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Undue Burden

Life and Death Decisions in Post-Roe America

Author Shefali Luthra
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Paperback
$19.00 US
Knopf | Vintage
On sale May 20, 2025 | 368 Pages | 9780593685334
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Finalist for the 2024 Kirkus Prize for Nonfiction • A TIME Best Book of 2024 • Longlisted for the 2025 PEN Open Book Award

An urgent investigation into the experience of seeking an abortion after the fall of Roe v. Wade, and the life-threatening consequences of being denied reproductive freedom. •  "An absolute must-read; tell your friends; buy it for your family; sit with it on your own. This is storytelling we need." —Rebecca Traister, New York Times bestselling author of Good and Mad and All the Single Ladies

On June 24, 2022, Roe v. Wade was overturned, and the impact was immediate: by 2023, abortion was virtually unavailable or significantly restricted in 21 states. In Undue Burden, reporter Shefali Luthra traces the unforgettable stories of patients faced with one of the most personal decisions of their lives.

Outside of Houston, there’s a 16-year-old girl who becomes pregnant well before she intends to. A 21-year-old mother barely making ends meet has to travel hundreds of miles in secret for medical treatment in another state. A 42-year-old woman with a life-threatening condition wants nothing more than to safely carry her pregnancy to term, but her home state’s abortion ban fails to provide her with the options she needs to make an informed decision. And a 19-year-old trans man struggles to access care in Florida as abortion bans radiate across the American South.

Before Dobbs, it was a common misconception that abortion restrictions affected only people in certain states but left one's own life untouched. Since the fall of Roe, a domino effect has cascaded across the entire country. As the landscape of abortion rights continues to shift, the experiences of these patients—who crossed state lines to seek life-saving care, who risked everything in pursuit of their own bodily autonomy, and who were unable to plan their reproductive future in the way they deserved— illustrate how fragile the system is, and how devastating the consequences can be.

A revelatory portrait of inequality in America, Undue Burden examines abortion not as a footnote or a political pawn, but as a basic human right, something worthy of our collective attention and with immense power to transform our lives, families, and futures.
Contents

Introduction 

Part I: Tiffany
LOSING ROE
Chapter 1: Where It Started, Where It Ends -- TEXAS
Chapter 2: “It Shouldn’t Be This Hard” -- OKLAHOMA

Part II: Angela
ACROSS STATE LINES
Chapter 3: Not Strong Enough -- NEW MEXICO AND ILLINOIS
Chapter 4: A Haven, for Now -- KANSAS

Part III: Darlene
THE SAFE HAVEN MYTH
Chapter 5: The Promised Oasis -- CALIFORNIA
Chapter 6: Just Because It’s Legal -- COLORADO
Chapter 7: Even the Best-Laid Plans -- NEW YORK

Part IV: Jasper
THE FIGHT FOR THE FUTURE
Chapter 8: The Center That Couldn’t Hold -- FLORIDA
Chapter 9: Neither Living nor Dead -- ARIZONA
Chapter 10: How Far Will This Go? -- WASHINGTON, D.C.

Epilogue: The World After Dobbs -- TEXAS

Afterword 
Sourcing Note 
Acknowledgments 
Notes 
Index
  • LONGLIST | 2025
    PEN Open Book Award
© Meka Hemmons of SpiderMeka Portraits
SHEFALI LUTHRA has covered national health policy for the past decade, most recently at The 19th. Her coverage of abortion rights has been cited in Congressional testimony and Supreme Court briefings and in 2023 received an Online Journalism Award. Luthra’s writing has appeared in The New York Times, The Washington Post, NPR, and more. She lives in Washington, D.C. View titles by Shefali Luthra

About

Finalist for the 2024 Kirkus Prize for Nonfiction • A TIME Best Book of 2024 • Longlisted for the 2025 PEN Open Book Award

An urgent investigation into the experience of seeking an abortion after the fall of Roe v. Wade, and the life-threatening consequences of being denied reproductive freedom. •  "An absolute must-read; tell your friends; buy it for your family; sit with it on your own. This is storytelling we need." —Rebecca Traister, New York Times bestselling author of Good and Mad and All the Single Ladies

On June 24, 2022, Roe v. Wade was overturned, and the impact was immediate: by 2023, abortion was virtually unavailable or significantly restricted in 21 states. In Undue Burden, reporter Shefali Luthra traces the unforgettable stories of patients faced with one of the most personal decisions of their lives.

Outside of Houston, there’s a 16-year-old girl who becomes pregnant well before she intends to. A 21-year-old mother barely making ends meet has to travel hundreds of miles in secret for medical treatment in another state. A 42-year-old woman with a life-threatening condition wants nothing more than to safely carry her pregnancy to term, but her home state’s abortion ban fails to provide her with the options she needs to make an informed decision. And a 19-year-old trans man struggles to access care in Florida as abortion bans radiate across the American South.

Before Dobbs, it was a common misconception that abortion restrictions affected only people in certain states but left one's own life untouched. Since the fall of Roe, a domino effect has cascaded across the entire country. As the landscape of abortion rights continues to shift, the experiences of these patients—who crossed state lines to seek life-saving care, who risked everything in pursuit of their own bodily autonomy, and who were unable to plan their reproductive future in the way they deserved— illustrate how fragile the system is, and how devastating the consequences can be.

A revelatory portrait of inequality in America, Undue Burden examines abortion not as a footnote or a political pawn, but as a basic human right, something worthy of our collective attention and with immense power to transform our lives, families, and futures.

Table of Contents

Contents

Introduction 

Part I: Tiffany
LOSING ROE
Chapter 1: Where It Started, Where It Ends -- TEXAS
Chapter 2: “It Shouldn’t Be This Hard” -- OKLAHOMA

Part II: Angela
ACROSS STATE LINES
Chapter 3: Not Strong Enough -- NEW MEXICO AND ILLINOIS
Chapter 4: A Haven, for Now -- KANSAS

Part III: Darlene
THE SAFE HAVEN MYTH
Chapter 5: The Promised Oasis -- CALIFORNIA
Chapter 6: Just Because It’s Legal -- COLORADO
Chapter 7: Even the Best-Laid Plans -- NEW YORK

Part IV: Jasper
THE FIGHT FOR THE FUTURE
Chapter 8: The Center That Couldn’t Hold -- FLORIDA
Chapter 9: Neither Living nor Dead -- ARIZONA
Chapter 10: How Far Will This Go? -- WASHINGTON, D.C.

Epilogue: The World After Dobbs -- TEXAS

Afterword 
Sourcing Note 
Acknowledgments 
Notes 
Index

Awards

  • LONGLIST | 2025
    PEN Open Book Award

Author

© Meka Hemmons of SpiderMeka Portraits
SHEFALI LUTHRA has covered national health policy for the past decade, most recently at The 19th. Her coverage of abortion rights has been cited in Congressional testimony and Supreme Court briefings and in 2023 received an Online Journalism Award. Luthra’s writing has appeared in The New York Times, The Washington Post, NPR, and more. She lives in Washington, D.C. View titles by Shefali Luthra

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