What Abortion Restrictions Have in Common With Domestic Abuse

Although the Kate Cox abortion case no longer dominates the news cycle, we should not stop talking about it. It highlights a terrible truth: that in the post-Roe world of state-sanctioned coercive control, women appear expendable to a growing subset of domineering, thoughtless, and often male politicians.

Coercive control: a cornerstone of intimate partner violence

The first time I heard the words “coercive control,” I was crying inconsolably before a beloved mentor. My abuser, I discovered, wasn’t done with me even after I’d left him. “He said I was the abusive one! I knew he’d deny what he did to me, but I didn’t know he’d outright lie about me!”

My mentor waited for a tactful moment before gently asking, “Chloe, I’m wondering if you know why he chose this tactic against you.”

Rubbing my eyes irritably, I quieted for a moment to think. “Self-preservation is the most important thing to him. I don’t think he cares about what he did, but he definitely cares about people finding out …”

“Sure, that’s part of it. But I’m actually thinking about this through a lens of coercive control. You left and challenged him. That’s never happened to him before. He’s punishing you for standing up to him, weaponizing your defense of yourself because you dared to fight back, and he lost control over you.”

I was perpetually hypervigilant with him. I had to be. I learned to regulate not only the content of my speech, but also my tone, volume, gestures, even my facial expressions. I worked tirelessly to offer consistent novelty since I was “boring” and “not outstanding” to him. I hid my tears (“Cut that shit out!”) behind a well-practiced, fragile smile.

It is exhausting to be enchanting all the time. But I felt I had no other choice.

The consequences for failure to comply frightened me to no end, and I chose miserable submission over his rage.

Until I couldn’t do it anymore.

Coercive control at the individual level is a perpetual state of hypervigilance, fear, and forced compliance for the target. I know this from experience. It constitutes a pattern of assault, threats, humiliation, or intimidation to scare, harm, or punish a victim; it is a cornerstone of the power differential in abusive relationships. It is not necessarily restricted to physical abuse, though physical abuse may be part of its insidious playbook. Its endgame is to keep a victim isolated, to regulate the victim’s behavior in accordance with the abuser’s wishes, and to force the victim into a state of dependence on the abuser.

And if the victim fights back, it continues with attacks on the victim’s character and credibility to distract from the abuser’s crimes. It escalates when the abuser involves our legal system, often a sinister and powerful enabler of coercive control.

Remember Kate Cox: the litigation of medical decisions

Today, in this byzantine post-Roe world, I fear that coercive control has become a state-sanctioned exercise in regulating women’s bodies and exacting vicious, drawn-out punishments for failure to comply.

The piece of the Kate Cox abortion case that most alarms me? How quickly and aggressively Attorney General Ken Paxton went after Cox. It feels vindictive, almost personal.

Recall the story: A woman, excited to expand her family, receives devastating news of an unviable pregnancy. The complication forces her into the emergency department several times and takes a toll on her body. Moreover, it threatens her future fertility and her dream of having more children. Her options: End a wanted but unviable and dangerous pregnancy, grieve, and try again; or continue the pregnancy and almost certainly lose it while risking her fertility, health, and even her life.

Neither choice will spare her significant psychological distress; she can only mitigate the harm. She discusses her choices with her doctors, trained professionals who understand these cases and strive to support and protect their patient’s health. It is evident that pregnancy termination is her best option.

Now, she must seek her health care through a court of law, her body fighting her as time passes, reliving what must be the worst moments in her life as she pleads with the court that her health and life are at risk if she does not receive appropriate medical treatment for her case.

The court grants her request. The very same day, the attorney general, who had openly celebrated the overturn of Roe v. Wade, threatens her medical team and physicians across the state with criminal charges, should they treat her, and petitions the ruling. Shortly after, the Texas Supreme Court denies her medical treatment.

Coercive control is a state-sanctioned tactic to enforce a dangerous ideology

Why prolong this case so avidly and so personally? It couldn’t be about inappropriate medical decision-making. Paxton had argued that the lower court ruling exempting Cox from Texas’ abortion laws was issued by an “activist” judge who lacked the medical qualifications to make this decision, ignoring that 1) he too lacks medical training and 2) he was flagrantly dismissing the expertise of her physicians, who agreed that abortion was the appropriate recourse for her situation.

And it couldn’t be about preserving life either; trisomy 18, the diagnosis in Cox’s case, carries an overwhelming risk of pregnancy complications, intrauterine death, and severe malformations. In one study, the fetal death rate among those diagnosed before 20 weeks’ gestation was 88%, the overall fetal death rate was 61%, and all infants born alive died within 48 hours of birth. At a population level, median survival time for this condition is two weeks; only 5-10% of infants survive the first year of life. No matter how you look at it, Cox’s case would almost certainly end in loss.

