Literally and metaphorically, I live in a fertile and dangerous bayou. My beloved adopted home of New Orleans is a place where, as a progressive Unitarian Universalist minister, I have witnessed the Louisiana legislature passing some of the most inhumane laws surrounding women’s reproductive rights and health. It is a place where I have personally experienced the consequences of when women are unable to make informed decisions about their healthcare. And it is also a place where incredible activists and organizers embody what faith in a better world can look like, even after countless stinging defeats—where communities of care love and support each other, and where growth is possible in theological, emotional, and intellectual reckoning.

My own fertile growth into reproductive justice advocacy began about five years ago on the steps of the Louisiana state capitol. I had always supported the tenets of reproductive justice—a movement created and led by women of color to advocate for the right to have children, to not have children, and to raise the children you do have in safe and healthy environments. But my truly embodied advocacy began when legislators bent on passing some of the most restrictive women’s health care policy in the nation stopped to stare at my then-eight-months-pregnant belly pressing up against the mic stand as I spoke at a reproductive rights rally. Their benign smiles turned to confusion as they looked up to see a ministerial stole draped over my “Planned Parenthood” shirt. What they didn’t seem to understand was that my own pregnancy had solidified my advocacy for reproductive rights: I now had a profound clarity surrounding the importance of women having health-related decision-making access for their sacred bodies. That day, I also witnessed just how easily Louisiana state legislators, overwhelmingly male, ignored women’s voices as they passed yet another series of bills slashing reproductive health services—a disturbing but now-familiar pattern. The struggle was no longer theoretical to me; it felt real and dangerous and fertile. But in my own life, as a relatively privileged white woman, there were ways that I still didn’t embody, and so did not recognize, the full range of issues surrounding reproductive justice. I was scar-free then, hopeful and a bit naïve about the struggles that many pregnant women face in the United States—a country which now has the highest rate of maternal mortality of any “developed” nation.

As my ministry in reproductive rights became more public, some clergy and faith organizations shunned me. Mainly, though, women of all faith traditions, or no faith tradition at all, took me aside to share their stories of reproductive health, some joyful but most traumatic: forced hysterectomies, waiting periods for abortion care causing job loss for financially struggling families, horrific complications due to hospital error.

Those stories stayed with me and wove into my activism.

However it wasn’t until joining the HIVE—a multi-year fellowship for Louisiana women-identified Reproductive Rights, Health and Justice advocates designed to envision and build new models of collaborative leadership and care—in the fall of 2016 that my advocacy collapsed into my experience. Because it was from these HIVE women, from doulas and nonprofit directors and trauma-informed social workers, that I heard stories that would one day save my life. And not metaphorically, but literally.

In the HIVE itself, these stories emerged with a common theme: all the ways in which women, particularly women of color, were ignored in their decision-making, access to reproductive healthcare, even being believed about their physical pain. Sadly, this is nothing new. According to several studies from the New England Journal of Medicine, “women in pain are much more likely than men to receive prescriptions for sedatives, rather than pain medication…(and) women are seven times more likely than men to be misdiagnosed and discharged in the middle of having a heart attack.” Why? “Because 80 percent of pain studies are conducted on male mice or human men.” Women become invisible in the medical system because our physiology, different from men’s, is not considered the norm. We become not-fully-human. Black women are ignored even more, with the highest maternal mortality rate in our country. Black mothers die at a rate of three to four times that of white mothers, and suffer severe complications twice as often. In this way, racism layers on top of misogyny in a doubly-blind system. And yet, no matter how privileged you are, you can become invisible.

