I was faced with a stark question—one that, though I have spoken openly about women’s rights, somehow I had not distilled into the succinct question posed by a coming-of-age woman living and attempting to digest our country’s policies. Simply put: “Mom, so they don’t care if women die?”

Oof! For a person who has a plethora of words for almost anything, I was caught off guard. My first instinct was to protect her—protect her innocence, allow her to believe that the systems in power care about her. She is wealthy and part of a white family, so like some sort of macabre tally, she gets those ticks.

I let the truth spill out quickly before I could hold back. “No, baby girl, they don’t care.” Though I have been accused of being a radical feminist, my basis for this belief doesn’t take a cynical lens to arise. Now in the state of Alabama, you can be charged with murder for the destruction of an embryo. I have heard of much lower charges when women die at the hands of their domestic partners. In this country right now, women who are aware of the far reach of some of these policies and are also pregnant are carefully considering travel to other states, knowing that if something happened with the pregnancy while there, they could die. “No, baby girl, they don’t care.”

The government has opined that they are the best decision-makers in matters of literal life and death affecting mothers and babies. Ectopic pregnancies, women being unable to make choices about the termination of pregnancies that resulted from trauma or are incompatible with life. Women, though entrusted with the care and health of children once they are born, are not trusted to make decisions about family planning and termination of pregnancies, and these are just a few of the outcomes of these decisions being made in courtrooms. “No, baby girl, they don’t care.”

The effects of the legislation on access to medical care for women are far-reaching. The influence of these decisions is poorly understood by the individuals who are making them. In this country, the maternal mortality rate of black women—according to a study done by the CDC in 2007—is 28.4 deaths per 100,000. Being black and pregnant was dangerous in this country even before the overturn of Roe v. Wade, and now even more so. “No, baby girl, they don’t care.”

The message is loud and clear—women’s bodies are not as important as fetuses or even embryos.

I am gutted that this is the world my daughter is coming of age in. We have to keep speaking, voting, and fighting whether they care or not.

Courtney Markham-Abedi is a psychiatrist in Lexington, Kentucky. She has written widely about physician suicide and other psychiatric topics for online publications and has appeared on several podcasts, work that led feedspot.com to name her one of the 1,000 best health care journalists and editors.

Her peer-reviewed work centers on the metabolic and neurologic effects of antipsychotic medications, including case reports on a probable association between ziprasidone and worsening hypertension, ziprasidone-induced catatonic symptoms, and hypertriglyceridemia tied to the direct effects of olanzapine rather than to weight gain.

She has also written a novel, Unlocking Lakin, set in a psychiatric hospital in her hometown. The manuscript won first place for full-length prose from West Virginia Writers, and she is currently seeking an agent to represent it.