This is an adapted excerpt from the March 1 episode of Velshi.

I first interviewed Margaret Atwood about her classic dystopian novel “The Handmaid’s Tale” on May 1, 2022, exactly one day before a draft of the Supreme Court’s decision to overturn Roe v. Wade was leaked. 

Atwood’s book famously takes place in a near-future totalitarian, theocratic, military dictatorship, known as the Republic of Gilead, which has overthrown the U.S. government. The new regime reorganizes society using an extreme interpretation of the Old Testament. Women are the lowest-ranking class — prevented from owning property, reading, writing and, of course, deprived of control over their own reproductive functions. Environmental catastrophes have rendered much of the population infertile, so the government has reintroduced forced surrogacy, like the handmaids in the Book of Genesis in the Bible. One of the most striking things about Atwood’s book, which we discussed that day, is that every brutal and terrifying aspect of the fictional Gilead was inspired by things that actually happened. The book was published in 1985 and, as Atwood was writing it, she collected newspaper and magazine articles of the real-life policies and events she used to create the fictional dystopia. She told the publishing house Penguin in 2019:

I didn’t even research it. There was no internet then, you couldn’t just go online and put in a topic, so this is just stuff I came across when reading newspapers and magazines. I cut things out and put them in a box. I already knew what I was writing about and this was backup. In case someone said, ‘How did you make this up?’ As I’ve said about a million times, I didn’t make it up. This is the proof — everything in these boxes.

I didn’t know when I was talking to Atwood that day that the era of federally protected abortion rights in America would soon come to an end. I didn’t know then that we were hours away from taking such a big step backward in time, back toward some of the cruel regimes that inspired Atwood to create Gilead.  It felt almost hard to believe that Atwood’s dystopian world, Gilead, was based on things that happened in the real world. But now, almost three years into post-Roe America, as we’ve watched a flood of creatively cruel policies take shape across anti-abortion states, it’s easier to see. 

In Atwood’s fictional Gilead, the state treats wombs like a “national resource.” The protagonist, Offred, tragically describes her own womb as “more real than I am.” In the real world, women from poorer regions, like India and Thailand, have long been exploited by a shadowy surrogacy industry catering to wealthier Western couples unable to conceive. According to reporting from “Velshi” producer Amel Ahmed, an attendee at a surrogacy conference heard lawyers and brokers casually refer to these women as “carriers.” Sociologist France Winddance Twine, author of “Outsourcing the Womb,” said “Women do this so they can afford a house with a toilet.” In other words, it’s not a real choice.

But this is no longer just a threat in other countries. In February, Republican lawmakers in Missouri introduced a bill to create a state-run registry of pregnant women who are deemed “at risk” of seeking an abortion. Those interested in adopting babies would have access to this registry, effectively turning pregnancy into a “state-monitored marketplace,” according to writer Jessica Valenti. In “The Handmaid’s Tale,” it was not just women who were targeted; doctors who performed abortions were treated in the eyes of the law as murderers and subject to the death penalty. Today, in post-Roe America, abortion bans target doctors with such draconian penalties that they routinely report being forced to violate their oaths as medical professionals. One doctor in a 2023 report from The Texas Policy Evaluation Project shared a chilling case in which a woman, actively miscarrying and in severe pain, was denied even a helping hand to get onto a hospital gurney because the mere act of assisting her could be interpreted as “aiding and abetting an abortion.”

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According to the doctor who handled the case, her colleagues “believed that providing an epidural could be considered [a crime] under the new law.” The doctor called it “a gross violation of common sense and the oath I took when I got into this profession to soothe my patients’ suffering.”

In Chapter 8 of “The Handmaid’s Tale,” Offred witnesses a funeral service for a miscarried fetus. Today, in America, some states quite literally require abortion clinics to provide a burial or cremation service for an aborted fetus. In February, an Ohio judge blocked one such law, ruling that it violates reproductive rights. The concept stems from a growing fetal personhood movement, which seeks to grant fetuses the same legal rights as people, including classifying an abortion as a homicide.

Meanwhile, Republicans in Montana tried to pass a bill that would charge pregnant women with “criminal trafficking” of their own fetuses if they attempt to cross state lines for a legal abortion in another state. The offense would be punishable by up to five years in prison, a $1,000 fine, or both.

“The Handmaid’s Tale” was published 37 years before the Dobbs decision erased abortion rights in America. Now, we are witnessing the echoes of the real-life horror stories that inspired Atwood to tell the tale and the warning of Gilead. American women are facing a reshaping of public policy that treats their wombs, as Offred put it in the book, as “more real” than the women themselves.