You're F**king Hilarious

Uteruses Don't Have Doors

On Friday night, my 8^th grade daughter told me she had an assignment for health class to find an article on a current event in sexual health. I asked her what she was going to write about, and she named a headline that sounded very familiar. Apparently, the teacher said she could use a Sex On Wednesday article. Then, completely unprompted, she said something that made my decade:

“You’re f**king hilarious!”

My kid thinks I’m funny! Parenting goal achieved. Life goal achieved.

Then she took out the second health assignment, which we both thought was pretty funny but not in a good way.

The class had to read an article that explained the stages of pregnancy. This seemed like one of those busy work assignments like labeling the seminal vesicles that are harmless enough (it’s not preaching that sex before your wedding will inevitably kill you) but I see as a waste of precious sex ed time.

There are so many things that 13- and 14-year-olds want to know about sex: Is it okay if I masturbate? How will I know if someone likes me? How will I know if I like someone else? How will I know if I’m ready for sex?

There are so many things that 13- and 14-year-olds need to know about sex: their birth control options, the importance of STI protection even if they’re not having penis-in-vagina sex, where to find sexual health care, how to negotiate condom use with a partner, how to know if you’re in an unhealthy relationship.

You’ll notice that neither list includes the difference between a zygote and a blastocyst.

Then she started reading out loud, and it got less harmless. The article explained that in the embryonic stage a heartbeat would start. As we all know from my previous rants about so-called heartbeat bills that justify banning abortion before women even know they’re pregnant by prattling on about a beating heart: it’s not a heart, and it doesn’t beat. There’s electrical activity in cells that will develop into the heart, and sonogram machines amplify those signals and create a sound that resembles a heartbeat.

This is (possibly deliberately) misleading. The original purpose was to reassure parents that a pregnancy was healthy, but it’s been pretzeled into a way of suggesting that a bunch of cells with potential to grow are equivalent to a full-fledged person and, worse, more important than the full-fledged person they will depend on for at least the next 40 weeks. I could almost forgive the homework article for buying into that hype, as it has unfortunately become a well-accepted bit of misinformation that makes it into many articles and books about pregnancy.

What came next, however, is unforgivable. The description of labor and birth reads as follows:

Once the baby has grown big and strong inside its mom’s belly, it’s time for the exciting moment when it comes into the world. Labor begins with something called contractions. These are strong squeezes of the muscles in the mom’s belly. They help push the baby downward. The cervix, which is like a door between the mom’s belly and her uterus, starts to fully open, the mom feels a strong urge to push. This helps the baby move through the birth canal which is a tunnel leading to the outside world.

That’s not how it f**king works.

That’s not how it f**king works.

That’s not how it f**king works.

This is for 8^th graders, not 4-year-olds. What’s with “belly” and “door” and
”tunnel?” It’s all so infantilizing (to the reader, not to the fictional baby making its grand entrance). It’s also not accurate. I guess you can say that a mother’s belly (not a scientifically recognized part of human anatomy btw) grows when she’s pregnant because from the outside she and Santa have something in common. Still, whether you’re talking to a 4-year-old, a middle schooler, or a state legislator, it’s important to be clear that the baby grows in the uterus. (It’s also important to give credit where credit is due: it’s the uterus that does the contracting.)

The word uterus clearly isn’t verboten in this article, but I wonder if the authors have any clue where or what it is (I also wonder if they’re human). The idea that the cervix could be a door between the uterus and the belly is kind of mind boggling to anyone who has even the remotest understanding of human biology. The cervix is the bottom part of the uterus that sits at the top of the vagina. It opens into the vagina. There is no side door or back door or fire escape that goes from the uterus into the abdomen. (I suppose one could argue that a baby delivered by a C-section is coming out a “door” between the uterus and the “belly,” but that door would more accurately be described as a surgical incision, and it’s nowhere near the cervix.)   

The worst part of this description, however, is not what the authors got wrong but what they refused to say at all. Vagina.

