Oklahoma Gov. Kevin Stitt signed a bill that will allow courts to shorten the prison sentences of people who can prove they committed their crime because they were experiencing domestic violence—a significant reform in a state that incarcerates many domestic violence survivors for fighting back in self-defense, doing drugs to cope, or failing to protect their kids from the abuse.

Stitt’s decision to approve the Oklahoma Survivors’ Act came last week, after he vetoed a similar bill with the same name in April. Oklahoma has the country’s highest rate of domestic violence per capita and among the highest rates of female incarceration. Under the new law, sentences of life without the possibility of parole could be reduced to 30 years or less; sentences of 30 years or more could be reduced to 20 years or less; and so on.

Incarcerated survivors in Oklahoma cheered the news of the law’s passage, though it came with a catch: To get the governor’s signature, compromise language was inserted into the bill that could make it harder for some of them to shorten their sentences. Bolts reported on the specifics:

The compromise language…raised the burden of proof for those convicted of violent felonies, such as assault, manslaughter, murder, and robbery. To qualify [for resentencing], they must provide documentation that the victim of the crime was also the perpetrator of the defendant’s abuse, the person who trafficked them, or that their action was coerced by their abuser.

Documentation can include trial transcripts, court briefs, law enforcement reports, or other records, according to Colleen McCarty, executive director of the Oklahoma Appleseed Center for Law and Justice, which advocated for the bill.

The compromise language could affect survivors who are incarcerated for failing to protect their kids from an abuser, a plight I covered in a Mother Jones investigation. Although many of these survivors committed no violence themselves, “failing to protect” a child is often charged as a violent felony in Oklahoma. As a result, in order to get resentenced under the new law, these survivors will have to prove that they didn’t stop the child abuse because they were coerced by the abuser. Some of them, disproportionately mothers of color, are serving more prison time than the men who harmed them and their kids.

The Oklahoma Survivors’ Act goes into effect in August. McCarty has already identified more than a dozen people whom her organization plans to help with resentencing petitions under the law.

Just a few years ago, maternal mortality was the rare reproductive justice issue that seemed to transcend partisan politics. In late 2018, Republicans and Democrats in Congress even came together to approve $60 million for state maternal mortality review committees (MMRCs) to study why so many American women die from causes related to pregnancy and childbirth. Donald Trump—not exactly famous for his respect toward pregnant women and new mothers in his personal life—signed the bill.

But some Republicans’ enthusiasm for these committees began to wane at around the same time abortion rights advocates began warning that draconian restrictions on reproductive care would only push the shamefully high US maternal mortality rate—the worst among affluent countries—even higher. Nor did conservatives, like Idaho lawmakers, appreciate the policy recommendations that came out of many MMRCs.

Texas, whose record on maternal mortality (and maternal health more broadly) has been an embarrassment since long before Dobbs, has a history of controversial attempts to play down potentially unwelcome findings from its MMRC. After the Dobbs decision, when the state committee was working on its report examining maternal deaths in 2019, Texas officials decided to slow-roll its release until mid-2023—too late for lawmakers to act on its recommendations. “When we bury data, we are dishonorably burying each and every woman that we lost,” one furious committee member told the Texas Tribune. Ultimately, officials released the report three months late, in December 2022. Soon afterward, the Legislature reconfigured the MMRC, increasing its size—but also ejected one of its most outspoken members. 

Now Texas officials have stirred up the biggest furor yet, appointing a leading anti-abortion activist to the panel. Dr. Ingrid Skop, an OB-GYN who practiced in San Antonio for 25 years, will join the MMRC as a community member representing rural areas (even though she is from the seventh-largest city in the US). But she also represents a largely overlooked segment of the anti-abortion movement: researchers who seek to discredit the idea that abortion restrictions are putting women’s lives in danger. To the contrary, Skop and her allies argue that abortions are the real, hidden cause of many maternal deaths—and that abortion restrictions actually save mothers’ lives.

One of several doctors suing to revoke the Food and Drug Administration’s approval of mifepristone, the medication abortion drug at the center of one of this term’s blockbuster Supreme Court cases, Skop has been a familiar face on the anti-abortion expert-witness circuit for more than a decade. She has frequently testified in favor of strict abortion bans in court cases, state legislatures, and before Congress. In a high-profile case this winter, she submitted an affidavit stating that a Dallas woman named Kate Cox— who was seeking a judge’s permission to terminate a nonviable pregnancy—did not qualify for an abortion under Texas’s medical exception. The Texas Supreme Court rejected Cox’s petition, and to get medical care, the 31-year-old mother of two had to flee the state. Apparently, Skop’s hard-line stance against abortion-ban exemptions extends to children. At a 2021 congressional hearing, she testified that rape or incest victims as young as 9 or 10 could potentially carry pregnancies to term. “If she is developed enough to be menstruating and become pregnant, and reached sexual maturity,” Skop said, “she can safely give birth to a baby.”

Skop’s relatively new role as vice president and director of medical affairs for the Charlotte Lozier Institute, the research arm of Susan B. Anthony Pro-Life America, has solidified her standing in the anti-abortion firmament. Lozier, which has positioned itself as the anti-abortion alternative to the Guttmacher Institute, described Skop’s role as “coordinat[ing] the work of Lozier’s network of physicians and medical researchers who counter the abortion industry’s blizzard of misinformation with science and statistics for life.” Elsewhere on its website, Lozier notes that Skop’s “research on maternal mortality, abortion, and women’s health has been published in multiple peer-reviewed journals.”

What her Lozier bio doesn’t mention is that three of the studies Skop co-authored about the purported risks of abortion were retracted by their publisher this February. Attorneys representing Skop and her fellow anti-abortion doctors had cited the studies in the FDA-mifepristone case. As my colleague Madison Pauly reported, an independent review of the papers found “fundamental problems,” “incorrect factual assumptions,” “material errors,” “misleading presentations,” and undisclosed conflicts of interest between the studies’ authors (including Skop) and anti-abortion advocacy groups (including Lozier). In a rebuttal on its website, Lozier called the publisher’s move “meritless,” adding, “There is no legitimate reason for [the] retractions.”

Skop’s work on maternal mortality hasn’t received the same attention as those papers—yet. But her reflections on maternal deaths in the US have raised plenty of eyebrows.

Skop has argued repeatedly that abortions are directly and indirectly behind the rise in maternal mortality in the US. In a 53-page “Handbook of Maternal Mortality” she wrote for Lozier last year, she says that CDC maternal mortality data can’t be trusted in part because “there is much unreported maternal mortality and morbidity associated with legal, induced abortion, often obscured due to the political nature of the issue.” She claims that a history of abortions puts women at risk in pregnancy, childbirth, or during the postpartum period—whether from maternal complications she contends are linked to prior abortions, or from mental health problems, such as drug addiction and suicide, purportedly caused by abortion regret. 

In another paper co-written with some of the same co-authors as in her retracted studies, Skop and her colleagues call for an overhaul of how states and the CDC collect maternal mortality data, urging the inclusion of “mandatory certification of all fetal losses,” including abortions.

