Project 2025’s promotion of restoring the American family combined with an anti-abortion agenda paint a rosy picture of pregnancy, motherhood, and prosperity. The authors state the CDC should “ensure that it is not promoting abortion as health care” and “fund studies into the risks and complications of abortion and ensure that it corrects and does not promote misinformation regarding the comparative health and psychological benefits of childbirth versus the health and psychological risks of intentionally taking a human life through abortion”. (Dans & Groves, 2023, p. 451). The wording of this statement seems to indicate the authors beliefs that pregnancy and childbirth pose no risks and are beneficial for all women and that abortion is both psychologically and medically dangerous and damaging for all women. In their ideal world every woman would want to focus on family, every pregnancy would be carried to term, healthy mothers would deliver health babies at the end of nine months, and we would all live happily ever after.
The problem is we don’t live in an ideal world. There are risks, complications, and benefits of pregnancy, childbirth, and abortion. Let us take a look at factual information on pregnancy, labor, and childbirth in the United States. Fair warning that this and the next post are research heavy pieces. My husband commented it was like reading a college term paper, which is fair enough. I realize this type of writing can be challenging to read but good research and good science are important in distinguishing myth from reality. In professional writing it is imperative to reference claims and statements of fact. It helps the reader know you did not pull a piece of information out of thin air because your claims are supported by scientific evidence. The authors of Project 2025 make many claims that are not factual and they do not provide reference material in support of these claims. Since I am challenging the validity of many of these statements it is important for me to provide reference material. My apologies if this makes it a difficult read. The good news is that the next post should conclude my examination of Project 2025 as it relates to women’s rights, allowing me to move on to other aspects of women’s power, women’s rights, and women’s history.
Like many other things in life, research can be well done or of poor quality, affecting the validity of the findings. There are two general categories of research design with subcategories in each. Qualitative studies use interview data from participants, observations, and other non-numerical data to look for meaning and patterns of specific phenomena. Quantitative studies use numerical data and statistical analysis to test hypotheses. A typical framework for a scholarly article presenting research findings includes an abstract and introduction followed by sections on methods, results, discussion, and conclusions. The article should also include any limitations or conflicts of interest and a reference section. Acceptance in a peer reviewed journal lends credibility. The peer review process allows those with expertise in a given field to filter submissions, and make sure they meet a stringent set of standards set by the publication.
I will use a hypothetical study to provide guidance on some basic areas to evaluate for accuracy and relevance. Our researcher, Dr. Happy, and his team have developed a new drug that they claim will eliminate hatred. They conducted a double blind randomized controlled trial that included 500 participants from the greater Seattle area in Washington State. The treatment group consisted of 250 participants who received a daily dose of the drug Empathy and completed screening tools and clinical interviews pre-treatment and at monthly intervals for the first three months. The remaining 250 participants were in the control group and received a placebo as well as the same screening tools and clinical interviews as the treatment group. All participants were randomly assigned to either the treatment or control group using a computer-generated algorithm and neither the participants nor the researchers were aware of who was in either group. The treatment and control groups were demographically matched, including age, gender, and race, and ethnicity. At the end of the study, Dr. Happy concluded that his drug Empathy decreased or eliminated hatred in the treatment group at a rate that was statistically significant compared with the control group.
What should we be looking for in Dr. Happy’s research article to help us understand the significance, or lack thereof, of his study findings? In the introduction it would be helpful to know why Dr. Happy developed this drug in the first place. Is there an excess of hatred in the world? How does hatred affect society? What benefit would elimination of hatred have in the world? In the methods section it is important to understand Dr. Happy’s definition of hatred, how he arrived at this definition, and how he is measuring hatred. Is there an existing body of literature on hatred that he used to help with his definition? Is he using measurement tools that are well established and proven to have good reliability and validity? Or did he create his own measurement tools and if so, how has he established reliability and validity? We also need to know in detail the structure of his research design. This section should be clear enough that a different research team could conduct their own study following his methods and replicate his results. In the results section we need to see his actual data and statistical analysis. The discussion section gives Dr. Happy’s interpretation of the data and the conclusion section provides a summary and review of important findings.
Dr. Happy should disclose limitations of his study. These would include things like the small sample size and single geographic location, both of which affect generalizability and representation. A study of 500 Seattleites is definitely not representative of all human beings or all Americans and in fact is not even representative of all Washingtonians. There is significant socioeconomic and political diversity in Washington State between the east and west sides, with the Cascade Mountain Range creating a natural divide of sorts. Are there significant differences in level, expression, and effect of hatred by geographic region in the United States and different countries around the globe? Dr. Happy should also disclose any conflicts of interest he or members of his team may have, like his role as a paid consultant with Pfizer and the fact his investment portfolio includes significant shares of stock in this company. While this hypothetical scenario is an over-simplification, I hope it helps you develop your own questions related to reliability, validity, and generalizability of the studies you read.
