10 weeks of pregnancy, medication abortion, which is less costly than an in-clinic procedure, was still an option, but it was no longer an option six weeks later when she was able to access care. She had to undergo a two-day procedure.
After Davis shared her story publicly, she raised nearly $40,000 on her GoFundMe campaign to fund her travel and abortion costs. Acrania has also since been added to the list of exceptions to Louisiana's abortion ban.
KELLY SHANNON ALABAMA
Kelly Shannon and her husband were excited when she found out she was pregnant last year. The couple, already parents to a daughter under the age of 2, had been actively trying for a second child.
Shannon asked for genetic testing, wanting to tell their family the baby's gender at Christmas, but the couple's excitement quickly turned to heartbreak.
Genetic testing revealed there was a likelihood her baby had Down syndrome. Upon further testing, the fetus was diagnosed with multiple life-limiting genetic anomalies and would likely not survive birth — scans showed evidence of swelling in the fetus' head and body wall, a heart defect and a tumor on the fetus' abdomen that was about one-third the size of the fetus baby and growing.
Shannon was told that the chances of the baby's survival were "negligible."
When Shannon and her husband decided to pursue a termination, she needed to fill out paperwork and get approvals from two hospital committees. While the first of the two committees approved her abortion, the higher-level committee denied her request, according to Shannon.
Shannon had to drive to Richmond, Virginia, to receive abortion care. It cost her thousands of dollars. After ABC News published a story about Shannon in May, an anonymous donor called the hospital and paid her remaining medical bills.
The couple still plans on growing their family and Shannon is now pregnant again.
JILL HARTLE SOUTH CAROLINA
Jill Hartle and her husband, Matt, learned that their baby had a birth defect called hypoplastic left heart syndrome — resulting in multiple severe, heart anomalies.
But in South Carolina, Hartle was told that her case was "too nuanced" and she was denied care.
"There is a fetal anomaly exemption in [South Carolina's abortion] law, but that fetal exemption does not cover any nuanced fetal anomalies, which is very frustrating," Hartle said.
Hartle and her husband had to travel to Washington, D.C., to get abortion care. But Hartle had to wait 49 days to get the care that she said she deserved to get in her home state, with clinics around the country overwhelmed with patients traveling for care.
Hartle had an abortion that involved a full induction of labor and delivery.
Hartle has since been outspoken in her state and has spoken with lawmakers about how health care is impacted by abortion bans, with doctors unclear what cases would qualify for abortions under exceptions.
"Every single fetal anomaly is different in their own unique way, and it is hard to put a blanket statement over something that is so specifically nuanced to every case," Hartle said.
Hartle told ABC News she is "working to correct" the fetal anomaly exemption in her state's abortion ban, "specifically to help other women so that they are taken care of at home, surrounded by family."
"That's a luxury that we were not provided with," Hartle said.
ALYSSA GONZALES ALABAMA
At 16 weeks pregnant, Alyssa Gonzales learned that her son had the genetic condition trisomy 18 and likely fatal anomalies. He had two holes in his heart, no nose bone and his brain had not developed. Doctors told Gonzales that he would be stillborn, would die soon after he was born or would not live to his first birthday.
Alabama's trigger law prohibiting nearly all abortions had gone into effect, after Roe was overturned. While there is an exception for conditions from which an unborn child would be stillborn, die after birth or die shortly after, Gonzales said the doctors still denied her care.
But Gonzales and her husband couldn't afford to go out of state.
"There are great organizations out there that allowed us to financially pursue this unfortunate tragedy," Gonzales' husband, Clay, said.
"We drove about 12 to 15 hours from Valley Head to Washington [D.C.] just so that way I could have a procedure. And the clinic there was filled to the brim," Gonzales said.
"Think of a can of sardines, that is how full it was," Gonzales said.
Gonzales, already a mother of one, was so traumatized by losing her child and her care that she tells ABC she chose surgical sterilization.
"I think back to what happened and I wouldn't ever want to go through this again and I wouldn't wish this on my worst enemy," Gonzalez said.
ANYA COOK FLORIDA
Anya Cook and her husband were elated when they found out that she was pregnant through IVF. After having had 17 miscarriages, this was the farthest along she had gotten in a pregnancy. Cook and her husband had started nicknaming their daughter Bunny.
After having dinner, Cook and her husband were in the parking lot of a restaurant when she felt a gush of fluid come out of her. She reached out to one of her friends who was a labor and delivery nurse, and her friend told her to head to the hospital right away. She was only 16 weeks pregnant.
The couple made a 5-minute drive to the hospital, where she normally received care. After being wheeled in, Cook sat in the waiting room for 45 minutes, gushing fluid onto the floor.
Cook had suffered a preterm premature rupture of membranes, when water breaks and amniotic fluid is lost before the fetus is viable.
Cook said that the doctor told her she would deliver in 12 to 24 hours and that she was at risk of hemorrhaging or getting an infection.
But, the doctor discharged her from the emergency room - her life was not yet at risk. In a state without an abortion ban, Anya would have been offered an immediate termination to protect her health. But in Florida, she was given antibiotics and sent home, told to return immediately if her symptoms worsened.
The next morning, Cook kept a previously scheduled hair appointment, saying she did not want her mother to worry about her hair if she died. Cook delivered the fetus alone in the bathroom of a hair salon, hearing her daughter hit the toilet. She did not deliver the placenta and could feel the umbilical cord still attached to her.
In the process, she lost a life-threatening amount of blood. She became critically ill, was put on a ventilator due to blood loss and was in the hospital for six days. She's had one follow-up procedure to remove placenta from her uterus; she needed another operation in order to potentially have children again.
ANABELY LOPES FLORIDA
Anabely Lopes was 15-weeks pregnant when she received the devastating news that the fetus had trisomy 18, which is described as incompatible with life.