I think this was about control. Paxton weaponized the legal system against Cox for daring to defy his ideology with a fervor bordering on fanaticism. Cox made a choice that decidedly does not fit into his rigid dogma, and for that, Paxton punished her, bullying hospitals and physicians away from her case and dragging her through the courts when a decision was made and validated by the lower court that he did not like. His actions suggest to me that he values his rigid ideology over a woman’s life. Not very pro-life, if you ask me.

Paxton prolonged the suffering of an innocent woman using his position of power and a legal system that enabled his persecution (I choose that word deliberately) of a frightened woman.

Coercive control checklist: Threats? Check. Intimidation? Check. Retaliation for not behaving according to the abuser’s ideal? Check.

Moreover, Paxton’s vicious crusade against Cox was horrifyingly effective, driving her to seek care outside Texas. Cox is fortunate that nearby states and her resources afforded her the option of termination, which she should have had access to without resistance — but what of the many other women who lack those resources? Coercive control worked, and I worry that more anti-abortion zealots will feel emboldened by Paxton’s success.

Rape offers another example of a woman being deprived of her bodily autonomy; the post-Roe world further perpetrates her abuse, allowing government-sanctioned control over her body in states with draconian abortion restrictions.

Republican politicians have casually dismissed pregnancy from rape, from denying that pregnancies can result from rape to categorizing these egregious violations as “opportunities” for the rape victim to raise a child, even if the victim is as young as 13. Texas has justified its deliberate lack of rape and incest exceptions with a ridiculous promise to end rape. As recently as this year, the Missouri Senate has voted to ban abortions in cases of rape or incest, some senators even arguing that carrying a pregnancy from rape is healing for the victim.

Many women who become pregnant as a result of male sexual violence choose not to terminate the pregnancy, which is entirely their choice, and a valid one. But many women want the option of termination after rape, and that option is an equally valid and understandable option that deserves respect. Rape and reproductive rights are inextricably linked; for as long as rape exists, especially in our society, which instinctively assumes that the victim is lying and discourages reporting, safe and legal access to abortion will always be necessary.

Under these Republican governments today, a victim who becomes pregnant by rape is violated twice, once by her attacker and again by abusive state governments that strip her of whatever agency she has left: denying the overwhelming trauma that is rape and forcing the woman into childbirth whether or not she wants it, suggesting with insidious paternalism that this is, in fact, good for her, and using the legal system to cut off her alternative options.

As a woman who has experienced domestic abuse, it is hard for me not to draw a parallel between my situation and the actions of state officials in the post-Roe world. I’ve lived under the shadow of coercive control in my home. It is terrifying. Frankly, I think I am fortunate to be alive, and I dread similar fates for fellow women under this repressive system post-Roe. We’re realizing a world in which the legal system can be weaponized against pregnant women who do not conform to expectations, whether by hard choice or cruel circumstance.

This is coercive control on a larger, sinister, institutional scale, where people with domineering tendencies can push their personal ideology over medical expertise at the expense of women’s freedoms and lives. The post-Roe world values not life, but control.

Where do we go from here?

At my lowest, I did not believe my life was worth living. My abuser had stolen so much from me and I felt worthless. I concealed my hopelessness; a quiet exit seemed like a relief. Although they didn’t realize the depth of my depression, my support system saved my life — defending me, visiting me, asking about my needs and working to meet them, baking with me at odd hours, and giving me the love and compassion missing from my relationship. I owe these people my life, and my heart is full of love and gratitude for them to this day. In this climate of coercive control, we owe each other the same lifeline of hope that my support system extended to me.

We could easily spiral into despair in this demoralizing condition. But despite the senseless cruelty that I’ve observed and lived, my faith in human compassion persists. When the world loses its color for me, and a loved one sends flowers to make me smile or spends hours on the phone with me, I believe in human goodness again. And so, I believe in our advocacy efforts. I believe in our ability to fight the good fight and to do what is right and compassionate for our most vulnerable despite the darkness.

The Rape, Abuse, and Incest National Network (RAINN) provides a breakdown of relevant laws state by state, runs the national sexual assault hotline, and offers other critical supports to assault survivors: https://www.rainn.org/. 24/7 hotline: 1-800-656-4673.

Special thanks to Lalita Movva, MD, for mentoring me and for reviewing this piece.