As you navigate the research world, try to remember that there are no perfect studies and no single study conclusively proves a point. All studies have limitations and sometimes there are no studies that provides the data you are seeking. Research studies are tools to help guide critical and analytical thinking and the information they generate needs to be used wisely.
Let us take a look at maternal and fetal complications during pregnancy, labor, and childbirth and briefly discuss pregnancy in special populations including teenagers, victims of rape, and victims of domestic sex trafficking. Pregnancy can be a very dangerous time in a woman’s life. The physiological and hormonal changes that take place during pregnancy, childbirth, and postpartum cause tremendous stress on the human body, including the brain. Hypertension can be both a pre-existing condition and develop during pregnancy with estimates ranging from 10-16% of pregnant women in this country. Pre-eclampsia and eclampsia are conditions that can develop rapidly during pregnancy causing hypertension with potential damage to other organ systems in the body leading to permanent damage and in some cases death. (Backes & Scrimshaw, 2020, p. 2; Kuklina et al., 2024, p. 2) Hypertension during pregnancy can lead to chronic high blood pressure after giving birth and cardiovascular disease after birth and later in life, including increased risk of death from cardiac problems. (Kuklina et al., 2024, p. 3) Other medical complications of pregnancy can include gestational diabetes, miscarriage, hemorrhage, placental abruption (partial or complete separation of the placenta from the uterine wall prior to delivery), and ectopic pregnancy (the fertilized embryo implants outside the uterus, often in the fallopian tube causing a medical emergency). (Backes & Scrimshaw et al., 2020, pp. 3-5; Mullany et al., 2023, p. 1) The rate of mortality from these complications varies and many lead to chronic conditions that negatively affect a woman’s health.
Medical complications of labor and vaginal childbirth can affect multiple systems in the body and include genitourinary (fistula development, urinary/anal incontinence, pelvic organ prolapse, infection and scar tissue from wound complications, and infertility); sexual dysfunction postpartum; psychological disorders (postpartum depression and psychosis, anxiety, birth related post-traumatic stress disorder, and extreme fear of childbirth); peripartum cardiomyopathy (weakening and decreased efficiency of the heart muscle); nerve injury causing pain and dysfunction; thyroid dysfunction; breast inflammation and infection; weight retention postpartum; sepsis (systemic infection); chronic anemia; and problems with future pregnancies. (Vogel et al., 2024, p. 319) Cesarean birth adds additional potential complications including infection at the surgical site, adhesions (scar tissue), development of clots, chronic pain, and problems with subsequent pregnancy, labor, and delivery. (p. 319)
There are risks to the fetus as well as the mother during pregnancy, labor, and delivery. Fortunately, fetal mortality rates are relatively low in the United States, with recent statistics from 2022 indicating for every 1000 live births approximately four deaths in Asians, five in whites and Hispanics, seven in American Indians and Alaska Natives, 10 in Blacks, and 11 in Native Hawaiian and other Pacific Islanders. (Gregory et al., 2023, p. 3) The varying rates among ethnic groups are most likely related to a combination of lack of medical insurance, lack of access to care, and bias within the health care system. Adverse neonatal outcomes during labor and delivery include: lack of oxygen and blood flow before, during, or immediately after birth, potentially causing brain damage; excess bilirubin; immature development of the lungs causing decreased oxygen to the brain and body and requiring mechanical ventilation; significantly elevated heart rate that may require medical intervention; breathing fetal stool into the lungs potentially causing respiratory difficulty; seizures; and sepsis (systemic infection) which can cause permanent organ damage and lead to death. (Gupta & Cabacungan, 2021)
Teen birth rates in the United States have been declining over the last three decades. In 2023 the rate was 13.1 live births per 1000 females aged 15-19. While the reasons for this decline are most likely a combination of multiple factors more recent data suggest an increased use of effective methods of birth control plays a major role. Despite the decline in teen birth rates, there are unique challenges for teenage mothers including disruption in education leading to decreased job opportunities, lower income, less social support, the potential for increased use of social services, and often heavy burdens on the families of teen mothers. Children of teen mothers may also be at risk for poorer outcomes medically, psychologically, socially, and academically than children born to older mothers (Mickler & Tollestrup, 2025, pp. 2-13)
And what about pregnancy in special circumstances? Estimates of pregnancy as the result of rape and/or sexual coercion in women in the United States are close to 1 in 20 (5%). Since rape is grossly underreported it is difficult to accurately estimate the number of pregnancies that result from this violation. In addition to the potential pregnancy complications already discussed, these women often experience ongoing physical and psychological consequences including chronic physical health conditions, anxiety, depression, and post-traumatic stress disorder. (D’Angelo et al., 2023, pp. 5-7)