And whereas the vast majority of public health experts predict that maternal deaths and near-deaths will increase in states with abortion bans, Skop takes the opposite view. In yet another Lozier paper, she lists 12 reasons why states with abortion bans will have fewer maternal deaths. For instance, she argues, because of abortion restrictions, women will have fewer later-term abortions, which tend to be more dangerous to women than first-trimester procedures. (In fact, researchers report, that state bans have led to an increase in second-trimester abortions.) She claims that since women who don’t have abortions won’t have mental health problems supposedly associated with pregnancy loss, their alleged risk of postpartum suicide would be reduced. (In fact, the idea that abortion regret is widespread and dangerous has been thoroughly debunked.) Skop makes a similar argument about abortion’s purported (and disproven) link to breast cancer, arguing that fewer abortions will mean fewer women dying of malignant tumors.

Much of Skop’s advocacy work has been done in collaboration with colleagues who share her strong ideological views. MMRCs, by contrast, have a public health role that is supposed to transcend politics—their focus is on analyzing the deaths of expectant and new mothers that occur within a year of the end of the pregnancy. Typically, committee members come from a wide range of professional backgrounds: In Texas, these include OB-GYNs, high-risk pregnancy specialists, nurses, mental health providers, public health researchers, and community advocates. Panels also aim to be racially and geographically diverse, the better to understand the communities—Black, Indigenous, rural, poor—where mothers are at disproportionate risk of dying. In a country that hasn’t prioritized maternal health, MMRCs are uniquely positioned to identify system failures and guide policy changes that can save lives.

Texas’s most recent maternal mortality report found that 90 percent of maternal deaths were preventable, racial disparities in maternal outcomes weren’t improving, and severe childbirth complications were up 23 percent—all before the state’s abortion bans took effect.

It remains to be seen how someone with Skop’s background and agenda will fit in with her new colleagues, especially at this dire moment for women in the state. Maternal health advocates aren’t optimistic: “This appointment speaks volumes about how seriously certain state leaders are taking the issue of maternal mortality,” Kamyon Conner, executive director of the Texas Equal Access Fund, told the Guardian. “It is another sign that the state is more interested in furthering their anti-abortion agenda than protecting the lives of pregnant Texans.”

Skop, contacted through Lozier, didn’t respond to a request for comment. In a statement to the Texas Tribune, Skop said she was joining the Texas MMRC because questions about maternal mortality data deserve “rigorous discourse.” “There are complex reasons for these statistics, including chronic illnesses, poverty, and difficulty obtaining prenatal care, and I have long been motivated to identify ways women’s care can be improved,” she said. “For over 30 years, I have advocated for both of my patients, a pregnant woman and her unborn child, and excellent medicine shouldn’t require I pit one against the other.”

Meanwhile, the American College of Obstetricians and Gynecologists criticized Skop’s appointment, asserting that members of any maternal mortality review committee should be “unbiased, free of conflicts of interest and focused on the appropriate standards of care.”

“The importance of the work done by MMRCs to inform how we respond to the maternal mortality crisis cannot be overstated,” the group said in a statement. “It is crucial that MMRC members be clinical experts whose work is informed by data, not ideology and bias.”

That’s one of the central findings of a new report released Tuesday, which found that there were nearly 86,000 average abortions per month in 2023, compared to about 82,000 a month in 2022. The rise is due, in part, to the increasing popularity of telehealth abortions, in which providers in blue states virtually prescribe and mail abortion pills—including to patients in red states—thanks to so-called shield laws that protect them from prosecution. According to the report, telehealth abortions accounted for nearly 1 in 5 abortions nationwide—about 19 percent—from October to December of last year.

The new report is part of a recurring study sponsored by the Society of Family Planning and known as #WeCount, which is aimed at providing quarterly updates on abortion access post-Dobbs. Earlier #WeCount reports found telehealth abortions accounted for 15 to 16 percent of all abortions conducted between July and September of last year, or about 14,000 abortions each month. This is a marked increase from April 2022, when telehealth abortions only accounted for about 4 percent of abortions nationwide, or about 3,600 a month, or December 2022, when they accounted for about 8,500 abortions every month, or 11 percent of the total. 

Medication abortions have long been a target of the anti-abortion movement, which has perpetrated myths about the so-called dangers of abortion pills. The recent case before the Supreme Court—FDA v. Alliance for Hippocratic Medicine—seeks to drastically restrict access to mifepristone, the first pill in the two-drug regimen, even as more than 100 studies have affirmed its safety and effectiveness. And recent research—including a paper published just this week in the journal JAMA Internal Medicine—has confirmed that the pills are just as safe when they’re prescribed virtually as in person.

Ushma Upadhyay, a professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of California, San Francisco, and co-author of the #WeCount report, says, “As the word gets out, as more people talk about it—on Reddit, online—and feel more comfort with this model, I expect that the numbers will increase.” 

A decision in the Supreme Court case on mifepristone—including the attempt to restrict telehealth access—is expected at the end of June. As my colleague Pema Levy has written, during the oral arguments in March, the justices appeared to be unlikely to roll back access to mifepristone. Upadhyay agrees but notes that even if the justices do place some restrictions on the drug, it’s “very possible” providers would continue mailing the pills from states that have enacted shield laws.

The latest #WeCount data also sheds light on the importance of shield laws during the post-Dobbs era. From July to December of last year, about 40,000 people—most of whom were in states with abortion bans—were able to access reproductive healthcare thanks to shield laws. Data from five states that had shield laws in effect last year—Massachusetts, Colorado, Washington, New York, and Vermont—are included in the latest #WeCount report. California only enacted a shield law for telehealth abortion providers in January.

These laws, Upadhyay says, seek to “minimize legal risks for those providing abortion care,” but do not “reduce the risk of criminalization, of being prosecuted because of perceived laws against self-managed abortion.” While only Nevada has a law that explicitly criminalizes self-managed abortions, Upadhyay said that people may assume that a state abortion ban may also criminalize receiving medication abortion in their state. There have not been any prosecutions of providers who have sent abortion pills to red states under shield laws, though court challenges to the laws are expected. Still, as restrictions mount—Florida, for instance, which was a haven for abortion access in the South, just imposed a 6-week ban on May 1—Upadhyay says “more people may turn to abortions provided under shield laws.” 

Other reasons for the overall increase in abortions post-Dobb include new clinics in blue states, increased funding for abortion care—from some blue state governments, private foundations, and individual people giving to abortion funds—and the destigmatization of abortion in states with fewer restrictions. But the new data should not be interpreted to suggest Dobbs hasn’t had a disastrous impact. As #WeCount co-author Alison Norris, a researcher at the Ohio State University, pointed out to reporters on Tuesday, the report found that nearly 180,000 fewer abortions were provided in-person in states that had total or 6-week abortion bans. In other words, telehealth abortion and shield laws are not adequate replacements for brick-and-mortar clinics. 

“People need trusted, in-person care locally,” Norris said. “They shouldn’t have to drive hours.”

Clinics are essential options for people who only learn about their pregnancy at, or after, 10 to 12 weeks at which point they are no longer eligible for medication abortions. Telemedicine is also not an option for those who learn something about their pregnancy after the first trimester that makes them need or want to terminate it. Teens and low-income people, in particular, also face major barriers to traveling for in-person care if they reside in states that no longer have operating clinics. 

