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Having a glass of wine will be child abuse if Roe is overturned

pregnant woman with wine
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Why does The Fulcrum feature regular columns on health care in America?

U.S. health care spending grew 9.7 percent in 2020, reaching $4.1 trillion — 19.7 percent of the gross domestic product. Over the long term this is clearly unsustainable. If The Fulcrum is going to fulfill our mission as a place for informed discussions on repairing our democracy, we need to foster conversations on this vital segment of the economy. Maximizing the quality and reducing the cost of American medicine not only will make people's lives better, but will also generate dollars needed to invest in education, eliminating poverty or other critical areas. This series on breaking the rules aims to achieve that goal and spotlights the essential role the government will need to play.

Pearl is a clinical professor of plastic surgery at the Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business. He is a former CEO of The Permanente Medical Group.

The Supreme Court’s leaked decision to overturn Roe v Wade, if finalized, would eliminate the constitutional right to an abortion, thereby handing over to states a choice that has been guaranteed to women for nearly 50 years.

Such a decision would not only cause major medical harm, but it would also turn tens of millions of women into instant criminals.


As a physician and health care leader, I side with the 80 percent of doctors who support the right of women to make choices about their own bodies. Medically, I concur with the scientific rationale provided in the Supreme Court opinions of Roe (1973) and Casey (1992) that fetal viability (when the child is “potentially able to live outside the mother’s womb”) establishes human life.

What’s been underappreciated in the debate over abortion are the criminal implications that would be created by defining human life at conception. Given the laws on the books, and those scheduled to go into effect should the Supreme Court overturn Roe, women in 22 states would be immediately in violation of child-abuse laws. I don’t believe doing so is what the Supreme Court justices intend or what the people of those states are expecting. But that is what will occur should the current draft become final.

To quote the governor of Oklahoma, who recently signed into law the nation’s strictest abortion ban: “From the moment life begins at conception is when we have a responsibility as human beings to do everything we can to protect that baby’s life and the life of the mother.”

Obviously, exposing fetuses to alcohol and the harmful chemicals in cigarette smoke would violate this prescription. Will law enforcement in the states that define human life at fertilization start prosecuting and potentially jailing any pregnant mother who smokes or drinks alcohol?

If a fetus is a living human, then smoking while pregnant would be equivalent to supplying cigarettes to a minor, punishable in most states by a large fine and possible jail time. Added to those penalties is the possibility of applicable child-endangerment laws. After all, nicotine dangerously reduces oxygen supply while smoke inhalation sends carbon monoxide directly to the fetus, both highly damaging. Prenatal heart defects, cleft lip and even miscarriage are just a few of the well-known consequences of smoking or breathing in second-hand smoke during the early part of fetal development. If such behaviors were to result in the death of a fetus, state prosecutors could see fit to charge parents with manslaughter or negligent homicide.

A similar concern applies to alcohol consumption. Currently, no states criminalize alcohol use during pregnancy, but supplying alcohol to a minor is illegal in every state. In many of them, it’s a felony when the crime results in serious injury or death. Self-reported studies reveal more than 1 in 9 women in the U.S. drink while pregnant. Among those of childbearing age, the prevalence of binge drinking is highest in many red states like Nebraska, Montana and North Dakota — places that are slated to institute abortion bans immediately following the ruling on Roe.

If it is determined that life begins at conception, so does the possibility of the enforcement of child-protection statutes. Any action taken by a pregnant woman that’s deemed harmful to the fetus could be child abuse, no different than if she were to intentionally harm a newborn, toddler or teenager. Research has shown that smoking and drinking in pregnancy negatively impact fetal development. The best approach to helping pregnant women abstain from alcohol and cigarettes are support groups and effective medical treatment programs.

For nearly a decade, attorney Lynn Paltrow has documented cases of pregnant women who’ve been arrested, tried and imprisoned for violating a range of anti-abortion laws, including examples of over-zealous law enforcement prosecuting women for potential harm to developing fetuses. The current Supreme Court draft would further empower such police actions.

I urge the Supreme Court justices to reconsider their preliminary opinions. As written the ruling would not only risk harm to the health of women but criminalize current law-abiding individuals. If the Supreme Court overturns Roe and allows states to define human life as beginning at fertilization, many unwarranted, unexpected and unfair prosecutions surely will follow.

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Following Jefferson: Promoting Inter-Generational Understanding Through Constitution-Making
Mount Rushmore
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Following Jefferson: Promoting Inter-Generational Understanding Through Constitution-Making

No one can denounce the New York Yankee fan for boasting that her favorite ballclub has won more World Series championships than any other. At 27 titles, the Bronx Bombers claim more than twice their closest competitor.

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Trump’s mass deportations promise security but deliver economic pain, family separation, and chaos. Here’s why this policy is failing America.

Getty Images, Tennessee Witney

The Cruel Arithmetic of Trump’s Immigration Crackdown

As summer 2025 winds down, the Trump administration’s deportation machine is operating at full throttle—removing over one million people in six months and fulfilling a campaign promise to launch the “largest deportation operation in American history.” For supporters, this is a victory lap for law and order. For the rest of the lot, it’s a costly illusion—one that trades complexity for spectacle and security for chaos.

