Autumn/Winter, 2029
Hope Thomas walked briskly up a wide and shady El Paso boulevard lined with graceful houses recessed on ample and handsome properties. The twenty-one-year-old woman was anxious and alone. Hope was estranged from her parents. She would have liked to have brought a friend, but didn’t dare risk word leaking out about the serious problem her carelessness had caused.
Hope was on her way to a follow-up consultation at The El Paso Women’s Health Project, which was almost universally referred to as “The Project.” If Hope was pregnant—she was more or less certain she was—her carefully planned future would be imperiled. It was unexpected and scary. But she was strong, and her resolve that sunny morning set a tone that would serve her well through the trying months ahead.
Three or four high school classmates had used The Project’s services. Those occasions were accompanied by cruelty and its outward manifestations: rumors, giggles and ostracization. Hope always had compassion for the girls and didn’t join in the nastiness, but thought they had brought on their own problems. It was not a moral judgment. She felt they would have avoided a tremendous amount of trouble by simply being careful. Hope hadn’t imagined how easy it was to make the mistake until she made it herself.
Hope was a thin woman with short brown hair. Though not classically beautiful, her personality was so authentic and she was so comfortable with herself that looks mattered little. Hope was warm and empathic, though not afraid to be direct and confrontational if necessary. Even in such situations, people knew she was listening hard and the strong words were evidence of genuine concern.
The young woman arrived a few minutes early for what would be a difficult meeting. Those few moments—walking up the steps, identifying herself to the receptionist and sitting in the waiting room—would have been infinitely harder if she was aware of her vulnerability. Hope Thomas had a good chance of being the first woman charged with murder under recently promulgated Texas abortion laws. A conviction could lead to execution by lethal injection.
This dramatic endpoint was reached gradually. The state methodically enacted regulations that made performing abortions increasingly restrictive and difficult to comply with. The general atmosphere became ever more poisonous. The result was unrelenting pressure on practitioners and clinics to abandon the procedure.
Hope was only vaguely aware that choice was under siege because she had not been affected. She later reproached herself for ignoring something so important. Other people her age were as busy and ambivalent but still managed to pay attention.
Texas increased the pressure significantly in 2021. Senate Bill 8 allowed civil lawsuits against anyone involved in administering an abortion after a pregnancy passed six weeks. Suits could theoretically be filed against an Uber or Lyft driver who brought the woman to the clinic, not to mention people who actually performed the abortion. These “bounty” lawsuits, which could be brought by anyone, carried a fine of $10,000 plus court costs and attorney’s fees.
Things changed further later in the decade. The woman getting the abortion could be charged both civilly and criminally. The possible criminal penalties included execution.
The Project was the center of the resistance in west Texas. It was run by Dr. Ellen Hart, an MD and activist. She was the woman with whom Hope would meet. Besides counseling pregnant women,
Hart’s days were filled with filing lawsuits against Texas, lobbying state and federal legislators and generally advocating for less draconian rules and regulations.
Hart was a gynecologist and had performed abortions until two years earlier. At that point, it became clear that her outspoken stance and high profile made this impractical and even irresponsible.
She was under intense scrutiny and feared her relationship with her patients—or even their safety—could be compromised. Hart missed practicing medicine but felt fighting for women’s rights took precedence.
The Project’s offices were in a cedar-shingled Dutch colonial she inherited from her parents. The mortgage was long paid off, only one full-time employee was on the payroll and the organization offered women’s services other than reproductive care. This diversity and frugality meant that the end of choice would not shutter The Project or end Hart’s fight for women’s rights. But it would be difficult.
This was the chronically tense atmosphere into which Thomas walked that October morning. She sat in the waiting room for several minutes before being led into Hart’s large oak-paneled office, which had been her family’s dining room three decades earlier.
The receptionist pointed to an overstuffed chair facing Hart’s desk. The small young woman sat down. Hope’s size and glum expression made her look like a fifth grader in the principal’s office.