“Our biggest concern is that with the rising numbers, people will interpret this as, ‘everybody’s getting their abortion,'” Upadhyay says. “It’s so important to highlight that there’s a lot of unmet need…there are people who are just not getting the abortions and continue to be forced to carry unwanted pregnancies to term.”

“I had the hormonal urges,” said Camille Parmesan, a professor and leading climate scientist based in France. “Oh my gosh, it was very strong. But it was: ‘Do I really want to bring a child into this world that we’re creating?’ Even 30 years ago, it was very clear the world was going to hell in a handbasket. I’m 62 now and I’m actually really glad I did not have children.”

Parmesan is not alone. An exclusive Guardian survey has found that almost a fifth of the female climate experts who responded have chosen to have no children, or fewer children, due to the environmental crises afflicting the world.

Such decisions were extremely difficult, they said. Shobha Maharaj, an expert on the effects of the climate crisis from Trinidad and Tobago, has chosen to have only one child, a son who is now 6 years old. “Choosing to have a child was and continues to be a struggle,” she said.

Maharaj said fear of what her child’s future would hold, as well as adding another human to the planet, were part of the struggle: “When you grow up on a small island, it becomes part of you. Small islands are already being very adversely impacted, so there is this constant sense of impending loss and I just didn’t want to have to transfer that to my child.”

“However, my husband is the most family-oriented person I know,” Maharaj said. “So this was a compromise: one child, no more. Who knows, maybe my son will grow up to be someone who can help find a solution?”

The Guardian approached every contactable lead author or review editor of all reports from the Intergovernmental Panel on Climate Change since 2018. The IPCC’s reports are the gold standard of climate knowledge. Of the 843 contacted, 360 replied to the question on life decisions, a high response rate.

Ninety-seven female scientists responded, with 17, including women from Brazil, Chile, Germany, India, and Kenya, saying they had chosen to have fewer children. All but 1 percent of the scientists surveyed were over 40 years old and two-thirds were over 50, reflecting the senior positions they had reached in their professions. A quarter of the respondents were women, the same proportion as the overall authorship of the IPCC reports.

The findings were in response to a question about major personal decisions taken in response to the climate crisis by scientists who know the most about it, and who expect global temperatures to soar past international targets in coming years. Seven percent of the male scientists who responded said they had had either no children or fewer than they would otherwise have had.

Most of the female scientists interviewed had made their decisions about children in past decades, when they were younger and the grave danger of global heating was less apparent. They said they had not wanted to add to the global human population that is exacting a heavy environmental toll on the planet, and some also expressed fears about the climate chaos through which a child might now have to live.

The role of rising global population in the destruction of nature and the climate crisis has been a divisive topic for decades. The publication of The Population Bomb by Paul Ehrlich in 1968, mentioned by several of the scientists in their survey responses, was a particular flashpoint. The debate prompted past allegations of racism, as nations with fast-rising populations are largely those in Africa and Asia. Compulsory population control is not part of today’s population-environment debate, with better educational opportunities for girls and access to contraception for women who want it seen as effective and humane policies.

Parmesan, at the CNRS ecology center in France, said: “When I was making my choice, it was very clear in the ecological community that human population growth was a problem: preserving biodiversity was absolutely dependent on stabilizing population.”

Prof Regina Rodrigues, an oceanographer at the Federal University of Santa Catarina in Brazil, who also chose not to have children, was influenced by the environmental destruction she saw in the fast-expanding coastal town near São Paulo where she grew up.

“The fact of the limitation of resources was really clear to me from a young age,” she said. “Then I learned about climate change and it was even more clear to me. I’m totally satisfied in teaching and passing what I know to people—it doesn’t need to be my blood. [My husband and I] don’t regret a moment. We both work on climate and we are fighting.”

Professor Lisa Schipper, an expert on climate vulnerability at the University of Bonn in Germany, chose to have one child. She said that coming from the global north, where each person’s carbon footprint is much bigger than those living in the global south, there is a responsibility to think carefully about this choice.

“It is honestly only now that I am starting to panic about my child’s future,” she said. “When she was born in 2013, I felt more optimistic about the possibility of reducing emissions. Now I feel guilty about leaving her in this world without my protection, and guilty about having played a part in the changing climate. So it’s bleak.”

An Indian scientist who chose to be anonymous decided to adopt rather than have children of her own. “There are too many children in India who do not get a fair chance and we can offer that to someone who is already born,” she said. “We are not so special that our genes need to be transmitted: values matter more.”

She said rich people who choose to have large families were “self-centered and irresponsible in current times,” citing low infant mortality and the huge gap between the emissions of the rich and the poor.

The links between environmental concerns and fertility choices are complex and research to date has found little consistency across age groups and nationalities. According to a recent review, choosing to have fewer or no children for environmental reasons could be the result of fears about the future, population levels or not having the resources needed to raise the children.

A study of Americans aged 27 to 45—younger than the IPCC scientists surveyed—found concern about the wellbeing of children in a climate-changed world was a much bigger factor than worries over the carbon footprint of their offspring. However, a focus group study in Sweden across all ages found few had changed or would change their plans for children owing to climate fears.

There has been almost no research in the global south. Many researchers noted that some women do not have the freedom or ability to choose if they have children, or how many.

On the debate on the role of population growth in environmental crises, Schipper said: “How many people we have is irrelevant if only a small percentage are doing most of the damage.” Parmesan disagreed, saying the total impact is the combination of people’s level of consumption and the total number of people: “Don’t cherrypick half of the equation and ignore the other half.”

Anna Jarvis, who launched the Mother’s Day movement in 1908 in honor of her own remarkable mother, would have had very complicated feelings about what the day has become, says Katharine Lane Antolini, associate professor of American history at West Virginia Wesleyan College and author of Memorializing Motherhood: Anna Jarvis and the Struggle for Control of Mother’s Day. Jarvis’ vision was childlike in its sentimentality, Antolini says: “To her, this was supposed to be the one day out of the year when you were just grateful for your mother.” But there was nothing sentimental about the way she fought to preserve that vision, whether she was battling the floral industry, Big Candy, or well-intentioned maternal health charities and the powerful people who supported them. I spoke with Antolini from her campus office in Buckhannon, West Virginia, about 40 minutes from the International Mother’s Day Shrine and Jarvis’ childhood home.

How did the idea of a day to honor mothers become such a focus of Anna Jarvis’ life?

The story of Mother’s Day really goes back to her mother, Ann Reeves Jarvis, who was a well-known social activist and community organizer during her time. They lived in the part of Virginia that split off during the Civil War to become West Virginia, part of the Union. Mrs. Jarvis had 13 children, only four of whom lived to adulthood. Anna, who was born in 1864, was the oldest surviving daughter. She never married or had children. She was never a mother herself. And that, I think, is an important part of her story.

