But once the babies are here, the state provides little help.
When she got pregnant, Mayron Michelle Hollis was clinging to stability.
At 31, she was three years sober, after first getting introduced to drugs at 12. She had just had a baby three months earlier and was working to repair the damage that her addiction had caused her family.
The state of Tennessee had taken away three of her children, and she was fighting to keep her infant daughter, Zooey. Department of Children’s Services investigators had accused Mayron of endangering Zooey when she visited a vape store and left the baby in a car.
Her husband, Chris Hollis, was also in recovery.
The two worked in physically demanding jobs that paid just enough to cover rent, food and lawyers’ fees to fight the state for custody of Mayron’s children.
In the midst of the turmoil in July 2022, they learned Mayron was pregnant again. But this time, doctors warned she and her fetus might not survive.
The embryo had been implanted in scar tissue from her recent cesarean section. There was a high chance that the embryo could rupture, blowing open her uterus and killing her, or that she could bleed to death during delivery. The baby could come months early and face serious medical risks, or even die.
But the Supreme Court had just overturned Roe v. Wade, which guaranteed the right to abortion across the United States. By the time Mayron decided to end her pregnancy, Tennessee’s abortion ban — one of the nation’s strictest — had gone into effect.
The total ban made no explicit exceptions — not even to save the life of a pregnant patient. Any doctor who violated the ban could be charged with a felony.
Women with means could leave the state. But those like Mayron, with limited resources or lives entangled with the child welfare and criminal justice systems, would be the most likely to face caring for a child they weren’t prepared for.
And so, the same state that questioned Mayron’s fitness to care for her four children forced her to continue a pregnancy that risked her life to have a fifth, one that would require more intensive care than any of the others.
Tennessee already had some of the worst outcomes in the nation when measuring maternal health, infant mortality and child poverty. Lawmakers who paved the way for a new generation of post-Roe births did little to bolster the state’s meager safety net to support these babies and their families.
In December 2022, when Mayron was 26 weeks and two days pregnant, she was rushed to the hospital after she began bleeding so heavily that her husband slipped in her blood. An emergency surgery saved her life. Her daughter, Elayna, was born three months early.
Afterward, photographer Stacy Kranitz and reporter Kavitha Surana followed Mayron and her family for a year to chronicle what life truly looked like in a state whose political leaders say they are pro-life. [...]
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