Hope had a strong sense of place and usually was inquisitive about her surroundings. On this day, however, she stared straight ahead until Hart entered the room. Instead of sitting behind her desk, the doctor motioned Hope to a small couch along the far wall.
The two sat down beneath a framed print of Before the Shot,” Norman Rockwell’s big-hearted painting of a boy studying his distracted doctor’s medical school diploma before getting an injection in his rear. It had hung there since decades earlier, when Hart’s parents had taught her about fairness, equality and justice and debated politics over long meals. The doctor considered it a good omen if she had important conversations beneath it. It felt as if her parents, Rockwell, the doctor and the boy were watching over her.
Hart studied Hope’s chart for a moment and then looked at her. “How are you feeling?” she asked.
“I’m okay,” Hope said without conviction. It was hard to hear her even though there was no ambient noise in the room.
“That’s good,” Hart said. She took Hope’s hands as she spoke. “The news is what you expected. The tests confirm that you are pregnant. Your home tests were not false positives. I know this isn’t what you wanted to hear and that this is a difficult moment, but it isn’t the end of the world. Trust me on that, Hope. It’s not the end of the world.”
Hope knew this would be the case, but hearing it “officially” in this setting still stunned her. Hart filled the silent Hope in on the need for proper nutrition, exercise, rest and behavior—no smoking, drinking or drugs, three things that she didn’t do—should she decide to continue the pregnancy. Hart urged Hope to eat more. “Every time you go to a restaurant, order something for you and something from the kid’s menu. I always liked ‘The Kangaroo,’ which was the mac and cheese,” she said with a small laugh.
That was the easy part. The hard part was educating Hope on the medical, political and legal battlefield that abortion was in Texas. Hart knew from their first meeting that Hope was intelligent but had only a superficial understanding of the ongoing fight.
Hope grew increasingly anxious as Hart described the situation. The doctor recited the recent history as even-handedly as she could. She did not mention the possibility of a death sentence for having an abortion. There would be time for that later.
It was left for Hope to ask the obvious question: “Why would anyone do all the things you describe?” she finally asked. “I mean, letting some poor Uber driver get sued? Making women have babies even if it puts them in danger? If they were raped? It makes no sense.”
Hart resisted the temptation to stray into politics and discuss what she felt was the disintegration of the once disciplined and principled conservative movement. In Hart’s view, it had devolved into a small core of good people with deeply held religious beliefs alongside a much larger clown car of shysters, opportunists, racists, cultists and misogynists. The focus needed to be on Hope’s plight, not her political analysis.
“There are lots of reasons, Hope, and none of them in my opinion are very good,” she said after a moment. “But let’s leave it at that. It’s a question for another day. The most important thing to think about right now is what you’ll do.”
Hart asked two questions to which she already knew the answers. “Do you have support at home? How would your parents react?”
“My parents would kill me,” Hope said with a cold chuckle. “They seem to have gotten very political. Weird politics. Besides that, they don’t like or trust the boy. I don’t either, actually. The funny thing is that that’s about the only thing we agree on. If they found out they would kick me out. They might beat the crap out of me first.” Hart noted that it was the only time Hope had come close to being animated during their two meetings.
“Do you have friends or relatives in other states that have not passed these types of laws who would help you?” Hart asked. “You’re actually lucky. New Mexico and Colorado are really good on this. And, of course, if you have money you can go anywhere.”
Hope thought for a moment. “I do have a high school friend who lives in Santa Fe,” she said. “Amy Aster. Amy and I were close once but fell out of touch when she moved. But it’s possible. I heard she’s still there.”
Hope felt the walls were closing in. The opportunity to fulfill her plans—college, law school and a big family—seemed to be evaporating. She was near tears, but managed to hold them back.
Hart, who would face her own challenges as a result of the meeting, paused for a moment. The doctor-turned-activist drew her face closer to Hope’s and spoke quietly, calmly and with a directness that made her words compelling.