In the 1850s, before Anna was born, it was very common for mothers in this part of Appalachia to die in childbirth and for babies to die. Poor sanitation was a major cause of death. Mrs. Jarvis organized what she called Mothers’ Day Work Clubs, where women would come together to educate themselves on issues of sanitation: what to do with sewage, where to put your outhouse so it wouldn’t contaminate your water supply or the milk from your cows. If there was a mini epidemic, they would help quarantine a family, bring them food, and help care for the sick. Mrs. Jarvis believed in a proactive kind of motherhood—in the book, I refer to it as “social motherhood,” where being a mother does not just mean taking care of your own children. You are caring for your community of children. By the time of the Civil War, these clubs were so well known that, according to local legend, a Union colonel asked Mrs. Jarvis if she could help the Union camps stop the outbreaks of disease that were killing so many soldiers. So, according to the story, Mrs. Jarvis organized mothers to help care for and stop the spread of diseases in the camps. 

Fast forward to the 1870s. Anna Jarvis is 12 years old. She’s standing outside a room where her mother is teaching one of her famous Sunday school lessons on mothers of the Bible. According to Anna, at the end of the lesson, Mrs. Jarvis offers a prayer of hope that somebody someday will create a day to honor mothers for their service. And as Anna tells it, her mother’s prayer sticks in her head. Thirty years later, in May 1905, Mrs. Jarvis dies in Philadelphia, where she had been living with Anna and two of her other children. And Anna decides, I’m going to dedicate my life to promoting my mother’s vision of a day honoring mothers. 

It’s such a noble idea. And yet, from the beginning, there was real tension about whose vision of motherhood was being honored. As it turned out, Anna and her mother probably would have had very different ideas of what Mother’s Day should be.

Mrs. Jarvis saw motherhood as a community responsibility. She envisioned a Mother’s Day when women would come together as mothers and be of service to each other. 

Anna Jarvis was not a mother. So she didn’t see motherhood through the same lens that her mother did. She saw motherhood through the eyes of a child. When you’re a child, the only mother you care about is your own. So Anna Jarvis’ Mother’s Day was very sentimental. It wasn’t a day to celebrate all mothers, it was a day for you to celebrate your mother—the mother as the center of a child’s world.

People ask me all the time, where do you put the apostrophe? Is it singular or plural? Anna’s idea was for a Mother’s Day, possessive singular. Her mother’s vision was more like Mothers’ Day—possessive plural. 

Anna Jarvis was obsessed with turning Mother’s Day into a movement. But she was also obsessed with having it be her movement. 

When Anna created her day, it was the second Sunday in May, because that was the closest Sunday to the anniversary of her mother’s death [on May 9]. She picked her mother’s favorite flower, the white carnation, as the symbol of the holiday. Her whole identity was wrapped up in this day. So, then, it had to be celebrated from the perspective of a daughter honoring a mother, not of a mother honoring motherhood. How did she think you should celebrate? You go home, like a Thanksgiving Day for mothers. If you can’t go home, you write or later, you call.

By 1912, Anna incorporated herself into the Mother’s Day International Association, which she ran out of the house in Philadelphia that she shared with her unmarried brother and sister. She copyrighted the phrases “Mother’s Day” and “second Sunday in May” and the white carnation emblem, and she included warnings in her association documents that she would legally protect her copyright from infringement. This was a single woman creating something for herself at a time when independent women were not common. And she became well known, even internationally known. This movement became a big part of her identity, which made her fiercely defensive of it.

How quickly did her Mother’s Day movement take off? And how did she react when it happened? 

By 1912, most states recognized Mother’s Day in some way. Anna did it by constantly writing letters and reaching out—she wrote to every state governor, to charities, to the editor of Ladies Home Journal, even to Teddy Roosevelt. It’s a huge campaign, very successful. 

Then in 1914, Woodrow Wilson signed a proclamation to make Mother’s Day a national day of observance. It was technically a flag resolution, all it asked everybody to do was hang a flag outside their house or on public buildings in honor of mothers. So as a concept, Mother’s Day entered the public domain. But to Anna, it was always her holiday. She copyrighted it. Oh, it made her so pissed off when anybody claimed that Woodrow Wilson was the founder of Mother’s Day. She would say, “All he did was sign it. I did all the work.” 

So then Anna began fighting to protect her day. She threatened lawsuits. She had battles with industries that were trying to commercialize her idea– the floral industry, the greeting card industry, the candy industry. The floral industry would hike the price of carnations up every Mother’s Day, which she hated so much. 

World War I began in 1914, and the US entered the war in 1917. How was Mother’s Day exploited then? 

Mother’s Day quickly became part of the war propaganda effort. The military used it to reach out to mothers.“You’re a good mother if you raise your son to be willing to fight.” Then to their sons: “Go fight to make the world safe for democracy, to keep your mother safe.” There was a huge campaign to get soldiers to write home on Mother’s Day. The military would actually provide cards to get the soldiers to do it.

One of Anna’s big fights was with a group called American War Mothers, which was founded to support the war effort, then pivoted to helping veterans as well as widows and mothers who were left with nobody to care for them. During the 1920s, they started using Mother’s Day as a fundraising device, selling carnations. Anna’s response was, “You don’t have permission to use my day. You don’t have permission to use my carnations. How dare you?” At one point, she crashed their annual meeting and was arrested for disturbing the peace. 

Her problem with charities was that she didn’t believe the money they were raising was going to the people who needed it. There was no transparency. She used to refer to charities as “Christian pirates” or the “expectant mother racket.” 

But what also really bothered her was how these charities seemed to violate the idea of Mother’s Day as she had envisioned it. To her, this was supposed to day of gratitude and respect. Not a day to feel sorry for mothers, not a day to try to rescue them. Her feeling was, you can pity mothers any other day. This is the day to just celebrate them.

One of Anna’s strangest battles is with maternal health charities—the kind of groups that her own mother would have supported and celebrated in her version of Mothers’ Day.

In 1933, during the Depression, the US Senate amended the original Mother’s Day resolution, asking that people donate to charities. Instead of just honoring your own mother and hanging a flag, let’s help mothers and families in the midst of this economic crisis where there was no male breadwinner or the father was dead. That opened the floodgates. Every charity that could tie Mother’s Day to their organization tried to do so. And Anna was outraged. 

One of the groups she went after was the Golden Rule Foundation, which promoted what was known as the Forgotten Mothers campaign to help poor women, including in Appalachia, where Anna was born. Where’s all this money going? she wanted to know.

Another was the Maternity Center Association, which was based in New York City and very focused on the idea of improving maternal mortality and health. Maternal deaths were still extremely high in the 1930s and the MCA was trying to address that problem in an era when you weren’t even supposed to say the word “pregnancy” in public, on the radio, or in print. MCA trained public health nurses and nurse-midwives. They also had classes on nutrition and prenatal and postnatal care. At first, their funding came from the federal government, but when that program dried up in 1929, they needed to raise money to get their message out. Mothers’ Day was perfect for that—to get around Anna’s trademark, they moved the apostrophe in the name. There’s a great quote from a magazine article at the time that summed up their sentiment: “Women are dying, and we’re giving them potted plants.” 

They had a lot of very big-name supporters, like Eleanor Roosevelt and Frances Perkins [the Secretary of Labor, the first woman cabinet secretary, and a major architect of the New Deal]. Eleanor Roosevelt didn’t understand why Anna was so mad at her: “We’re promoting your day!”

Nonetheless, she accused the First Lady of “grand larceny of human reputation and achievement” for using her day in a manner Anna never intended. She often complained about Mrs. Roosevelt’s support of the charitable campaigns in telegrams to FDR. She even wrote Frances Perkins demanding that she resign; Anna accused her of using federal funds to support the MCA’s ability to steal the holiday.

