A Matter of Necessity

Shefali Luthra covers abortion for The 19th at a crucial moment

December 6, 2022
Darrel Frost

Shefali Luthra remembers a woman named Karla, a twenty-three-year-old grocery store cashier whose birth control failed. Luthra, a healthcare reporter for The 19th, an outlet focused on politics and policy through a gender lens, met Karla in September 2021 in McAllen, Texas, at a facility run by Whole Woman’s Health, a healthcare management and reproductive-care company. Just weeks before, a state law known as SB 8 had banned abortion after the point when an ultrasound detects a fetal heartbeat, which generally takes place around six weeks of gestation. Luthra flew in to the Rio Grande Valley from Washington, DC, to see what was happening at one of Texas’s most oversubscribed, under-resourced clinics. “The most important thing to me,” she said, “is trying to capture what it means for people who had rights and lost them.”

Karla had come to Whole Woman’s Health that day to get an abortion. Actually, she had visited already to receive an abortion, but she wasn’t sure it had worked: she’d been prescribed mifepristone and misoprostol to terminate her pregnancy, but she didn’t bleed or have cramps. She went back for another appointment and tried the treatment again; still, nothing happened. Now she was returning to the clinic to inquire about a surgical procedure, which would cost eight hundred dollars. Because Texas requires anyone seeking an abortion to wait twenty-four hours after an initial consultation, Karla had visited Whole Woman’s Health a total of four times between when she found out she was pregnant and when the ban would prohibit her from terminating. The whole ordeal would cost far more than it does in many other states, partly because Whole Woman’s Health, situated in one of the poorest regions of the country, has to fly doctors in. Karla was worried about the money and the fact that she had to take several days off from work. But she was clear about the trade-off. “I can be broke now, or I can be broke the next eighteen years of my life,” she told Luthra. 

Luthra described Karla’s experience in a feature for The 19th—and noted that she was one of the lucky ones, who lived close enough to a clinic to make repeat trips and who knew she was pregnant right away. “She could tell by the smells,” Luthra wrote. Karla told her, “Everything was rancid.” Veronica Hernandez, the manager of McAllen’s Whole Woman’s Health, told Luthra that after SB 8 went into effect, the number of women coming in for care had fallen by close to half. When Luthra arrived, only two of eight patients seeking an ultrasound were eligible for an abortion. Speaking to sources, she felt “a combination of shock and realization that this is where it was all going.” She realized, too, “how little separates you from them.”

To Luthra—who spent most of her childhood in the Bay Area, where she grew up thinking of abortion as a standard component of healthcare—the situation in Texas was unlike anything she’d faced. Yet, she said, “I feel very close in age to the people I write about.” She is thirty, and recently engaged, petite with curly bangs. She speaks quickly, as though she urgently needs to get her point across. In her story, Luthra described Karla’s case in the service of a larger idea: “The window of eligibility to get an abortion in Texas is infinitesimal,” she wrote. “Functionally, pregnant people have about a one-week window in which an abortion is feasible—even smaller than the two-week period experts initially forecast as a best-case scenario.” Less than a year later, the Dobbs decision has made it all but impossible for many more women to get an abortion.

When Luthra was hired at The 19th—in 2020, the year the site launched—her assignment had been to report on everything from mental health to drug prices to Medicaid expansion. But as it turned out, the vast majority of her coverage since SB 8 has focused on reproductive rights and care. Part of that is owed to the fact that The 19th has Texas roots: the founders, Emily Ramshaw and Amanda Zamora, are veterans of the Texas Tribune; the newsroom has a small headquarters in Austin. “I think it poised us to tell stories that other people were not telling,” Abby Johnston, Luthra’s editor and the editorial director of The 19th, told me. As restrictions on bodily autonomy have accumulated, leading up to the Dobbs decision and in its aftermath, Luthra’s reporting, and her ability to forecast what might come, have become an anchor for The 19th.

It’s an important beat at a crucial time for an unconventional outlet. Rebecca Traister, a writer at New York magazine and The Cut who has covered politics, power, and gender for decades, told me, “The seriousness with which they treat so many of these issues—abortion, immigration, voting rights—it’s appropriate to the moment.” Readers are paying attention: Alexandra Smith, the audience director of The 19th, said that since Dobbs, “the average monthly visitors are higher than before the decision.” For Luthra, devoting herself to abortion coverage has been less a matter of choice than one of pressing necessity. “The end of Roe v. Wade,” she said, “it does have implications for marriage equality, it has implications for access to gender-affirming care, it matters for economic equality, it matters for how education works.” She went on: “There are so many people whose lives are ultimately at stake because of abortion restrictions and abortion bans. The fact that I get to cover this and share those stories—I feel really privileged to get to do that.”

