I did not train as a historian. The opposite, in fact: I trained as an engineer, then as a scientist, then as a physician. I came to this work counting things — measuring, modeling, looking for the mechanism beneath the symptom. But the longer I have done it, the more I have come to believe that history is one of the most precise instruments we have. It is another lens, sitting alongside the legal, the medical, the cultural, and the societal lenses we already use — and it brings into focus something the others cannot. It shows you that the present is not an accident, and not a surprise. It is a pattern. And a pattern, once you can see it, can be named — and what can be named can be fought with more precision.
So before this series walks you through a hundred and fifty years of American reproductive control, I owe you an answer to a fair question: why is a medical-intelligence project reaching back into history at all? Because the attack on women is not new. None of it is new. It is so deeply rooted in the American story that you cannot understand what is happening in an emergency room in 2026 without going all the way back to the structures that made it possible. We say it constantly — none of this is new — and "The Long War" is the name for exactly that continuity. What looks like a sudden emergency is only the latest turn of a very old machine.
History is also useful here for a sharper reason: the conservative legal movement weaponizes it. Roe, and then Dobbs, were argued on "history and tradition" — and on the question of a woman's authority over her own body, that history-and-tradition story is, to put it plainly, bullshit. Justice Alito reached into a selective, deeded version of the past and called it the whole record. But what they forgot is that we can read too. We understand history as well as they do — better, in the places they would rather we not look. No matter what they think, they do not own it, and they do not get to decide where the record begins and ends. The history of this country belongs to all of us, and it is on all of us to understand how it shapes our present. This introduction is the doorway into the series that does exactly that — and you will see it cite our own forthcoming work as we go: the history of the midwives, the history of the AMA, and a direct reckoning with what Alito called "history and tradition."
The real history and tradition
Here is the real history and tradition. Women's reproductive health used to be the domain of women. It was midwives; it was mothers; it was a body of knowledge held, practiced, protected, and passed between women. And when men found a way to make money from it, they did two things, in this order: they pushed women out of the profession, and they criminalized and punished the behavior they did not like. That is the actual tradition, not the sanitized version now being sold back to us. And we see the same behavioral pattern today — which should not surprise anyone who knows this history. Ask the counterfactual: if obstetrics and gynecology were a more male-dominated profession, would it be under this kind of attack? It would not.
This is what happens to fields women enter — they get devalued, and as the profession is devalued, the infrastructure that holds it up is devalued right along with it. That is not a metaphor. It is what is happening to OB/GYN in real time, and these things are connected. We are going to weave that argument through the essays as they come. And history teaches one more thing — not just what is moral, but what is effective: what arguments and what storytelling actually move people. It teaches you the circularity of all of this. Read Horatio Storer, the nineteenth-century physician who led the medical campaign to criminalize abortion, and his demographic anxieties — about who was being born, and who was not — ring with an unmistakable echo of the demographic panic being voiced right now, in the post-Roe attack on women. The target is different. The argument is the same exact cycle: rinse, wash, and repeat.
The profession owes women an apology
I am going to say the next part plainly, because the profession will not. Physicians are responsible for where we are. The profession holds a great deal of the responsibility for the state of reproductive rights in this country — full stop. That is not comfortable, but it is true. The AMA holds a tremendous amount of it. The AMA owes women an apology. Honestly, a lot of people do, because we would not be here without those framings, without the deliberate destruction of midwifery, without these political forces being given professional cover. People may be allies now, and I am glad of it — but we cannot forget where this profession was born, because it still carries the markers of the history that produced today's crisis.
And the profession is not stepping up. OB/GYN leadership's job, right now, is to be in front of Congress, advocating. That should be the job, full stop — and it should not fall to people like me. This is the biggest fight of our profession and of our generation, and what is the response? More practice bulletins. That is being out to lunch. If you do not believe this fight is your job, you should not be in leadership — because leadership has a specific meaning: it means preparing the people under your protection for what the profession actually demands of them. Right now what the profession demands is very different from what is being provided. It is genuinely tragic that a self-funded team of about ten people is making more noise than some of our professional organizations with far more money, access, and authority. That is unforgivable.
Why the old traps stay on the books
There is one more thing the history forces us to confront: why conservatives leave statutes like Comstock on the books for a century and a half without repealing them. These dormant laws are not oversights. They are traps — a standing check on society, ready to be reactivated — and they sit in open conflict with the "rights and freedoms" framing conservatives claim to champion. So why would they do that? This series will show you the answer: because when they say "rights," they implicitly mean citizens — and they do not regard women, or people of color, as full citizens. In their minds there is no contradiction, because we were never part of the discussion in the first place. Naming that contradiction is part of the work.
Draconian, then dystopian
And then there is the part that turns an old danger into a new one. These laws were always draconian. In the age of AI, they become outright dystopian — because AI makes complete surveillance possible. Understand the history here, because it is the whole point: the thing that used to keep constant surveillance impractical was cost. Watching everyone meant paying people to physically read everyone's mail. That expense was a natural limit on how oppressive enforcement could become. AI removes the limit by making surveillance cheap, scalable, and constant. And we already know the government wants this capability — the fight between Anthropic and the U.S. Department of Defense was about exactly this. They want it, and they were willing to bully one of the most valuable companies in the world to get it, crossing even the "don't touch the free market, don't touch profits" line conservatives normally treat as sacred.
Understand what is at stake if they get it. What keeps us out of jail is not that we don't break laws — the penal code is extraordinarily restrictive, and most of us are technically in violation of something. What keeps us free is that the overwhelming majority of laws are never prosecuted. Full-enforcement capability changes that fundamentally. It hands the state a precise coercion lever: any time it needs you to comply, it has the means to make you. That is game over for our freedoms — flat out. And it is why every American, on every side, has a vested interest in limiting it before it becomes normal.
What you can do — Project 28
So we end the way we should end every essay: by telling you what you can do, because people are always asking, and the action is the reason to join us. Where they wrote Project 2025, we are writing Project 28 — a concrete, stackable, ready-to-govern agenda for the work that has to start now. Voting rights have to be in it. Reproductive rights have to be shored up in every manner available under the law, because we cannot depend on any single protection — we have to stack the law, so that if and when we come back into power, these things are ready to go. I will be honest: I am not a lawyer. That part needs legal hands. But I know what needs to be done. And on the medical side, we have to strengthen the profession's own infrastructure, so it can respond to medical crises both inside and outside the health-care system, instead of pretending those crises are someone else's job.
That is the work. This is the doorway. Let's go all the way back — because once you see how old this machine is, you stop being surprised by it, and you start being ready to dismantle it.