How could Anna Jarvis have argued with the mission of saving mothers’ lives?

Some of it definitely was her ego. Some of it went back to Anna saying, Can we just have one day when we just love mothers and thank them? On this one day, do we have to upbraid women and tell them they’re not good enough mothers because they’re not educated enough, because they don’t see a doctor? She hated the idea that Mother’s Day came with conditions, or pity because you’re poor or uneducated. She wanted the message to be, unconditionally, “You’re a good mother.”

Her own mother would have loved what the Maternal Center Association was doing—educating and empowering mothers to survive childbirth and keep their children alive. 

Over the years, she had so many fights, with so many powerful people—some women and a lot of men. How did they react?

Powerful men would say, well, she’s just crazy. And Anna definitely was intense. At one time she had over 30 lawsuits pending, according to a Newsweek article. But calling women crazy is historically how we’ve always dismissed them. She was an independent woman trying to carve out her life for herself and protect her intellectual property. I’ve got to admire her spunk. She would stand toe to toe with anyone. There wasn’t a man or a woman she was afraid of.

So what happened to Anna Jarvis? How did her battle over Mother’s Day end? 

Her battle ends because she just couldn’t fight it anymore. It took everything out of her emotionally and physically—and financially. When the brother she lived with died in 1926, she inherited his money and used it to fund her work. But eventually it was gone. I have never come across anything that suggests that Anna Jarvis ever profited from Mother’s Day financially. 

A Newsweek article from 1943 detailed her stumbling into a Philadelphia hospital, emaciated and sickly. She ended up in a sanitarium, like a nursing home. Her younger sister, who had been living with her, didn’t want to leave their house, and two months later she was found dead in the kitchen. Supposedly it was so cold that there were icicles hanging from the ceiling. Anna died in 1948 and was buried next to her mother, brother and sister in Philadelphia. 

What would Anna think of Mother’s Day, or Mothers’ Day, today?

Anna would not be happy with the commercialization of it, but she would have approved of the more sentimental part of it: “Don’t shame me because all I want to worry about is my mother.” 

And what do you think of it?

I’m surprised the day is not being used more for progressive movements. Maybe we should shame people for only caring about their own mothers. Especially in this environment. Maybe we really need to start worrying about all mothers. I live in a state with no abortion rights. I teach 19-year-olds who want to be mothers someday, but we don’t protect maternal health. I worry about my students. I worry about their futures. 

As Israel prepares a ground invasion of Rafah, Rochios—who is working with the Canadian healthcare organization Gila and talked to me by told me by phone on Thursday afternoon—says the hospital has seen a massive influx of patients. It is running low on the most basic supplies like gloves and scissors. Humanitarian experts have warned of catastrophic consequences if Israel does invade Rafah. In a statement Sunday, Natalia Kanem, executive director of the United Nations Population Fund, said that “an attack in Rafah could turn [Al-Emirati Hospital] and other health facilities from places of hope into rubble and dust.”

American and Israeli officials, meanwhile, have traded barbs. President Biden told CNN on Wednesday that he will stop shipping certain weapons to Israel if Prime Minister Benjamin Netanyahu proceeds with a major ground invasion of Rafah. “I made it clear that if they go into Rafah…I’m not supplying the weapons,” Biden told CNN’s Erin Burnett. White House Spokesperson John Kirby added Thursday that Biden does not believe “smashing into Rafah” will help take out Hamas. Netanyahu seemed to fire back at Biden’s threats, saying, “if Israel is forced to stand alone, Israel will stand alone.” 

But Rochios wants the world to know the impact of the war on Gaza’s children: “The bombing and shelling is incessant. It is happening. And there’s nowhere else to go.” That means the lives of 50 newborns in the hospital’s intensive care hang in the balance: if the hospital is ordered to evacuate, none of those babies would survive transportation, Rochios said. 

I spoke with her about daily life at the hospital under the bombardment.

This interview has been lightly condensed and edited. 

Can you say more about how an invasion of Rafah will affect births in Gaza? 

What birth has looked like since October has been chaotic and disrespectful. And it’s not for a lack of effort on the side of health care workers in Palestine—but because of an almost 20-year blockade that already limited resources and the further limitation from the block of supplies and aid by the Israeli military right now.

With over a million displaced people in Rafah, the hospital has had to kind of expand out of nowhere in order to support all of the births. Prior to October, there was about 70 births a month. And most recently, there have been like 80, 85 births a day. 

What is happening now is that the Israeli military is attacking Rafah, and women are confused about where to go to seek care. Historically, given how violence has happened within hospitals, people are afraid to go to hospitals. People are being redirected back to areas like Khan Yunis, where hospital infrastructure has been obliterated, if not severely damaged. So a threat of further invasion of Rafah means the complete end of healthcare in Gaza, and in this context, for birthing people and their newborns. 

Are you thinking of the worst-case scenario, that the hospital could be obliterated, or are you talking about the fact that even if the building remains safe and secure, you’re already dealing with the blockade and that makes the work impossible?  

Both. So if the invasion continues into Rafah, the Ministry of Health is going to evacuate Emirati Hospital. And although there are field clinics sprouting up, no place has the capacity, infrastructure, manpower, and resources to meet the healthcare needs of pregnant and birthing people and of newborns. And the Rafah border crossing was the way that medical supplies, medications, equipment, and aid workers were getting into Gaza. With the loss of that, that gateway into Gaza, we have no idea how more supplies will be getting in, or how aid workers will be getting in and out, how medical evacuations will happen for people who need it. 

Who’s being served at the hospital right now—how many babies and pregnant people are there? 

There’s up to 15 C-sections that happen a day, up to 70 vaginal deliveries that happen a day, and many others who are being triaged and evaluated. It’s important to remember that women in Gaza are not receiving any prenatal care, so coming into the maternity emergency room is where they’re getting any sort of care or evaluation.

Today in the hospital, volume was less and the amount of workers was less; so many of the healthcare workers who were at Emirati were also displaced people. Throughout the week I have seen people have to leave in the middle of their shift because they found out there’s an evacuation and they need to figure out where to go. There’s a dwindling amount of people who can provide care to women here. 

Bridget, a midwife from California, is inside Rafah's last remaining maternity hospital. She's witnessing the effects of the brutal attack on Rafah, the Israeli occupation, and ongoing genocide against birthing people, newborns and children #AllEyesOnRafah pic.twitter.com/gKt8MNu7tQ

— The Glia Project (@Glia_Intl) May 8, 2024

Is there a neonatal intensive care unit (NICU)?

There is a NICU. Unfortunately, if evacuation is required, there are not the resources, capacity, or supplies to continue the life-saving interventions for those babies and they would die in transport or would not be able to be received at the next health stop. 

What medical supplies are you running dangerously low on?

Everything. There has at this point been access to basic things, which has been great. I brought in a lot of my own personal supplies, too. But with this blockade of Rafah crossing, unless it reopens this will be an incredibly dire situation where medication, tools, everything, antibiotics in particular—anything that a Mom needs will not be available.

