Arwa Mahdawi warns CDC abortion surveillance expands

Arwa Mahdawi points to one exchange in a US Senate confirmation hearing to show how quickly public-health data can be turned into a tool of political control. During her July 2023 confirmation hearing as director of the US Centers for Disease Control and Prevention, Dr Erica Schwartz was pressed by Republican Senator Josh Hawley on abortion data collection, and she committed to making “abortion surveillance” a critical part of the agency’s work, according to The Guardian.

Mahdawi’s column describes the CDC’s Abortion Reporting System as voluntary, with some states not submitting data. That patchwork matters because it creates an opening for politicians to argue that missing data is evidence of concealment, while also giving federal officials an argument for expanding collection. The piece notes that mandated reporting is already widespread: the Guttmacher Institute counts 44 states plus Washington DC with some form of required abortion reporting. The debate, then, is less about whether abortion is counted at all than about who gets to define the categories, set the reporting rules, and decide what is linked to what.

Schwartz told senators she wanted to ensure emergency services data is not conflated with abortion data and stressed the need for “clear case definitions” to keep numbers accurate. In Mahdawi’s telling, that is the technical language that makes an expanded reporting regime sound neutral: define terms, standardise fields, improve comparability. But the column also highlights how Hawley’s framing treats abortions as acts that are “committed,” language that fits a criminal-justice register more naturally than a medical one. Once the same event is treated as both a health outcome and a potential offence, the practical question becomes which systems talk to each other, and under what authority.

The Guardian piece also places Schwartz’s confirmation inside a leadership churn at the agency. The CDC had been without a permanent leader for almost a year, Mahdawi writes, and her predecessor Susan Monarez lasted only 29 days before being ousted after clashes with Robert F Kennedy Jr over vaccine policy. Schwartz, who served as deputy surgeon general during Donald Trump’s first term, told senators she would “never betray the science,” while avoiding direct answers on how she would handle pressure from Kennedy on vaccines.

Mahdawi points to New York as an example of how reporting rules can be written to limit the state’s visibility into private medical decisions: the state requires abortion reporting only when a patient requests it in relation to the disposition of fetal remains. In a country where most states already mandate some reporting, the difference between a minimal dataset and a maximal one is not a philosophical abstraction; it determines what must be disclosed, to whom, and how permanently.

Schwartz’s promise of “abortion surveillance” was made in a public hearing, under questioning from a senator who welcomed the commitment. The next step is administrative: forms, definitions, and data flows that rarely make headlines once the cameras leave the room.