Luthra started her journalism career in earnest during consecutive college internships at the Texas Tribune. Ramshaw had been one of the site’s founding reporters, joining in 2009 with a focus on investigations, before eventually rising to editor in chief, in 2016. Over ten years there, she helped the Tribune grow from a nonprofit startup that no one was sure would make it into a staple of Texas news, recognized for enterprise reporting, a goal to diversify its editorial staff and audience, and strong financials at a time when legacy publications were laying people off. Zamora, The 19th’s cofounder, came to the Tribune as chief audience officer in 2016 from ProPublica. She grew the Tribune’s readership, and was recognized by Evan Smith, the Tribune’s CEO, as a champion for diversity and a mentor to young talent.

When Luthra arrived in Texas, it was 2012; the Affordable Care Act was soon to be rolled out across the United States, “with Texas rejecting basically the whole law,” as she remembers. On her first day, an email blast went out to the interns, looking for someone to cover a healthcare story. Luthra volunteered first. She hadn’t expected that to become her beat—she studied English literature at Brown, where she was editor in chief of the campus newspaper (“I really love the modernists”)—but she liked how the subject allowed her to think about policy, business, and science. The next summer, she returned; it was the year Rick Perry signed an omnibus abortion bill and Wendy Davis filibustered in sneakers for nearly eleven hours. She wrote about both.

Luthra wrote about other topics, too. She covered the need to expand community care for disabled people and a state initiative to reduce the cost of neonatal intensive care. But reproductive health kept popping up. She wrote about the shuttering of Planned Parenthood clinics in Texas and the brewing legal fight over the state’s new abortion restrictions. She could see the writing on the wall. “Those two summers really helped me understand just how fraught the protection for abortion rights was, if it even existed,” she said. 

Courtesy of Shefali Luthra

When she graduated from college, in 2014, she took a position in Washington, as a correspondent at Kaiser Health News covering healthcare and policy. She wrote about drug pricing, political fights over health insurance, and healthcare costs; KHN had a recurring column crowdsourcing medical bills and explaining the charges, to which Luthra contributed. In 2019, she received a reporting fellowship to work in Germany, and spent two months hosted at Der Spiegel, writing stories for KHN comparing Germany’s universal healthcare with America’s mostly privatized system. As the 2020 elections approached, she got familiar with every Democratic presidential candidate’s universal-healthcare proposal. The work felt urgent. “The financing system, the insurance system—these are all things that are life or death for people,” Luthra said.

Then came covid. During her last six months at KHN, she covered the politics of health misinformation and contributed to a collaboration with The Guardian to document the lives of the more than three thousand US healthcare workers who died from covid in the pandemic’s first year. Luthra spoke to grieving family members to write capsule obituaries. “It’s been a very long, full few years,” she told me. The anguish in those stories lingers with her. “But I think it’s shown us, at the very least, that this stuff really matters. Healthcare journalism with an equity focus has been treated as a human-interest story a lot of the time. It’s rarely on A1. And I think we’ve learned that it deserves to be.”

Back in Austin, Ramshaw and Zamora had been thinking similarly. Ramshaw likes to say that she came up with the idea for The 19th while on maternity leave, covered in spit-up and drowning in diapers, watching the 2016 election and the conversations it spawned on electability and likability. “I had this moment of clarity, where I saw even women weren’t ready to elect a woman president,” she told me. After Hillary Clinton’s defeat came the Women’s March, the extended outrage of Donald Trump, and #MeToo. By 2020 there were more women running for office than ever before, “but the end result of the election was still a white man” as president. She’d observed for years the influence women could have, and felt the media was not keeping women sufficiently informed. “What needed to change in the national narrative for us to see nontraditional candidates as leaders?” she wondered. “What was the media’s responsibility in ensuring that we normalized leadership of women of color, of queer people, in the national landscape?” In Ramshaw’s view, the promise of the Nineteenth Amendment, which gave Americans the right to vote regardless of gender, had been left unfulfilled. That amendment became her new venture’s namesake—with an asterisk in the logo, to remind readers that women’s rights remain “unfinished business.” 