Today, a negotiation of mine was, like: What I’m going to use gloves for? Birth is kind of a messy thing. There’s amniotic fluid, there’s blood, there’s feces. One way that you make sure that a woman is staying healthy and birthing with dignity is by changing the pads underneath her and making sure that the environment is clean. We don’t have enough pads…when it would never be a second thought in the United States.

And that is just around cleanliness. I don’t always have scissors to cut an umbilical cord with. 

What do you do in those moments? 

We use a razor blade, which is not the safest.

The system is just overwhelmed. 

What about pain medication for labor? 

In Rafah, there is spinal anesthesia—like an epidural, essentially—for C-sections, but there’s no pain medication available for vaginal births.

What does birth now look like for those women who are going without pain medication?

When women don’t have pain medication, they need a huge amount of support. And when that much birth is happening, where does that exist? Where does any physical or emotional support exist? A big part of birth too, is really feeling safe. That’s what allows birth to happen—is knowing that you’re safe. Hormonally, it’s hard for our bodies even to go into labor when there is a sign of fear. But how comfortable or safe can you feel in a tent in the middle of a genocide?

In the US, women—at a minimum—stay 24 hours postpartum to be observed to watch for hemorrhage, to watch for gestational hypertension, to make sure that breastfeeding is going well. But because of high volume in Rafah, women are discharged from the hospital at a maximum six hours after delivery, and those are for people who’ve actually experienced complications in labor. There’s zero postpartum oversight just as there is zero prenatal care.

The breastfeeding that is happening for infants is way smaller than it should be. You need a lot of calories and a lot of clean water and a lot of rest in order to produce breast milk. And none of those things exist here.

How does the situation right now and the feeling in the hospital right now compare to when you arrived?

The vibe has totally changed. Morale is low. People are really afraid about what’s going on. We’ve seen what has happened systematically to the health care systems throughout Gaza. So everybody’s kind of waiting with bated breath, and everybody’s absolutely exhausted, and that goes for patients and staff alike.

How are you feeling? Can you talk about what it’s like to try to provide care in the circumstances that you’re working in?

It’s an incredibly devastating situation. Women and pregnant people, birthing people, deserve the utmost amount of dignity, respect, care, and attention when they are going through such an important life transition, as do their babies. And it is not for a lack of effort on behalf of the health care workers here who are valiant and hardworking and so exhausted.

It is just incredibly devastating to see very simple, life saving procedures that can be done in Gaza, but there’s no capacity resource for it because of this war. To see newborns die because they don’t have these surgeries. Knowing they would easily be able to live if we were not under these conditions. It is really upsetting to see mothers who’ve experienced so much loss. These babies have grown inside of them. And now they are giving birth to the background noise of machine guns going off and bombs dropping.

It’s traumatic and there’s not one person here who I have interacted with who has not been heavily affected by what’s going on.

In an award-winning investigation in 2022, I told the story of Kerry King, a mom in Tulsa who got 30 years in prison under the state’s “failure to protect” law because she couldn’t stop her abusive boyfriend from beating her 4-year-old daughter. He received significantly less time behind bars for committing that violence. When my colleague Ryan Little and I conducted a groundbreaking review of Oklahoma’s court records, we identified hundreds of people like King who had been charged under the state’s law since 2009 for allegedly failing to protect their children from another adult’s harm. About 90 percent of those imprisoned under the statute were women, disproportionately Black mothers. Many of them experienced abuse from the same person, often a romantic partner, who harmed their children.

In recent weeks, Oklahoma’s legislature overwhelmingly approved the Oklahoma Survivors’ Act, which would allow courts to shorten prison sentences for people who can prove their crime stemmed from domestic violence. The legislation could help mothers like King who are convicted for “failure to protect,” as well as others who killed an abuser in self-defense, or committed a crime while attempting to escape from the abusive relationship, or followed an abuser’s order to break the law for fear of retribution. It would apply to both new and old cases, theoretically helping people with active trials or those who want to retroactively shorten their sentences.

It’s a big deal that this legislation passed with so much support: As I’ve reported before, only a few other states have laws like this, including New York. And none of those states are as conservative as Oklahoma. But the issue appears to have struck a chord on both sides of the Sooner State’s political aisle. “This may be the first time in my life I agree with someone from San Francisco,” then-Rep. Todd Russ, who is Republican and now Oklahoma’s state treasurer, wrote to me in 2022 after I emailed him from California to share our investigation. In March, the state Senate unanimously approved the Oklahoma Survivors’ Act, and in April the state House approved it with a vote of 84-3.

Despite such broad support, Republican Gov. Stitt vetoed the bill on Tuesday. He described the legislation as “bad policy,” arguing that “untold numbers of violent individuals who are incarcerated or should be incarcerated in the future will have greater opportunity to present a threat to society due to this bill’s impact.” (Our investigation found that the vast majority of women in Oklahoma convicted for failure to protect—a nonviolent crime—had no prior felony record.)

In his veto message, the governor also warned that defendants could point to abuse that happened years ago as justification for crimes they were committing today, something he described as “a bridge too far.” But that’s not how the bill would actually work. The Oklahoma Survivors’ Act applies only in cases where someone was experiencing abuse at the time they committed the offense, and only if they can prove the abuse was “a significant contributing factor” causing them to commit it. “He either has no grasp of this policy or doesn’t care enough to get involved to inform himself,” Senate Pro Tempore Greg Treat, a Republican who authored the bill, said in a statement. “Whichever it is, it’s embarrassing, especially for our state that has such a high rate of domestic violence.”

Oklahoma ranks first in the country for the most domestic violence cases per capita, according to one recent study, and many women in the state’s prisons are survivors of abuse. “Women, especially in Oklahoma, are overpunished,” Amanda Ross, whose aunt got a life sentence for killing an abuser, told the Oklahoma City-based television station KFOR-TV. Under the bill, sentences of life without the possibility of parole could be reduced to 30 years or less; sentences of 30 years or more could be reduced to 20 years or less.

The Oklahoma District Attorneys Council supports the veto, arguing the bill is too broad. But criminal justice reform advocates haven’t given up on the legislation. On Wednesday, the state Senate overrode the governor’s veto with a vote of 46-1. If the state House overrides it too, the bill could still become law. Incarcerated “survivors have been waiting and praying for the opportunity to return to their children and families,” Alexandra Bailey, a campaign strategist for the nonprofit Sentencing Project, which supported the legislation, said in a statement.

Kerry King is now nearly a decade into her 30-year sentence and has tried her best to stay in touch with her four kids, the oldest of whom was about 9 when she was convicted. She calls them as often as she can and writes them letters, and sends them socks and blankets with yarn she bought at the commissary. When I visited three of her kids in 2022, they were confused and devastated about why she was still locked up. “Like, I kind of know why she’s in jail, but I know she’s not supposed to be there,” 11-year-old Lilah said, holding back tears.

“I just really miss her,” she said. “You can’t really make memories on a phone.” To learn more about King’s case and the incarceration of other survivors in Oklahoma, read our investigation and watch the documentary I helped make with filmmaker Mark Helenowski below.

“And we all must understand who all is to blame,” Harris, who has become the Biden administration’s most vocal official on abortion, said. “Former President Donald Trump did this.” She said that a second Trump term would produce even more abortion bans and adversely affect reproductive care for women. 

