Four years ago, Barack Obama beat John McCain among women voters by a healthy 13 point margin. That gap was doubtless made larger by McCain's shameful performance in the final presidential debate, when during an exchange about reproductive rights he used air quotes to mock the very idea of the "health of the mother." Now, just as the Republican Party risks immolating itself with a draconian anti-abortion platform consistent with the views of Missouri Senate candidate Todd Akin, Americans are learning that Paul Ryan, too, dismissed the health of the mother exception as "a loophole wide enough to drive a Mack truck through."
Ryan's jaw-dropping disregard for the health and safety of American women came during the 2000 debate over the so-called "partial birth abortion" bill. As NPR explained, the very rare intact dilation and extraction (used only 2,200 times out of 1.3 million procedures performed in 2000) was resorted to precisely to protect the health of the woman in certain late-term pregnancies. The alternative, NPR noted, "can involve substantial blood loss and may increase the risk of lacerating the cervix, potentially undermining the woman's ability to bear children in the future."

Mitt Romney's new running mate was having none of it. During House debate on April 5, 2000, Wisconsin Rep. Tammy Baldwin told the House that "the women I have spoken to wanted nothing more than to have a child and were devastated to learn that their babies could not survive outside the womb. They made difficult decisions with their doctors and families to terminate pregnancies, to preserve their own health and in many cases their ability to try to have a child again." Afterwards, Paul Ryan rose to denounce that position:

Mr. Speaker. I just have to take issue with the comments that have been preceding this debate. This is not a political issue. This is a human issue. Let me just say this to all of my colleagues who are about to vote on this issue, on the motion to recommit. The health exception is a loophole wide enough to drive a Mack truck through it. The health exception would render this ban virtually meaningless.

Ryan's gambit failed. But in 2003, President Bush signed the Partial-Birth Abortion Ban Act into law. And by 2007, the United States Supreme Court adopted Ryan's attack on "abortionists" and the health and safety of American women.
After Justice Stephen Breyer in 2000 upheld the Court's previous exception for the "for the preservation of the...health of the mother," Justice Anthony Kennedy eradicated it in his baseless and paternalistic 2007 Gonzales v. Carhart opinion. Derisively referring to physicians as "abortion doctors" and with callous disregard for the health of American women, Kennedy in the 5-4 majority opinion decreed that father knows best. (His 2000 dissent in Stenberg v. Carhart used the incendiary term "abortionist" no fewer than 13 times.) As the Washington Post's Ruth Marcus recalled:

"Respect for human life finds an ultimate expression in the bond of love the mother has for her child," Kennedy intoned. This is one of those sentences about women's essential natures that are invariably followed by an explanation of why the right at stake needs to be limited. For the woman's own good, of course.
Kennedy continues: "While we find no reliable data to measure the phenomenon, it seems unexceptionable to conclude some women come to regret their choice to abort the infant life they once created and sustained." No reliable data? No problem!

Sadly for Justice Kennedy and sadder still for American women, the mythical post-abortion syndrome he posited has been repeatedly debunked, most recently by a study in Denmark.

In her dissent, Justice Ruth Bader Ginsburg reminded Americans what they had just lost, "The health exception reaches only those cases where a woman's health is at risk." As Roger Evans, then public policy director at the Planned Parenthood Federation of America, put it:

"Where there is medical disagreement, the tie no longer goes to protecting women's health."

By the time their new majority took over the House in January 2011, "protecting women's health" was no longer a factor at all for Republicans. In H.R. 358 (the "Protect Life Act"), sponsor Joe Pitts (R-PA) and co-sponsors Todd Akin and Paul Ryan had proposed legislation which TPM explained "would allow hospitals to let a pregnant woman die rather than perform the abortion that would save her life."

A bit of backstory: currently, all hospitals in America that receive Medicare or Medicaid funding are bound by a 1986 law known as EMTALA to provide emergency care to all comers, regardless of their ability to pay or other factors. Hospitals do not have to provide free care to everyone that arrives at their doorstep under EMTALA -- but they do have to stabilize them and provide them with emergency care without factoring in their ability to pay for it or not. If a hospital can't provide the care a patient needs, it is required to transfer that patient to a hospital that can, and the receiving hospital is required to accept that patient...
Pitts' new bill would free hospitals from any abortion requirement under EMTALA, meaning that medical providers who aren't willing to terminate pregnancies wouldn't have to -- nor would they have to facilitate a transfer.
The hospital could literally do nothing at all, pro-choice critics of Pitts' bill say.

As Donna Crane, policy director at NARAL Pro-Choice America, put it, "This is really out there. I haven't seen this before."
But she and all Americans can expect to see this again and again from Mitt Romney, Paul Ryan and their Republican Party. After all, women's health is no consideration at all in the new Republican platform, which like four years would extend 14th Amendment protections to fetuses it would withhold from the women themselves.