Another special circumstance to consider is pregnancy in the context of domestic sex trafficking. Accurate data is hard to come by and accounts vary widely but a recent study conducted in the United States was quite illuminating. Although the sample size was very small because this was a pilot study for development of a human trafficking survivor survey, the information gleaned clearly supports the need to gather additional information on this population. Keeping in mind the small sample size (31), over half reported gynecological issues including: vaginal infection, discharge, and pain; painful sex; urinary tract infections; and problems with menstruation. Other gynecological symptoms reported in 13-42% of survivors included painful menstruation, pelvic pain, vaginal bleeding, bladder infection, pelvic inflammatory disease, ovarian cyst, cervical infection, and cervical cancer. (Lederer et al., p. 68) Between 13% and 45% of survivors reported sexually transmitted infections including chlamydia, gonorrhea, genital herpes, trichomoniasis, genital warts (HPV), and syphilis. The number of survivors reporting some form of birth control was 87%. Despite this, total pregnancies reported by survivors were 119 with 44 abortions, 32 miscarriages and one still birth. The majority of survivors that carried a pregnancy to term kept and raised these children. Only 37% of survivors reported receiving full pre-natal care and less than 10% who interacted with health care professionals felt they received trauma informed care, helpful referrals, and follow-up care. (pp. 69-72,75)
Perhaps the most meaningful findings from the domestic sex trafficking study are the heart-rending quotes from several of the survivors that include: “I had so many problems that I believe are connected to when I was trafficked. I had vaginal infections, UTIs, PID (pelvic inflammatory disease), cysts and scar tissue from abortions. When I got out and married, I couldn’t get pregnant, and my gynecologist said I would have to have an operation to make it possible for me to have children. Now I have uterine cancer.”; “I was pregnant three times during the time I was trafficked and all of them were by different buyers.”; “I got pregnant twelve times – all of them by my trafficker/pimp. I had three abortions, three children, and many miscarriages”; and “I must have gone to dozens of emergency rooms, clinics, and even private physicians and not one of them asked me or understood what was happening to me.” (Lederer et al., pp. 67, 69, 74) The trauma experienced by these survivors has lifelong destructive consequences. Damage from infection, miscarriage, abortion, lack of access to appropriate medical care, pregnancy, and childbirth may cause permanent dysfunction resulting in chronic gynecological problems and potentially limit a survivor’s ability to carry a pregnancy to term. The psychological ramifications are substantial including chronic depression, anxiety, and severe symptoms of Post Traumatic Stress Disorder. Children raised in this environment also experience significant medical and psychological sequelae.
Given the potential complications and chronic health conditions from pregnancy, labor, and childbirth it should be every woman’s choice to decide if she will carry a pregnancy to term. This is especially true in situations when pregnancy is a result of violation of her body against her will. Despite risks many women look forward to, choose, and embrace motherhood. But just because women can bear children does not mean they have to. There are many women who are unable to conceive and many who make conscious choices not to become parents. This does not in any way diminish their feminine identity or their contributions to society.
As mentioned at the beginning of this piece, Project 2025 emphasizes a woman’s role in restoring the American family. The authors attempt to acknowledge the challenges of motherhood stating, “Conservatives should ardently pursue these pro-life and pro-family policies while recognizing the many women who find themselves in immensely difficult and often tragic situations and the heroism of every choice to become a mother”. (Dans & Groves, p. 6). The key words here are “choice” and “heroism”. In demanding an anti-abortion agenda, the authors are eliminating a woman’s “choice” so it is an interesting word to use in the same sentence as pro-life. Perhaps “forced choice” would have been more appropriate. The word heroism means “heroic conduct especially as exhibited in fulfilling a high purpose or attaining a noble end”. (Merriam-Webster, n.d.) I suspect if women who did not want to carry a pregnancy to term were forced to do so and asked how they felt about it, the words heroic, high purpose, and attaining a noble end would not be included in their responses.
Is Project 2025 and the conservative movement’s utopian ideology a cover for some other agenda? The authors are very clear on the importance of a woman’s primary role as procreator, how much they value this role, and how rewarding and fulfilling it is for women. The evidence they provide to support these views and the recommendations they make for policy change do not substantiate their claims and in fact they significantly limit women’s choices and roles and disrespect women’s bodily autonomy and contributions to society. Let us not become complacent, lulled to sleep by the rosy glow of sunset on the water, unaware of the crashing waves, riptides, and jagged rocks below. Continue to be observant, thoughtful, and question what is below the surface of the ideal world.