Vagina.

Vagina.

Vagina.

The vagina plays an important role in how most of us come into the world (two important roles really), and it doesn’t even get an honorable mention? Having had two vaginal births and two episiotomies, I’m personally offended by this.   

I have also always hated vagina/birth canal as tunnel analogy and not just because it makes me think of the New York/New Jersey state line tiled into the side of the Lincoln Tunnel. (Do we have to replace it with a born/not born line on the uterine wall?) The tunnel image causes people to think of the vagina as always open and waiting around to be filled up with a tampon or penis or something. That’s not how it f**king works. The vagina isn’t a hollow tube. It’s a muscle that can stretch to accommodate a tampon or penis or, you know, full-sized infant, and as such it deserves some damn respect around here.

In addition to thinking I’m f**king hilarious (yes I’m just going to keep saying it), my kid gets a kick out of my professional outrage. We have a great time being horrified by the vocabulary homework that sticks to the letter of the dictionary definition but not the color of the actual spoken English language. And we had a great time being appalled by this article, but I’m also sad that in my super-liberal town in my solidly blue state, this nonsense made it into a sex education class. Imagine what they’re learning—or not learning—in Florida or South Dakota or even other Trumpier parts of New Jersey where lawmakers and parents are whipped into a frenzy about “protecting the children.” It’s all tunnels and doors there I’m afraid.

**I made the picture with Shutterstock’s generative AI, but the first few tries failed because the program kept putting the door at the bottom of the uterus where the cervix should be. Even the algorithm knows better.

Abortions Exemption: Texas Argues Women Who Suffer Should Sue Their Doctors Not the State

Speaking of people who don’t entirely understand pregnancy, the lawyer arguing to uphold Texas’s strict abortion bans was caught off guard when a Texas Supreme Court Justice asked about a specific fetal anomaly. It was not just any fetal anomaly; it was one that a plaintiff had described in her testimony when she told her story of being forced to carry a fetus with no chance at life to term and to watch that baby die. The lawyer giggled before admitting she wasn’t sure. (See Jessica Valenti, who writes Abortion Every Day, take down this obnoxious display of ignorance on TikTok.)

This exchange happened right before Thanksgiving when the state’s highest court was hearing arguments in Zurawski v. State of Texas, a suit brought by 20 women and two OB/GYNs who believe the state’s abortion laws are dangerously vague about what warrants an exception to save a woman’s life. Texas’s trigger law—the one that took effect as soon as the ink was dry on the Dobbs decision—allows for an exception if a doctor, using “reasonable medical judgement,” acts during a “medical emergency” that constitutes “a life-threatening physical condition aggravated by, caused by, or arising from a pregnancy that places the female at risk of death or poses a serious risk of substantial impairment of a major bodily function.”

Doctors in Texas, however, are scared to use their own reasonable medical judgement because the law/prosecutors have threatened unreasonable legal judgment. If the prosecutor doesn’t agree that the situation qualified as a life-threatening medical emergency, the doctor could be prosecuted and lose their license, be fined up to $100,000, or go to jail for up to 99 years. Hospitals have not been willing to take a helpful stand on what constitutes a life-threatening medical emergency, likely out of fear of being sued into oblivion. And the state legislators who wrote the law have refused requests to further define what a life-threatening medical emergency might be. (Oh, so this is when they realize they didn’t go to medical school and don’t actually know?)

The women in the suit say they’ve been directly harmed by this ambiguity. Amanda Zurawski was almost 18 weeks along when she found out there were problems with her cervix. (I dare you to call it a door now.) While the pregnancy was no longer considered viable, the fetus did still have a heartbeat, and Amanda’s life was not yet in immediate peril. Doctors feared this didn’t meet the requirements of the exception and sent her home to wait for it to become an emergency. Later when her water broke, she came back to the emergency room, and was told it still wasn’t life threatening enough, so she went home and got sicker and sicker. (To be clear, doctors knew it would become life threatening at some point.)