“Hope, if you choose to get an abortion, the temptation will be to have the procedure done by the first person who comes along who promises you that everything will be okay. But they might not be qualified,” she said. “You do need to do it soon, but you have to find the right people. You will want to just get it done, to put all of this confusion and pain behind you. Don’t give in to that. First of all, it’s not true. It won’t be behind you. These people will try to punish you no matter what you do. You’re a pawn on the political chessboard to them. And pawns get sacrificed.”
Hope saw the passion in Hart’s eyes. It both frightened and reassured her.
“More importantly, this is a serious procedure. If it is done poorly you could get an infection. You could lose the ability to have children. You could bleed to death. It happens. One of the reasons the new laws are so destructive is they make those awful outcomes more likely for many women. You need to be as sure as you can that you are not dealing with a quack who only wants your money. There are a lot of those people out there.”
Hart paused to let that sink in. She continued a few seconds later in a more businesslike voice. “There are people in Texas who are performing abortions properly, despite the risks they are taking,” she said. “I am in contact with people here in west Texas doing it. If you decide to terminate your pregnancy, I suggest you have the procedure done by these people. I know they are good, have proper equipment and care about the women they treat.”
Hart continued talking as she walked to her desk. “If you go to New Mexico or somewhere else I won’t be able to advise you. I don’t know where to send you outside of this area. We purposely isolate ourselves so that if somebody from one group is arrested they can’t provide information on others. If you decide to have it here, call the number I’m going to give you and follow their instructions. You should leave the state as soon as you can after you have the procedure. The farther you get away from the Texas authorities, the better off you’ll be.”
Hart returned from her desk with a piece of paper and an envelope and handed them to Hope. A phone number was written on the paper. Hope noted that it was on plain paper that didn’t have the firm’s logo or contact information.
“We refer to these folks as ‘the helpers,’ which is corny but intentionally vague,” Hart said. “This number will only be good for a week.”
The envelope contained six fifty dollar bills. Hart explained that the procedure itself would be free if it was performed by the helpers. The money was to cover expenses.
“Hope, look at me,” Hart said. “You need to promise that you won’t use the money to get an abortion on the street. You need to take a sacred vow that whatever way you choose—in Texas or elsewhere—that you will only use qualified medical professionals. If you don’t, it means these evil people win. They hate you and they would win. Do you understand me? Do you promise you’ll do it right?”
Hope felt like a recruit to a military outfit being brought up to speed by a hardened vet who had seen lots of action. She nodded and managed to look Hart straight in the eye. This suggested to the doctor that she was serious, at least at that moment. Hart knew that regardless of how bright and committed a patient seemed, stress and fear often caused them to act impulsively. She used every tool to drive home the importance of not taking unnecessary risks.
Hart paused for a moment and smiled self-consciously. “Hope, this sounds like a movie, pretty cloak and dagger, but if anyone asks you, you don’t know me,” she said. “We never met. You weren’t here. Also, please burn the paper I gave you as soon as you decide. Burn. Don’t toss or shred. I wish things were different. I wish I could give you the care you need and deserve. But I can’t. The wrong people have gotten a lot of power. This is all I can do.”
Hope nodded and tried to say “thank you” but was only able to mouth the words. No sound came.
The doctor smiled. “My daughter is your age,” she said. “You could be her. Hope, if you decide to have the baby, God bless and good luck. If that’s the case, send the money back. No return address. But if you do choose to continue the pregnancy, I suggest very strongly that you try to mend fences with your parents. No matter what happens, this is a hard thing, physically and emotionally, even for a person with support. It’s doubly hard alone. I’m sure your parents love you. Try. Will you try?”
Hope gathered herself. “It would be nice,” she said with a weak smile. “But I don’t think that’s in the cards. At least not now.”
Hart hugged Hope, holding it a brief moment longer than usual in such a setting. Hope put the envelope in her pocket and left.