When I first met Amy in the emergency room, she had a minor laceration on her finger. She claimed it was from an accident in the kitchen, but her cowering posture, downcast eyes and hesitant responses to basic questions suggested there was more to her visit than she was letting on.
Amy reminds me of the girls I grew up with. Delicate, but exhausted and under pressure. She works long hours at a convenience store with a manager who offers no flexibility. Determined to save enough for college classes toward her degree, Amy has also shouldered the responsibility of supporting her mother, who has grown dependent on painkillers. She cleans homes to cover unexpected expenses, like becoming pregnant after a condom broke during sex, but she was unable to scrape together enough cash to purchase the morning-after pill.
On June 3, the Trump administration revoked guidance that required hospitals to provide emergency abortions for patients in need. This national directive was issued in 2022 by the Biden administration, using the Emergency Medical Treatment and Active Labor Act (EMTALA), after the Supreme Court overturned Roe v. Wade, and it was intended to assist women facing medical emergencies and other serious complications. The Trump administration’s action is just the latest salvo in an ongoing battle, one in which reproductive freedom seems to be losing ground every day. The mood, among both doctors and patients, is one of persistent uncertainty and fear. Here in the emergency room, Amy and I both feel it.
The cut on Amy’s finger was a ruse — a desperate act to access care. She is pregnant and doesn’t want to be. But in our state, abortion is illegal. As an emergency physician, I tell her – quietly – that if she travels to another state, she can receive proper care. She’ll need to budget a certain amount of cash for travel expenses. We keep this conversation between us.
The possibility of this scene has become all too familiar a worry in real life, but the truth is that Amy isn’t real. And I’m not really an emergency physician, I just play one in a movie.
A few months after the Supreme Court overturned Roe v. Wade on June 24, 2022, while we were both still attending journalism school at New York University, my friend Nate Hilgartner approached me about a film he wanted to write and direct about the ethical implications of a post-Roe world. He had me in mind to play a doctor in a rural town torn between her duty to help her patient and the imperative to obey restrictive new laws. It would be an American horror story, he told me. At the time, it seemed prophetic but impossible, a bit of artful exaggeration to warn against a dystopian tendency. Today, it’s our reality, and in some ways, things are worse.
The consequences of a woman not receiving the reproductive healthcare of her choice could lead someone like our fictional protagonist to lose her ability to create a life on her own terms, trapping her in a cycle of poverty with a lack of education.
In Georgia, a pregnant woman who has been declared brain-dead is being kept on life support until her baby can be delivered. Across the country, women have been turned away from emergency rooms after suffering ectopic pregnancies, which require an emergency abortion to prevent potentially fatal outcomes. Doctors have been reprimanded and fined, including Caitlin Bernard, an OB-GYN from Indiana, who performed an abortion on a 10-year-old rape victim denied an abortion in Ohio. Three years ago, all of this would have sounded like fiction, a fever-dream storyline out of The Handmaid’s Tale.
An investigation by ProPublica in December 2024 revealed that doctors in states with abortion bans often feel abandoned by lawyers and hospital leaders when seeking guidance on how to proceed with patients in emergencies. Since information about managing the bans in each state have been provided only on a “need-to-know” basis, many doctors are left to navigate alternative options on their own, with some becoming too afraid to offer care, fearing professional and personal consequences. Sen. Ron Wyden (D-Oreg.) described the situation as doctors “playing lawyer” and lawyers “playing doctor,” leaving pregnant women facing life-or-death situations caught in the middle. Experts warn that the decision to eliminate access to emergency life-saving abortions will further exacerbate the crisis for doctors.
The Trump administration’s order to revoke emergency abortions sends a clear message to women who lack adequate resources to afford proper care. EMTALA, enacted in 1986, was designed to protect patients and ensure they receive stabilizing emergency care, regardless of their insurance status or ability to pay. While all pregnant women benefited from this law, it now appears that only those with sufficient health care and life circumstances will be able to survive potential emergencies.
I am a writer and an actor, not a doctor. But for a time I imagined what it was like to be seated across from a woman scared and uncertain about the choices she could make about her body. Amy may not be real, but her plight is. Many of us may not admit it, but we’ve had our scares, moments where we’ve had to seriously consider the possibility of what we’d do if confronted with a pregnancy we weren’t ready to have. At an age where I contemplate my own reproductive future, I am given pause: How can anyone assume there will never be complications in their pregnancy? Stories like Amy’s aren’t just about the right to make decisions about our bodies; they’re also about the painful truth that those choices often come with a cost.
When we set out to make this film, No Choice, we hoped to imagine a plausible future — not to prophesy our present reality. We could never have predicted just how quickly real-world headlines would not only validate our story, but outpace its darkest possibilities. Making a film was just one of many actions we hope other people will take to challenge the belief that a woman’s body belongs to the state, not to herself. No Choice premieres in Los Angeles at the Dances With Films festival on June 23 — just one day shy of the third anniversary marking the fall of Roe v. Wade.