Let’s dispense with the fantasy first. The administration insists that mass deportations will save billions, reduce crime, and protect American jobs. But like most political magic tricks, the numbers vanish under scrutiny. The Economic Policy Institute warns that this policy could destroy millions of jobs—not just for immigrants but for U.S.-born workers in sectors like construction, elder care, and child care. That’s not just a fiscal cliff—it is fewer teachers, fewer caregivers, and fewer homes built. It is inflation with a human face. In fact, child care alone could shrink by over 15%, leaving working parents stranded and employers scrambling.

Meanwhile, the Peterson Institute projects a drop in GDP and employment, while the Penn Wharton School’s Budget Model estimates that deporting unauthorized workers over a decade would slash Social Security revenue and inflate deficits by nearly $900 billion. That’s not a typo. It’s a fiscal cliff dressed up as border security.

And then there’s food. Deporting farmworkers doesn’t just leave fields fallow—it drives up prices. Analysts predict a 10% spike in food costs, compounding inflation and squeezing families already living paycheck to paycheck. In California, where immigrant renters are disproportionately affected, eviction rates are climbing. The Urban Institute warns that deportations are deepening the housing crisis by gutting the construction workforce. So much for protecting American livelihoods.

But the real cost isn’t measured in dollars. It’s measured in broken families, empty classrooms, and quiet despair. The administration has deployed 10,000 armed service members to the border and ramped up “self-deportation” tactics—policies so harsh they force people to leave voluntarily. The result: Children skipping meals because their parents fear applying for food assistance; Cancer patients deported mid-treatment; and LGBTQ+ youth losing access to mental health care. The Human Rights Watch calls it a “crueler world for immigrants.” That’s putting it mildly.

This isn’t targeted enforcement. It’s a dragnet. Green card holders, long-term residents, and asylum seekers are swept up alongside undocumented workers. Viral videos show ICE raids at schools, hospitals, and churches. Lawsuits are piling up. And the chilling effect is real: immigrant communities are retreating from public life, afraid to report crimes or seek help. That’s not safety. That’s silence. Legal scholars warn that the administration’s tactics—raids at schools, churches, and hospitals—may violate Fourth Amendment protections and due process norms.

Even the administration’s security claims are shaky. Yes, border crossings are down—by about 60%, thanks to policies like “Remain in Mexico.” But deportation numbers haven’t met the promised scale. The Migration Policy Institute notes that monthly averages hover around 14,500, far below the millions touted. And the root causes of undocumented immigration—like visa overstays, which account for 60% of cases—remain untouched.

Crime reduction? Also murky. FBI data shows declines in some areas, but experts attribute this more to economic trends than immigration enforcement. In fact, fear in immigrant communities may be making things worse. When people won’t talk to the police, crimes go unreported. That’s not justice. That’s dysfunction.

Public opinion is catching up. In February, 59% of Americans supported mass deportations. By July, that number had cratered. Gallup reports a 25-point drop in favor of immigration cuts. The Pew Research Center finds that 75% of Democrats—and a growing number of independents—think the policy goes too far. Even Trump-friendly voices like Joe Rogan are balking, calling raids on “construction workers and gardeners” a betrayal of common sense.

On social media, the backlash is swift. Users on X (formerly Twitter) call the policy “ineffective,” “manipulative,” and “theater.” And they’re not wrong. This isn’t about solving immigration. It’s about staging a show—one where fear plays the villain and facts are the understudy.

The White House insists this is what voters wanted. But a narrow electoral win isn’t a blank check for policies that harm the economy and fray the social fabric. Alternatives exist: Targeted enforcement focused on violent offenders; visa reform to address overstays; and legal pathways to fill labor gaps. These aren’t radical ideas—they’re pragmatic ones. And they don’t require tearing families apart to work.

Trump’s deportation blitz is a mirage. It promises safety but delivers instability. It claims to protect jobs but undermines the very sectors that keep the country running. It speaks the language of law and order but acts with the recklessness of a demolition crew. Alternatives exist—and they work. Cities that focus on community policing and legal pathways report higher public safety and stronger economies. Reform doesn’t require cruelty. It requires courage.

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U.S. President Donald Trump takes the stage during a reception for Republican members of the House of Representatives in the East Room of the White House on July 22, 2025 in Washington, DC. Trump thanked GOP lawmakers for passing the One Big Beautiful Bill Act.

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Just the Facts: Impact of the Big Beautiful Bill on Health Care

The Fulcrum strives to approach news stories with an open mind and skepticism, striving to present our readers with a broad spectrum of viewpoints through diligent research and critical thinking. As best we can, we remove personal bias from our reporting and seek a variety of perspectives in both our news gathering and selection of opinion pieces. However, before our readers can analyze varying viewpoints, they must have the facts.

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U.S. Constitution
Imagining constitutions
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The decade between 1776 and 1787 was defined by a period of bold and intentional nation and national identity building. In that time, the United States declared independence, crafted its first national government, won a war to make their independence a reality, threw out the first government when it failed, and forged a new federal government to lead the nation. We stand at a similar inflection point. The coming decade, from the nation’s semiquincentennial in 2026 to the Constitution’s in 2037, offers a parallel opportunity to reimagine and reinvigorate our American civic culture. Amid the challenges we face today, there’s an opportunity to study, reflect, and prepare to write the next chapters in our American story—it is as much about the past 250 years, as it is about the next 250 years. It will require the same kind of audacious commitment to building for the future that was present at the nation’s outset.

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