Ramshaw had been Luthra’s editor at the Tribune—“kind, supportive, no-nonsense,” Luthra said, someone who made her feel trusted even as a “baby intern.” They stayed in touch. “No matter what she did, I had to follow,” she told me. “And very luckily, she brought me in.” Luthra was hired at The 19th with a mandate to find gender angles on all the healthcare topics she had been covering at KHN, from Medicaid expansion (it “has huge ramifications for pregnancy-related health and gender equity,” she told me) to mental health (“depression and anxiety are more common in women”) and healthcare costs (“women are way more likely than men to not get prescriptions because of the price” even as “women need more medications, including contraception”). 

Luthra got a chance to dabble in these topics early on, writing stories on the increased risks of being pregnant during a pandemic, the surge in domestic violence during early covid restrictions, and the potential impact of Medicaid expansion on maternal mortality. But in May 2021 she went to Kansas to report on what would happen if neighboring states banned abortion and Kansas became a nexus of care. Around that time, the Supreme Court agreed to hear the Dobbs case. She had known since starting her new job that abortion would be an important part of her beat. But it wasn’t until then that it clicked for Luthra: the end of Roe v. Wade “was going to happen very soon.” 

The 19th is similar to the Texas Tribune in a lot of ways: it’s a member-supported, nonpartisan, nonprofit, digital-first newsroom focused on policy and politics. It is often mentioned in the same breath as ProPublica. It is less often compared to self-consciously feminist media—that world of Feministing, The Hairpin, The Toast, XoJane, Slate’s DoubleX, Vice’s Broadly, The Lily at the Washington Post, and Bitch, to name a few. Many of those outlets have lately shuttered or been folded into parent publications. In some cases, the branding had grown stale—the name DoubleX seemed retrograde, excluding nonbinary people and trans women. In others, the leadership was cannibalized by legacy media. And then, some of the fading interest had to do with voice. In a piece for the New York Times, Samhita Mukhopadhyay, a former executive editor at Teen Vogue and Feministing, told Michelle Goldberg, “That type of earnest, identity-focused feminism has also grown out of style.” Financially, she suggested, a feminist platform is difficult to sustain. Mukhopadhyay told me, “They don’t have great business models.” Traister, too, sees headwinds. “Understand that even taking issues of gender seriously is assumed within mainstream media to be ideological,” she said.

In contrast to an earlier era of women’s magazines and blogs, The 19th takes a neutral tone; instead of rewarmed takes, you get “The 19th Explains.” The design of the website is spare; news photographs are favored over illustrations. Smith, the site’s audience director, likes to say that The 19th is not going to be most people’s only source of news, which means that reporters can forgo incremental stories. “You can come to us and trust The 19th to give you some more context,” she told me. Many of the site’s subjects and sources are women, nonbinary people, or people of color—a corrective to overreliance, elsewhere in the press, on white men. The 19th’s coverage is entirely free; there are no paywalls, and other outlets can republish whatever they want. Many avail themselves of that opportunity—including the Texas Tribune, The Guardian, New Hampshire Public Radio, Ms., and Teen Vogue. For that reason, readers told me, they frequently come upon a 19th article without realizing its origin. You have to notice the fine print. Even some admirers don’t know a 19th story when they see one—but, when asked, express appreciation that the newsroom exists. 

The 19th is supported by donors, all of whom are listed on the website, including major investors such as Kathryn Murdoch (one of Rupert’s daughters-in-law) and Quadrivium, her foundation; the Rockefeller Philanthropy Advisors’ Collaborative for Gender + Reproductive Equity; Craig Newmark Philanthropies; and the Robert Wood Johnson Foundation. Additional revenue comes from speaking engagements, and the site has cultivated sponsors for events; a recent one in Atlanta, in partnership with Live Nation Women and Teen Vogue about the midterm elections, featured Stacey Abrams and the singer Allison Russell. 

The website also includes a statement about representation: “Today, women make up more than half of the American electorate and are more engaged than ever in our politics,” it reads. “Yet they remain underrepresented in government and in the nation’s executive ranks.” In calling out a lack of female leadership, The 19th can sometimes feel like a throwback to girlboss feminism, a notion that attributes women’s inequality to a lack of powerful representation and one that has been widely rejected as too white and too privileged. But if, in the early days, that gave The 19th a whiff of fustiness, Ramshaw and her colleagues quickly adjusted course. In its first two years, the site has evolved to cater not only to women but to the LGBTQ+ community and people of color. “We’re trying to serve, truly, anyone who has found themselves marginalized by the enduring power of the patriarchy,” Ramshaw told me; that pivot has “made us so much better and so much stronger.” 