Serena Williams, the GOAT—greatest of all time—in tennis and one of the most recognizable sports figures in the world, almost died of blood clots after childbirth. As she noted in a 2018 Vogue interview, she knew what was happening with her body, having experienced pulmonary embolisms before, but she was not believed—first in her pain and then in her diagnosis. At a crucial moment in the course of her hospital recovery, Williams was given a different test than the one she needed. “I was like, a Doppler?” Williams said. “I told you, I need a CT scan and a heparin drip.” Only after the “Doppler” (an ultrasound) discovered nothing was Williams sent for a CT scan, where blood clots were found in her lungs. “I was like, listen to Dr. Williams!” she said, retrospectively musing on what must’ve been a terrifying situation. Even in immense pain, Williams advocated for herself because, seemingly, those surrounding her in the medical system did not wish to hear what she knew to be true.

But I would be ignoring yet more truth if I did not acknowledge that the system I am a part of—organized religion—has done its share of damage to women’s bodily autonomy, undergirding a system of racism and patriarchy. Yet, just as I have seen many medical professionals in Louisiana stand up for women’s reproductive healthcare, faith leaders and people of faith can and do lift up the visibility of people and their truths.

And that very lifting-up starts, perhaps, with acknowledging some uncomfortable truths of our own.

In the Hebrew Bible, there is the famous story of the lineage of Abraham, in which Abraham’s wife, Sarai, was initially unable to conceive. So Sarai, a woman with societal power in her community, “gave” her servant Hagar to Abraham. The story, in its straightforward telling, upholds patriarchal and racist roles: Abraham’s, Sarai’s, even God’s. Hagar—a “servant” and woman of color—is raped by Abraham, conceives a child, and is forced into the wilderness (twice!) for the audacity of continuing to exist after giving birth. There have been a great many interpretations of this story, most brilliantly from womanist theologian Delores Williams in her seminal work Sisters in the Wilderness, where she connects the Genesis stories to “black women’s experience of Christ in the face of race, class, and gender oppression during antebellum and post-bellum America.”

If we are to connect this story to a more updated narrative of the personal, political, and theological today, Hagar is not given bodily autonomy and is then punished for parenting. Tragically and truthfully, the impetus for much of this cruelty is another woman, oppressed in her own reproduction (or lack thereof): Sarai. But instead of recognizing shared reproductive struggles—Sarai is not able to (initially) conceive, and Hagar has no choice around her conception—Sarai chooses to use her limited power to, along with Abraham, exploit and then expel Hagar. “Then Sarai said to Abram,” reads Genesis 16: 5-6, “‘May the wrong done to me be on you! I gave my slave-girl to your embrace, and when she saw that she had conceived, she looked on me with contempt. May the Lord judge between you and me!’ But Abram said to Sarai, ‘Your slave-girl is in your power; do to her as you please.’ Then Sarai dealt harshly with her, and she ran away from her.’”

In 2016, 47 percent of white women voted for Donald Trump weeks after he bragged about “[grabbing] them by the p*ssy.” Trump’s coarse discourse is only overtaken by his racist and sexist policies, eviscerating women’s reproductive rights among many other issues. These 47 percent chose fear and illusory power over equity and allyship. And we are all now paying the price. And though I like to think that my choices as a white woman would be different than Sarai’s (in case you couldn’t tell, I was not one of the 47 percent who voted for the current president), I often wonder what stories I have failed to hear; whom I have failed to believe; whose voice I have dismissed just as Sarai abused and “dismissed” Hagar.

We know very little about what happens to Hagar after God gives her son Ishmael—the product of her rape by Abraham—favor in a new land. But, when I read this story as a minister, a Louisianan, a mother, and a woman who has now been through some stuff and heard some stories, I do know we need Hagar’s holy rage at her inhumane treatment—unspoken but present in each escape, each mention of “contempt” for her “mistress”. But we also need her holy love, as she advocates for her and her family’s life: Hagar speaking directly to God and naming him in Genesis 16:13. “So she named the Lord who spoke to her, ‘You are El-roi;’ for she said, ‘Have I really seen God and remained alive after seeing him?'” But most of all, we need Hagar’s wisdom—as a mother, a woman, and a human being—as we advocate for ourselves and others in the broken systems of our present moment.