But Florida's 15-week ban had already gone into effect. Despite the ban having exceptions for fatal fetal abnormalities, Lopes said she was unable to get care in her state.
A clinic in Florida tried for three days, but was unable to get Lopes care. The clinic helped her find an out-of-state facility to offer treatment.
Surrounded by states with strict bans that have stopped nearly all abortions, Lopes had to travel nearly 1,000 miles from Miami, Florida, to Washington, D.C., to get care.
She said the flight was a "nightmare," with everyone asking her about her visible pregnancy.
CHLOE PARTRIDGE ARIZONA
Chloe Partridge was excited when she found out she was pregnant with her second child.
But at 23 weeks, Partridge learned that her fetus had holoprosencephaly, a fatal anomaly in which the fetus' brain does not develop as it should — failing to divide into two hemispheres.
Heartbroken, Partridge said she didn't want her baby to suffer or be in pain and she scheduled a termination in June 2022. But when Roe v. Wade was overturned days before her scheduled care, the abortion was canceled.
Partridge scheduled another termination appointment at a clinic in Colorado. But after posting her story on social media, her story went viral and threats were being made against her life and clinic staff so her appointment was canceled.
Partridge had to carry her pregnancy to term. She gave birth to her baby — who she named Lela Grace — and watched her die 44 hours after she was born.
Partridge said those two days were "horrible" and she felt there was nothing she could do to protect her baby but give her pain medicine.
ALLIE PHILLIPS TENNESSEE
Allie Phillips' baby was diagnosed with multiple lethal anomalies, but Tennessee doesn't have exceptions for fatal fetal anomalies. Phillips and her husband spent days looking for a place where she could get an affordable termination.
She finally found a clinic in New York that could take her. By the time she got there, her situation was far more dire — her fetus had died inside her.
After getting tests and routine bloodwork at the clinic, Phillips had an ultrasound — only to discover that the fetus no longer had a heartbeat and was not moving.
"The doctor told me that because we don't know when my daughter passed, there is about a two-week window when you carry a deceased fetus when your body doesn't recognize it when you are at risk for blood clots, infections or going septic," Phillips said.
"He's like, 'Since it has been a week and three days you are very close to that window. We need to do this now,'" Phillips said her doctor told her.
She had her abortion within an hour of finding out her baby had died.
Phillips said she fell into a deep depression when she returned home and didn't leave her room for two weeks.
Phillips announced that she is running for the Tennessee House of Representatives.
CHELSEA STOVALL ARKANSAS
Already parents of two, Chelsea Stovall and her husband were excited to learn that she was pregnant.
But, when she was 20 weeks pregnant, Stovall found out that her fetus had multiple anomalies — the fetus was abnormally small, growing without a chest cavity and organs that were wrapped around her heart.
But Arkansas' near-total abortion ban only makes exceptions to save the life of the mother. Devastated, Stovall and her husband had to do their own research to find a clinic where she could get a termination.
The couple, surrounded by states with bans that have ceased nearly all abortions, drove 400 miles to Illinois to get a termination. Stovall said it cost them all their savings, more than $3,000, and her insurance would not cover the care.
Due to Illinois law, Stovall's husband couldn't be with her for the termination, which she said made her feel even more lonely. She also asked for her baby's remains after the procedure, but the clinic denied her request.
Stovall told ABC News in December that they do not plan to have more children because of their fear that this could happen again.
MEAGAN WISCONSIN
Meagan, who asked that her last name not be revealed due to privacy concerns, and her husband became pregnant for the first time earlier this year. At her 20-week ultrasound, they received devastating news.
"Their baby was extraordinarily small and unusually small in a way that wasn't just indicative of 'you have a small baby,' but something is very abnormal," Dr. Jordan Crow told ABC News.
More testing indicated that the fetus had a severe, life-limiting anomaly called skeletal dysplasia.
Meagan was also diagnosed with placenta previa, a rare condition in which the placenta covers the opening of the mother's cervix during pregnancy, putting her life in danger. It would be too high risk for her to deliver vaginally, because the baby would have to go through the placenta and Ross could experience severe bleeding, Crow said.
In July, when Meagan was still pregnant, Wisconsin's near-total abortion ban was in effect, only allowing the procedure for the life of the mother, and even then three doctors have to sign off on an abortion.
While doctors who Crow reached out to agreed with his assessment that Meagan's condition was a "clear risk to her life with a potential fatal diagnosis for her pregnancy," he was not able to convince colleagues to perform an abortion for her in Wisconsin.
Crow, Meagan and her husband had to research and make countless calls to find her care that would be covered by her insurance. She then had to travel to Minnesota to get a termination.
CREDITS:
Photographer: Brandon Thibodeaux
Video Producer: Jessie DiMartino, Erin Murtha, Katerina Rosen
Reporter: Nadine El-Bawab
Photo Editors: Gary Hershorn
Text Editor: Lion Calandra
Visual Content Director: Andrew VanWickler
Managing Editor - Video: Brian Canova
Managing Editor - News: Tom Liddy
Director - Digital Content: Paul Shin
Vice President - Digital Content: Lulu Chiang
Impact X Nightline Correspondents: Diane Sawyer, Rachel Scott
Impact X Nightline: On the Brink Executive Producer: Eman Varoqua
Senior Streaming Producer: Candace Smith Chekwa
Senior Producers: Tess Scott Davidson, Christina Ng, Karin WeinbergCoordinating Producers: Knez Walker
Producers: Acacia Nunes, Laura Coburn, Nadine El-Bawab
Senior Editorial Producer: Desiree Adib
Field Producers: Erin Murtha, Katerina Rosen, Jhasua Scicchitano