Today, The 19th’s staff reflects that broadened aim: the newsroom is 65 percent women of color, with 28 percent identifying as LGBTQ+; 16 percent are people living with disabilities. “We pledged to build the most representative newsroom in America,” Ramshaw told me. “I think we are pretty close to that point.” Luthra believes that diversity of experience and viewpoint improves coverage. “They really understand that the person you are shapes the work that you do, shapes the stories you will see,” she said. “To see that treated as an asset, and to see people interested in my whole self, both for the work it brings me to do but also because that’s who I am, is really hard to come by.”

This year, The 19th launched a salaried fellowship program, in partnership with Nikole Hannah-Jones, to bring graduates of Historically Black Colleges and Universities into the newsroom and create a pipeline for women of color in media. The inaugural class are all Black women with strong ties to the Southeast. “We want to recognize that staying in journalism is hard, especially if you come from a marginalized background,” Johnston told me. “We want to do everything that we can to ease that burden.” Employees are offered above-standard benefits, including six months of fully paid parental leave and four months of fully paid caregiver leave. Luthra told me that, after she broke down crying during a meeting with HR, Johnston encouraged her to take a mental health break for a week. The newsroom has also embraced remote work, with reporters scattered across the country; Ramshaw wants everyone on staff to live wherever they have “the best childcare, the best elder care, the best family or peer support they need to do the job.” 

“When we look at questions of gender equity in both newsrooms and news content, professional culture is a huge issue,” Meg Heckman, an assistant professor of journalism at Northeastern University, said. “There are so many stories of inequitable pay, sexual harassment, a lack of seriousness assigned to the work of women journalists.” Building a supportive culture has a direct impact on the work that gets produced. As Luthra told me: “It really makes it a place where I do feel I am the best journalist I can be.”

Luthra’s coverage of abortion for The 19th has ranged from an analysis of Republican strategy around abortion bans (“Republican-led state legislatures will be quick to emulate Texas”) to explainers on why so many abortion restrictions were suddenly being introduced in state legislatures (“It is part of an effort to ensure that states have laws on the books that restrict abortion in as many ways as possible”) and a prescient piece on how laws restricting abortion will affect the care of patients who miscarry. She always makes sure to include information on the wider effects of local bans—reporting, for instance, on Florida becoming a regional hub for abortion even as the time frame to seek an abortion there has diminished, and on how Oklahoma’s increasingly strict abortion bans (before the state effectively barred the procedure outright) hurt not only Oklahomans but Texans, Kansans, and Arkansans, too. When Kansans rejected a proposed amendment to their state constitution that would have removed the guaranteed right to abortion, rather than focus on the political competition, as the New York Times’ coverage did, or rehash boilerplate outrage at the Supreme Court, as seen in Jezebel, Luthra noted the state’s importance as a destination for abortion, in spite of the fact that Kansas has only five abortion clinics. She takes evident pleasure in pointing out antiabortion gaslighting, as in her coverage of Lindsey Graham’s introduction of a national ban. Other outlets reported on its likelihood of passing and the hypocrisy of claiming that abortion regulation should be determined by the states only to turn around and introduce a national bill; Luthra took the news as a jumping-off point to quote experts on why rape and incest exceptions such as those in Graham’s bill are “nominal at best.”

She has also become an authority on health equity reporting. On the day the Dobbs decision came down, Luthra made an appeal to colleagues at the Center for Health Journalism: “It’s tempting to focus on the political battles,” she wrote, but “doing this story justice requires empathy, nuance and sustained, long-term attention.” She advised abortion reporters to “be cognizant of the risks people take when they speak to us, and respect their wishes for privacy and protection.” Luthra told me she feels a need to prove to sources that she deserves their trust. “I do my best to be a decent person to them while they were processing something that was really difficult to go through,” she said.

Her ability to identify potential consequences for women, LGBTQ+ people, and other marginalized groups has not been limited to the reproductive-care beat. In September, she reported on a ruling by a federal judge in Texas that full insurance coverage of certain ACA preventive-care provisions was unconstitutional. When the Times covered the ruling, it explained the judge’s reasoning but stopped short of looking at how the ruling was expected to have a disproportionate impact on reproductive- and sexual-health services. In contrast, Luthra headlined how striking down the provision would threaten gender-based protections in particular, from PrEP to breastfeeding support to contraception.

