Pregnant and Unmarried? In Tennessee, That’s Now Grounds for Denial of Care.

A new law allows doctors to deny treatment based on ‘conscience.’ Now a woman has been denied prenatal care.

Originally published on The Contrarian with the headline, “Tennessee opens a new front in its unrelenting attacks on bodily autonomy.”

Abortion restrictions are never only about obtaining abortion care. Bans on gender-affirming care or bathroom access are never just an attempt to discriminate against trans people. One thing is certain: These kinds of laws double as an affront to democracy.

A breaking story out of Tennessee makes this abundantly clear. TN Repro News reported on a Jonesborough town hall, where a pregnant woman stood up and shared that she was denied prenatal care because she is unmarried. (For the record, the patient has been with her partner for 15 years and they have a 13-year-old child.) In an exclusive interview by reporter Rachel Wells, the woman—who requested anonymity out of fear of retaliation—shared that their family’s home is “lovingly referred to … as the ‘hangout house,’ where her kid’s friends regularly come to hang out, play games and make art.”

… Not that any of that should matter. But wow.

This is the first reported case of a woman being denied prenatal care for being unmarried in the state of Tennessee and the country. And it is the direct result of the state’s 2025 Medical Ethics Defense Act, which went into effect in April. The law enables physicians, nurses, hospitals and insurers to invoke religious, moral or ethical objections to the provision of care and treatment, with no legal requirement to provide patients with a referral or alternative.

Tennessee is the 12th state to pass such a law, putting it in the company of Alabama, Arkansas, Florida, Mississippi and South Carolina, among others. With conscience carveouts for health services, including abortion, gender-affirming care, contraception or any other procedure that conflicts with a provider’s “sincerely held” beliefs, patients are not even required to be notified in advance. This means they might become aware of a refusal only in real time, in the waiting room or on the examination table. For those who live in rural or underserved areas, the consequences are devastating. The woman at the town hall said she is now traveling out of state to receive prenatal care.

Proponents of the bill claim it serves Tennessee’s healthcare needs because it will help the state recruit and retain physicians.

To be clear, Tennessee has seen a decline in OB-GYNs since its sweeping abortion ban went into effect almost immediately after the Supreme Court ruling in Dobbs v. Jackson Women’s Health in 2022. (Dr. Sharon Malone and I recently wrote about the correlating phenomenon nationwide for The Contrarian and Ms.: “A warning bell for all women in America“). Not surprisingly, Tennessee has the highest maternal mortality rate in the country and equally alarming infant mortality rates. A July 14 CNBC study ranked the state dead last in the nation for quality of life, highlighting its decade-long attack on the rights of LGBTQ+ people.

Tennessee’s broad attacks on bodily autonomy have been unrelenting. The U.S. Supreme Court’s decision last month in United States. v. Skrmetti, which upheld a state ban on gender-affirming care for people under 18, came courtesy of Tennessee. Just last week, a federal judge struck down a portion of Tennessee’s 2024 law barring adults from providing information to minors about legal, out-of-state abortions, a decision Tennessee Right to Life immediately pledged to challenge.

I asked Lynn Paltrow, founder of Pregnancy Justice, about the brazenness of state-sanctioned discrimination.

“For years, abortion laws were the primary mechanism by which women could be controlled and sexism expressed, but with a large degree of plausible deniability,” she explained. “After Dobbs, though, there is no longer a need for pretense. States can outlaw abortion. So all of the social outcomes lawmakers sought to accomplish through the distraction and politicization of abortion, they can now do directly, like penalizing unmarried women. The need for pretense is gone.”

Contrarian contributor Joyce Vance further threads the needle in her Substack Civil Discourse:

“Unmarried? Pregnant? Sorry, no healthcare for you. … We’ve heard about Christian bakers not wanting to bake cakes for gay couples. This is the next logical step in the Supreme Court’s permissive politics towards Christianity. Except that this doctor seems to have forgotten that Mary was an unmarried, pregnant woman when Jesus was conceived.”

Indeed.

According to TN Repro News, neither of the U.S. senators from Tennessee, Marsha Blackburn and Bill Hagerty, responded to inquiries from the woman who was refused care. Hagerty’s staff reportedly told her that the senator is not obligated to listen to his constituents.

That prompted Tennessee state Rep. Gloria Johnson to weigh in with all the clarity of the moment, “It’s absolutely not pro-life, and not very Christian at all. And who else are they not going to treat? … I mean if you can just refuse treatment to anybody whose lifestyle you disagree with, this is not medical ethics. This is fascism.”