Soon after I received the welcome news, on a Friday in late spring of 2018, that I was pregnant with a second child, I knew something was wrong. The day before Mother’s Day, as fate would have it, the pain began: wrenching vomiting and a heaviness that pinned me to the floor. Then came the blood. Plans were canceled. Doctors were called. Assurances were made. No need to come in. The pain can’t be that bad; bleeding was normal. I believed the on-call medical professionals. Why should I not? But the pain was not going away. I called on Sunday, was told to call back first thing Monday. Called on Monday, feeling as if I was 14 months pregnant and 100 years old. After multiple phone calls, I was told to wait two weeks until my first check-up—no one to see me. It should be fine. I then did something that I never imagined that I would do—something impolite. Because I knew in my bones—or, looking back, I suppose, my fallopian tubes—that I was decidedly not fine. Sweating, in pain, outside a restaurant while my family shared a meal with friends, I demanded to be seen. “I cannot wait. I need to see the doctor,” I gasped.

While so much of my professional life, my ministerial life, is about support and advocacy for others, advocating for myself has never quite taken priority. And it had been part of my privilege, as a white woman growing up in a state with relatively good medical care (California), to never not be believed in the medical system. But it was the stories and advice I had heard in HIVE, particularly from women of color, of being dismissed and still demanding care that stuck with me—stories that I not only fiercely believed, but believed in fiercely.

It was those stories that saved my life.

On the following Tuesday morning, I went straight to my OB-GYN. By Tuesday lunchtime, I was in the emergency room. By the late afternoon, I had been rushed to surgery for an ectopic pregnancy that had progressed to internal bleeding and near-death. My pregnancy would never have been viable—that was unavoidable. However, what could have been avoided was the pain, physical and emotional, that I endured needlessly. The days of anguished waiting and desperate phone calls. The miscommunication between my OB-GYN’s office and the ER staff at the hospital, so that I was left in stirrups while a sonogram technician repeatedly congratulated me on a future I knew wouldn’t exist. The loss of a fallopian tube and the possibility that I may never have another biological child. While many of the medical professionals who treated me were wonderful (I am alive, after all), I live in a state where women’s health care has been slashed, cut to basics, from Medicare coverage to post-natal care to abortion. And I was at a major hospital that has recently been highlighted by USA Today as an outlier in shockingly high maternal mortality and complication rates, with very few alternatives in New Orleans. In fact, the USA Today report found that “White mothers at the outlier hospitals were three times as likely to experience potentially fatal complications (than the average). The complication rates also were higher for mothers with health insurance.” And black women at those outlier hospitals had still higher rates of complications and mortality.

The hope is that care for women of all racial backgrounds rises together; the disturbing equity we’re seeing in Louisiana is reduced and diminished care for all women. Louisiana’s system is one in which women’s pain and needs are made invisible, from care for pregnant woman to almost nonexistent sexuality education to environmental toxins to lack of abortion access to lack of support once women have children. Is it cause for wonder that states with the most restrictive reproductive healthcare laws also have some of the highest maternal mortality rates?

Even today, I am fighting the insurance company who declared my emergency surgery “elective.” I find myself re-telling my story again and again, to a new disembodied voice each time, holding back tears to just get through it, just as I did and then eventually failed to do that day in the emergency room. And as I consider trying for another child, I wonder, where can I go to have this baby that doesn’t terrify me even thinking about walking through the doors? Do I want to risk leaving my other child motherless?