Though Luthra may be The 19th’s star player on abortion and reproductive-health coverage, almost everyone in the newsroom is reporting on the ways reproductive-health policy affects women. Chabeli Carrazana, an economics reporter, covers abortion from that vantage; Kate Sosin and Orion Rummler, two reporters focused on LGBTQ+ coverage, bring in reporting on what the Dobbs decision may mean for LGBTQ+ rights. Sara Luterman, The 19th’s caregiving reporter—a dedicated position that covers everything from childcare to community-based resources for family caregivers—has written about how people with disabilities feel about abortion. The newsroom has also recently waded into polling, teaming with SurveyMonkey to ask more than twenty thousand people their opinions on, among other things, abortion, caregiving, and healthcare; the results have been mined for stories, including one by Luthra and her colleague Jasmine Mithani reporting that 70 percent of Americans don’t trust politicians to be informed enough to make abortion policy.

Ramshaw told me that having different beats collaborate and overlap is key to The 19th’s approach, “because all of these things touch each other.” The result is a clear sense of how areas of policy intersect. That appeals to Sarah Leonard, the editor in chief of Lux, a feminist socialist magazine. “What they’re producing ought to be in newspapers anyway,” she said. “The issues they’re dealing with at The 19th are major, mainstream political issues that are shaping every midterm race as we speak, and what they’re doing is building concentrated power to rectify a gap that never should have existed in mainstream news.”

In August, two months after the Dobbs decision, the New York Times reported that “readers have flocked to women-centric publications that support abortion rights to understand how it will shape their lives.” The article cited The 19th in particular, which saw a 63 percent jump in readership for its abortion-related stories. Readers had been visiting the site not only for breaking news coverage but also for reporting about how other civil rights might be affected, from access to contraception or Plan B to speculation about attacks on same-sex marriage. A dashboard of abortion laws by state drove a lot of traffic. Leonard told me the map was an important service, systematizing that information for casual readers as well as for reporters, activists, and organizers; she refers to it often. “It takes time and experienced journalists to put in the hours to collect that information and keep it up to date as the landscape is changing every single day,” Leonard said.

The interest appears to be sustained. In 2022, The 19th saw an almost 300 percent increase in search referrals, bringing new readers onto the platform. Overall, Smith told me, the biggest bump has been to health- and abortion-related articles—she singled out a story Luthra wrote about three women who had become pregnant in Texas after the six-week ban took effect—but LGBTQ+ coverage, business and economics news, and political stories are all popular verticals that drive traffic. Whereas an earlier, more voice-y generation of women’s media sought primarily to attract a young audience, The 19th might have broader appeal: most of the site’s readers range from twenty-five to forty-four years old, and a significant number are over fifty-five. Smith said she has received a lot of feedback from older women who have appreciated seeing themselves represented in coverage. In an era of widespread accusations of bias leveled against media outlets of all stripes, The 19th’s scrupulous neutrality may insulate it from being siloed. Ramshaw noted that almost half the readership is made up of men. “That was something I absolutely did not anticipate,” she said, “and it’s a really good sign, because we are not going to have any true narrative shift without their buy-in.”

Luthra is hopeful about the role The 19th has carved out and what the ripple effects might be. “Having a publication like The 19th exist, and seeing the response from readers, has helped other media outlets understand that there was a void,” she said. At the same time, for Luthra personally, covering the breakneck pace of abortion news has been as galvanizing as it has been draining. It’s hard to step away when it feels like people depend on you to tell these crucial stories. In addition to her day job, Luthra has become a go-to on-air expert, appearing on All In with Chris Hayes, PBS NewsHour, and WNYC’s Brian Lehrer Show. She is now writing a book about abortion, one that will take a broader look at the erosion of rights across the country. She hopes it will make readers see that “this is not a niche topic,” she said; it is something that could affect any of us. “I don’t mean that in the metaphorical sense that abortion rights is part of broader privacy rights. I mean abortion in and of itself is now only a few degrees removed from you.” 

Recently, Luthra talked to a source who was concerned that news of Dobbs and all it meant—for women’s rights, for privacy, for healthcare, for families’ economic futures—was already fading from major outlets. Luthra shares that worry. Yet we are only beginning to see the impact, she said, especially as the antiabortion movement figures out “how far they want to go in terms of what they will criminalize and what kinds of alternatives they promote.” Luthra could only reassure the source that, at The 19th, abortion will continue to receive above-the-fold treatment as she and her colleagues follow what comes next, especially at the state level, and “the unequal impact abortion bans can have” when it comes to race, class, and the experiences of trans people. As that new reality unfolds, she wants readers of The 19th to “have a much stronger sense of what the post-Dobbs world means.” Restriction of abortion access, she said, “is something we are willing to keep saying is really important—and deserves to be at the foreground of everyone’s mind.” 

Anna Altman is a writer living in Washington, DC.