When she went back to ER a week later, doctors finally agreed to act. Why the change of heart? Because she had sepsis, which is blood poisoning caused by a rapidly spreading infection, and this condition can kill someone quickly if left untreated (yay, sepsis?). Amanda survived the procedure, but her uterus has been so scarred by the incident she may never be able carry a pregnancy. (Remind me again, how this is all for the babies?)

Other plaintiffs told similar stories of being stuck in medical/legal limbo waiting to get sick enough to qualify for treatment, while some testified about the trauma of being forced to carry a fetus to term despite knowing there were anomalies so severe that their baby could not live more than a few hours if at all.  

Beth Klusmann, the lawyer for the state, argued that because the law targeted doctors not patients, the patients didn’t have standing to sue the state. (Standing, for those of us who are not legal scholars, is a concept that says in order to sue, a plaintiff must have suffered harm or face an imminent injury and that the harm/injury must be traced directly to the defendant.) If these women believed they were harmed by the medical care they did or did not get, she argued, they should sue their own damn doctors not the state.

Part of the state’s argument seemed to hinge on the timing of this suit. None of these women were currently mid-crisis or actively seeking an abortion so clarifying the law now would not address their claims. (AKA: F**k future women in peril.) Justice Jeff Boyd seemed to grasp the absurdity of this argument, asking Klusmann:  

Your position is that, in order to seek the kind of clarity that these plaintiffs are seeking, you have to have a woman who is pregnant, who has some health condition that she believes places her life at risk or impairment to a major bodily function, but her doctor says, ‘I don't think it does.’ And she has to then sue the doctor, and maybe the attorney general, at that point, and then she would have standing and sovereign immunity would be waived?

Klusmann replied that at least then it would be clear that the law was at fault and not the doctor. She added, “Some of these women appear to have fallen within these exceptions but their doctors still said no. That’s not the fault of the law.” Boyd, who the Texas Tribune described as exasperated by this, disagreed saying, “That’s what gives rise to the need for clarity.” (AKA: How about we don’t f**k future women in peril?)

But other justices seemed moved by the idea that these should be medical malpractice cases.  Justice Brett Busby asked the plaintiff’s lawyer, Molly Duane of the Center for Reproductive Rights, why the women weren’t just suing their doctors instead. Duane explained that the patient-plaintiffs understood the doctors’ predicament: “… as all of our patient-plaintiffs have testified, their doctors didn’t know what to do. Their hands are tied.”

This argument about standing is particularly maddening coming out of Texas where a recent decision allowed a Christian father whose children did not get nor try to get birth control from a Title X clinic to sue on behalf of all parents. It seems his harm or imminent injury was the mere possibility that his kids might someday get their hands on a federally sponsored pack of pills. Standing is also a big question in the mifepristone case that is still wending its way through federal court. That case was brought against the FDA by a group of conservative doctors who do not prescribe mifepristone. To prove standing one of the doctors in that case argued that she was injured because she had to take time out of caring for pregnant women to care for women who had complication from mifepristone. And of course, she knows that this harm was directly caused by the FDA’s approval of mifepristone over 20 years ago and not, say, by an overtaxed and underresourced healthcare infrastructure.

I know that these cases were in front of different courts and that the state of Texas wasn’t directly involved in either, but it does feel like we’re playing fast and loose with the concept of standing. No one can better prove harm than the women in that room who nearly lost their lives and may have lost their future fertility. Dismissing them for not having brought a lawsuit while they were actively suffering from sepsis or kidney infections is infuriating.

The issue of legal standing to sue is merely a smoke screen to hide the fact that the Texas legislature passed a law that lacks clarity and scares the s**t out of doctors, that doctors who are scared and confused can’t do their jobs well, and that women of Texas are suffering as a result. Why aren’t legislators, even prolife legislators who say they’re just trying to protect women and save babies,—f**k that, especially legislators who say they’re just trying to protect women and save babies—falling all over themselves to fix this problem?