After the surgery, my therapist asked me if I wanted to keep my rage or let it go. I want to keep it, use it to fuel my advocacy and my life. Because that holy rage—my anger at the injustice of a system that denies the voices and rights of half our human population around their bodies and care—has led me to a more holy love, too. There was the tech who searched for a fetus while I lay prone on a table, pridefully holding back the tears; but there was also the orderly who pulled the cart over as we left the sonogram so I could quietly weep while a nurse came over with a tissue. “Here you go, baby,” she said. There were the colleagues who dropped their whole day—just from the pitch of my voice as I canceled a meeting—to care for my son while my beloved husband held my hand. There was the HIVE collective who sent notes of love and encouragement. There were the friends, church members, and family that have loved me in such a way that my holy rage—at an impersonal medical system and legislative advocacy that continues to cut women’s healthcare with false grandstanding around being “pro-life”—is matched only by the holy love that I’ve been blessed to receive. And in receiving this blessing of holy love, I want to pay that love forward: to listen, learn, and advocate ever-more-fiercely for women’s healthcare so that fewer women have to endure what I did.

And so that fewer women have to endure far worse than me.

Six months after my surgery, in fall of 2018, I found myself standing on another set of steps—those of the US Supreme Court, in defiance of then-Supreme Court nominee Brett Kavanaugh’s appointment. And though it was likely Kavanaugh would be seated (he was) and once seated would consistently rule against women’s rights (he does), I still had a voice to speak out. I still had two ears to listen to the stories of women who had been denigrated by Kavanaugh’s judicial rulings and conduct. I still had two eyes to witness Kavanaugh’s probable swearing-in. I still had one clergy collar symbolizing my dedication to showing that religion can play a part in positive social change, even amidst temporary defeats. And hidden from sight, I now had multiple scars on my stomach and, beneath them, one fallopian tube.

That day, on those steps, I preached of a holy love that propels us toward advocating for more equity and compassion. I also spoke of a holy rage that just as fiercely propels us to push back against institutional violence and the erasure of other human beings. The path between my missing fallopian tube and my collar connected that holy rage and holy love in a story that I continue to live more into each passing day as a minister, a mother, a Louisianan, and a woman in a health care system determined to erase me.

I pray, too, that my small story, shared here, might help someone else speak out of those places of holy love and holy rage—embodied by Hagar and the countless women before and since—in a system that denies women access and visibility. That some of us might recognize, too, the ways in which we may embody the cruelty and dismissiveness of Sarai in order to fit into a patriarchal framework that was never meant to accommodate us. That we can grow toward something new. Perhaps, someone will read this and it might save their life, the life of a loved one. Or, truly, for those of you who have never had to endure an embodied moment where your lack of healthcare is directly related to your genitalia (i.e. cisgender men), and especially those who sit in our highest legislatures—may you have the strength to realize that it does not need to happen to your daughter, your mother, your wife, or your sister for you to care about women’s health. You have the capacity to listen to and believe women, particularly women of color, in their stories of lack of healthcare access, or even simply to take seriously the data that has been passed down on healthcare outcomes for women. And for all of us, we can do more listening and more advocacy in both big and small ways: voting for more reproductive healthcare access and candidates who unequivocally support that access, and advocating a little more fiercely for ourselves and others, including medical professionals, in an overtaxed Louisiana medical system.

When my therapist asked me to think of a healing image alongside that hardest of moments in the hospital—prone in stirrups for longer than any woman ever should be, because no doctors were available to see me—I imagine something closer to home.

That fertile and sometimes dangerous Louisiana bayou.

The blue light from the ultrasound monitor becomes the soft glow of a Louisiana twilight. The gaunt shapes of the medical equipment turn to bent cypress trees veiled in Spanish moss, the beep of monitors to the whir of cicadas. My love of this place I call home is equal to my anger with it, something akin to how I feel about this country today. I am called by that love, by the holy rage and holy love of Hagar, to stand on state legislative steps, Supreme Court steps, on the steps of hospitals and churches and porches, with patients and medical staff and friends, comforting, planning, advocating, doing what needs to be done to move the places and people I love toward ever-greater wholeness. I will do this with my one collar, my one heart, my one fallopian tube. And I will do it in chorus with the many, many voices of people across this nation, crying out—in rage and in love—for equity, compassion and healthcare access for all.