Harris calling out Trump comes as the former president appears to be carving out distance between himself and anti-abortion policies. Over the past week, he has repeatedly said that there is no longer a need for a federal abortion ban, because “we broke Roe v. Wade.” On Wednesday, he said he would decline to sign such a ban, and on Monday, he claimed that abortion policy should be left to the states. He also released a statement opposing the Arizona ban. 

Democrats, including President Biden, have accused Trump of lying as he attempts to avoid the political fallout of being associated with strict anti-abortion policies, which consistently poll as extremely unpopular among voters. 

Trump has moved back and forth on abortion as it has been politically expedient—prior to running for office, he both claimed to be “very pro-choice” and then “pro-life.” In 2016, he said he would attempt to defund Planned Parenthood and then try to provide “some form of punishment” to women seeking abortions. In 2017, he supported the 20-week abortion ban that the House passed, saying that he would sign it, though the bill never made it through the Senate. 

Trump then blamed the GOP failing to meet its expectations in the 2023 midterm due to the “abortion issue” and started slightly softening his position from his previous statements, reportedly discussing a 15- or 16-week abortion ban, shortened from the 20 weeks he had previously advocated for. Political observers have widely seen the Supreme Court’s decision to end Roe v. Wade, enabled by Trump’s nominees to the court, as perhaps the key factor in hurting Republicans in the midterm elections. 

According to the groundbreaking work of Dutch researcher Dr. Tessa Roseboom, the impacts of near starvation are also likely being experienced by generations not yet born. Roseboom, a biologist and professor of early development and health at the Amsterdam UMC/University of Amsterdam, has been studying the long-term consequences of prenatal malnutrition for almost 30 years.

Much of her work focuses on people like her parents, who were born around the time of the Dutch “Hunger Winter” at the end of World War II. In dozens of studies, Roseboom and her colleagues have provided some of the first direct evidence in humans of the intergenerational impact of in-utero exposure to stresses such as famine. Their work suggests that malnutrition during pregnancy can have lasting consequences not only for the future health of the child but for subsequent generations. “It’s one of the things that makes me very passionate to talk about how the decisions we make today will have an effect for many, many decades,” Roseboom says. “I really feel the generations before me urging me to speak out.”

Audio journalists Neroli Price, Salman Ahad Khan, and Gabrielle Berbey talked with Roseboom as part of their investigation into how Israel’s blocking of aid trucks carrying food and medical supplies is leading to a maternal and infant health disaster. Excerpts of their conversation can be heard on the latest Reveal radio episode, “In Gaza, Every Pregnancy is Complicated,” (available for listening on nearly 600 NPR stations or for download).  Given the timeliness and urgency of the subject, we are presenting a longer digital version here. 

Let’s start with the Hunger Winter. What was the confluence of events that made the winter of 1944-1945 so devastating for people in the Netherlands?

The Hunger Winter was a period of famine that occurred at the end of the Second World War, in the part of the Netherlands that had not been liberated by the Allied forces. [After the D-Day invasion in June 1944], the Allies liberated France and Belgium and retook the southern part of the Netherlands. The Dutch government-in-exile called for a railway strike to support the Allies, but the operation failed before they could retake the north and west of the country, which included the capital, Amsterdam. The German occupying forces retaliated for the railway strike by banning all food transports from rural parts of the country to urban areas. Suddenly, rations that had been around 2,000 calories a day during the entire war dropped to around 400 to 600 calories a day. Two slices of bread, two potatoes, and half a sugar beet was the typical ration for adults during that period.

The blockade coincided with a very early and extreme winter, which froze all the waterways in the Netherlands—and canals are an important way of transporting food. So it was really a combination of this harsh winter and the blockade that suddenly led to a very acute period of famine, which lasted until the Netherlands was liberated and the war ended, in May 1945.

How did that extreme level of famine affect mortality?

During the first six months of 1944, when there was sufficient food, mortality rates were half what they were in the first six months of 1945, during the famine period. It is estimated that a total of 25,000 people died during the Dutch Hunger Winter.

What do you know about what happened to your family during this period?

My father was born in the first weeks of the famine and my mother was born in the month after liberation, so they don’t remember anything of course. But my grandmothers remember what it was like to be pregnant during a war and during a period in which there was very little food available.

Luckily both my parents were born in the rural part of the country, where the famine was much less extreme. My father’s mother told me how she delivered my father at home when there was no light and bombings were going on. She told me how families from Amsterdam came fleeing to the part of the country where she lived, looking for food. Even though my father was only 10 weeks old, he was already heavier than the 10-month-old boy from Amsterdam.

When you began to study the broader effects of this famine, what did other people tell you?

Even though I spoke to them decades later, they still remember it as such a traumatic period. I remember one woman who was so undernourished after the birth of her first baby, she couldn’t breastfeed. She told me that her baby looked like a skinned rabbit– that’s how skinny he had become after a few days. So she went to church to try and find someone willing to take him because she realized, “He’s going to die if I keep him with me.” Luckily, someone helped her get milk and food, so she could feed herself and her baby. But she felt so guilty all her life that she had considered giving him away. It took her almost 50 years before she told her son this story.

You’ve authored or coauthored numerous papers about how the Hunger Winter affected the long-term health of people conceived or born during that period. What are some of the impacts you’ve found?

In almost three decades of studying men and women who were being shaped inside their mother’s womb during the Dutch famine, we know that the lack of nutrients left lasting marks on on the organs and tissues that were forming at the time.

The babies who were conceived during the famine and whose mothers were undernourished while their brains were being built—those brains were smaller. When those people were adults, their brains were wired in a different way. They were more susceptible to stress and addiction, their cognitive function was affected. They were less likely to participate in the labor market.

We found that babies who were conceived during the famine had a higher risk of depression in particular. They also had a higher risk of schizophrenia and antisocial personality disorders.

Their metabolism was altered as well. It makes a lot of sense that if you are taking in very few nutrients in utero, your body will develop a very, very efficient way of metabolizing the calories you do get. But then, because of your efficient metabolism, when food becomes more plentiful later in life, you have a higher risk of becoming obese. Our research found more obesity and Type 2 diabetes, higher cholesterol levels, and people developing cardiovascular disease at a younger age.

Were these effects immediately apparent when the Hunger Winter babies were born?

No. It’s fascinating, but based on the size of babies who were born just after the Dutch famine ended, one wouldn’t have thought that they were that much impacted. At birth, babies were not particularly small, particularly thin, or particularly any different from most babies. So for a long time, we thought maybe they’re not going to be affected by famine. They’re safe inside their mother’s womb. We shouldn’t be too worried.

But based on our research now, we know that the structure and function of their organs are different. And it’s only as we age that problems with our organs tend to arise as damage accumulates across the life course.

Separate from the effects of famine, did you find any impacts of maternal stress on babies during that period?

In general, [the fetus is] protected from the stress hormones that the mother has in her own bloodstream. But when women are undernourished, the enzyme in the placenta that protects the fetus from getting exposed to this stress hormone is not functioning properly anymore. So with high stress levels and low nutrition, the baby will get exposed to the stress levels that the mother is experiencing.