Photo by Kathy Kroening. Cannon Beach, OR. September 2018
Up next, a look at abortion safety and statistics and the emotional and socioeconomic sequalae for a woman and a child when government regulation denies a woman’s right to bodily autonomy. Until next time sisters stay safe, be well, be kind to yourself, support each other, and spread the love.
Photo by Kathy Kroening. Seattle, WA. May 2025
References:
Backes, E.P. & Scrimshaw, S.C. (Eds.). (2020). Epidemiology of Clinical Risks in Pregnancy and Childbirth. Birth Settings in America: Outcomes, Quality, Access, and Choice. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Division of Behavioral and Social Sciences and Education; Board on Children, Youth, and Families; Committee on Assessing Health Outcomes by Birth Settings; Birth Settings in America: Outcomes, Quality, Access, and Choice. Washington (DC): National Academies Press (US); 2020 Feb 6. Available from: https://www.ncbi.nlm.nih.gov/books/NBK555485/
D’Angelo, D., Liu, Y., Basile, K., Smith, S., Chen, J., Friar, N., & Stevens, M. (2023) Rape and Sexual Coercion Related Pregnancy in the United States. American Journal of Preventative Medicine, 66(3), 389-398. https://pubmed.ncbi.nlm.nih.gov/37935321/
Dans, P., & Groves, S. (Eds.). (2023). Project 2025 Mandate for Leadership: The Conservative Promise. The Heritage Foundation. https://www.documentcloud.org/documents/24088042-project-2025s-mandate-for-leadership-the-conservative-promise/
DeBoth, A. & Napili, A. (2025). Title X Family Planning Program. (CRS Report No. IF10051, Version 28) https://www.congress.gov/crs-product/IF10051
Defund Planned Parenthood Act of 2025, H.R. 271, 119th Cong. (2025-2026) https://www.congress.gov/bill/119th-congress/house-bill/271
Gregory, E., Valenzuela, Z., & Martin, J. (2023). Fetal Mortality in the United States: 2020-2021 and 2021-Provisional 2022. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/data/vsrr/vsrr032.pdf
Gupta, R. & Cabacungan, E. (2021). Neonatal Birth Trauma: Analysis of Yearly Trends, Risk Factora, and Outcomes. The Journal of Pediatrics, 238, 174-180. https://pubmed.ncbi.nlm.nih.gov/34242670/
Kuklina, E.V., Merritt, R.K., Wright, J.S., Vaughan, A.S, & Coronado, F. Hypertension in Pregnancy: Current Challenges and Future Opportunities for Surveillance and Research. Journal of Womens Health( Larchmont). 2024 May;33(5):553-562. https://doi.org/10.1089/jwh.2023.1072
Lederer, J., Flores, T., & Chandler, M. (2023) The Pregnancy Continuum in Domestic Sex Trafficking in the United States: Examining the Unspoken Gynecological, Reproductive, and Procreative Issues of Victims and Survivors. Issues in Law and Medicine, Spring, 38(1), 61-76. https://pubmed.ncbi.nlm.nih.gov/37642454/
Merriam-Webster. (n.d.). Merriam-Webster.com dictionary. Retrieved July 27, 2025, from https://www.merriam-webster.com/dictionary/heroism
Mickler, A. & Tollestrup, J. (2025). Teen Births in the United States: Overview and Recent Trends. Congressional Research Service Report, R45184. https://www.congress.gov/crs-product/R45184
Mullany, K., Minneci, M., Monjazeb, R.C., & Coiado, O. Overview of ectopic pregnancy diagnosis, management, and innovation. Womens Health (London). 2023 Jan-Dec;19:17455057231160349. doi: https://doi.org/10.1177/17455057231160349
Office of Population Affairs (2024). Title X Program Guidelines. https://opa.hhs.gov/sites/default/files/2025-03/title-x-program-handbook-dec-2024.pdf
One Big Beautiful Bill Act, H.R. 1, 119th Cong. (2025-2026) https://www.congress.gov/bill/119th-congress/house-bill/1
Planned Parenthood (n.d.) Our Services. https://www.plannedparenthood.org/get-care/our-services
Vogel, J.P., Jung, J., Lavin, T., Simpson, G., Kluwgant, D., Abalos, E., Diaz, V., Downe, S., Filippi, V., Gallos, L., Galadanci, H., Katageri, G., Homer, C., Hofmeyr, J., Liabsuetrakul, T., Morhason-Bello, I., Osoti, A., Souza, J.P., Thakar, R., Thangaratinam, S., & Oladap, O. Neglected Medium-Term and Long-Term Consequences of Labour and Childbirth: A Systematic Analysis of the Burden, Recommended Practices, and a Way Forward. The Lancet. 2024 February; 12(2):317-330. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(23)00454-0/fulltext
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