Your research didn’t stop with people born around the time of the Hunger Winter. You also studied their children. What did you find?

We saw that both through the mother and the father, these effects can be transmitted to future generations.

As a biologist, I often talk about the fact that each and every one of us, every human being, started as a single fertilized egg. But the egg that made you and me didn’t arise just before it was fertilized. It was actually formed when our mothers were in our grandmothers’ wombs. So the egg that made me was formed during the Hunger Winter.

Human beings are very sensitive to their environment, particularly in early life during development. And we know that the environment, whether it is nutrition or whether it’s a traumatic experience, has an impact on the expression of the genetic code—what we call epigenetic effects. The environment has a big impact on the extent to which your genetic potential is being expressed. The Dutch Famine Study, as well as other studies looking at other crises and catastrophic events—9/11, climate disasters such as flooding and fires—they’ve all consistently shown that there are epigenetic effects. Not so much of the DNA structure is changed, but the extent to which our genes are expressed is altered by the environment in which we grow and develop, and even these effects are transmitted from one generation to the next.

The blockade of food transports by the German occupying forces seems like a parallel to what’s happening in Gaza right now.

I think there is a strong parallel with what’s going on in Gaza. And because of the research I’ve done, I’m not worried only about the people currently experiencing the situation there. I’m very worried about the long-term consequences this will have for the generation that isn’t even born yet.

We’ve spoken with ob-gyns from Gaza who ran out of basic medical supplies to take care of women and babies back in October. How might that kind of collapse in the medical infrastructure affect fetal development?

I can only guess what the impact might be. Based on the studies that we’ve been doing on the Dutch famine, I have no proper comparison of the medical system collapsing because, quite surprisingly, during the war and the famine, the medical system continued to operate. Doctors and nurses continued to provide care and record details of the pregnancies that we’ve been able to see because these records were kept.

But based on other studies of disruptive situations, like flooding, that didn’t allow pregnant women to go to their doctors or midwives, we know that increases stress levels and has a negative impact on the development of the [fetus]. You can actually still see [this] in the way that their genes are expressed, in the way that these children develop, and in their risks of chronic diseases later in life.

I’m imagining a mother who is living through what has been happening in Gaza, who may be wondering if there was any way to protect her infant from those negative long-term effects.

It’s a very difficult question because during your time in the womb, your organs are formed and you cannot do that again. You cannot rebuild your brain. But the scientific evidence is quite clear that in terms of stress, the effects can be greatly reduced if people get social support. Even if you cannot get out of that stressful situation, getting social support can be very important in helping reduce the negative impact.

Another thing that people could do if they have been unnourished or have a child who is unnourished during pregnancy is to make sure they eat healthy diets and exercise as they grow up, which will help reduce the risk of developing cardiovascular disease or Type 2 diabetes.

If you could grab all the world’s leaders, and get on your soapbox, what is the one message you would tell them about mothers and babies and war and famine?

I’d say that we as human beings have all been shaped by the environment that our ancestors created. The world that we live in, the knowledge that we have access to, our societies, our cities, our families are shaped by those who came before us. What we do today is literally shaping the environment in which future generations will be allowed to develop to their full potential.

And these future generations are not some imaginary future creatures that are not around already. As I said before, the egg that made you and me was already there when our mothers were in our grandmothers’ wombs. The future generations are already here, in the present, and we are affecting them with our actions right now.

This interview has been edited for clarity and length.

Yesterday, Uganda’s constitutional court, the country’s second-highest judicial body, cited the US Supreme Court decision overturning Roe v. Wade in its ruling to uphold the majority of a sweeping anti-gay law that criminalizes homosexuality and same-sex marriage, and allows for convictions of up to life in prison and the death penalty in some cases.

The court wrote that Dobbs constitutes a recent development “in human rights jurisprudence…where the Court considered the nation’s history and traditions, as well as the dictates of democracy and rule of law, to over-rule the broader right to individual autonomy.”

In the ruling, which came after the challenges to the “Anti-Homosexuality Act” passed by President Yoweri Museveni last year, the court repealed certain sections of the law, including those that criminalized renting property to LGBTQ people and mandated reporting “acts of homosexuality” to police. 

But the fact that the court upheld most of the law obviously amounts to a massive setback for LGBTQ Ugandans—and offers a striking look at how Dobbs might be marshaled to restrict other rights both in the US and around the world.

“We have been saying in the United States that the decision in Dobbs could easily be extended to the context of personal liberties, like the choice to engage in sex with a person of the same sex, to marry a person of the same sex, to use contraception,” Melissa Murray, a professor at New York University’s School of Law and a leading legal expert on reproductive rights and justice, told me. “The fact that a high court in another country used it in that way suggests how easily it might be deployed in our country for the same thing.”

“Folks in this country ought to take a page out of it—this is really alarming,” she added. 

The UN’s High Commissioner for Human Rights, Volker Türk, condemned the high court’s ruling in a statement yesterday, noting that nearly 600 people “have been subjected to human rights violations and abuses” based on gender identity or sexual orientation since the law took effect last year. The law, Türk said, “must be repealed in its entirety or unfortunately this number will only rise,” adding that it was also contrary to “Uganda’s own constitution and international human rights treaty obligations.” Amnesty International also notes that, since the law passed, there have also been more than 250 evictions of people suspected to be LGBTQ or to associate with LGBTQ people, and more than 200 “other cases of actual or threatened violence.”

Human Rights Watch called the law “abusive” and “radical,” alleging that it “further entrenches discrimination against [LGBTQ] people, and makes them prone to more violence.” National Security Advisor Jake Sullivan said it’s “deeply disappointing, imperils human rights, and jeopardizes economic prosperity for all Ugandans.” And Secretary of State Antony Blinken said the country’s “international reputation and ability to increase foreign investment depend on equality under the law.” (Homosexuality is criminalized in more than 30 of Africa’s 54 countries, the Associated Press reports.) 

This is, of course, not the first time that Dobbs has been used to restrict rights beyond abortion access—including here at home. Dobbs was cited throughout the Alabama Supreme Court decision last month that effectively banned IVF procedures. (The Alabama Legislature subsequently passed a bill, which the governor signed, to protect IVF access, but it didn’t address the legal status of frozen embryos.) And Justice Clarence Thomas used the Dobbs decision to call for the court to revoke the rights to marriage equality, intimate sexual relationships, and contraception, all of which he called “demonstrably erroneous.”

Dobbs has also been cited by anti-abortion activists seeking to roll back legal rights in Kenya, Nigeria, and India, according to research compiled by the advocacy organization Fòs Feminista. Globally, though, most countries have actually liberalized their abortion laws over the past few decades, with only four—the U.S., Nicaragua, El Salvador, and Poland—restricting them, according to the Center for Reproductive Rights. And last month, France became the only country to explicitly guarantee a right to abortion in its constitution, which President Emmanuel Macron and other French lawmakers promised to prioritize just hours after the Dobbs ruling dropped in June 2022. 

The fact that the US rollback of abortion rights could give rise to both France’s protection of them and Uganda’s elimination of LGBTQ rights, Murray said, shows that Dobbs “is viewed as authoritarian”: Its power, in other words, lies in the hands of whoever gets to interpret—or resist—it.