In Challenging Pregnancy, Genevieve Grabman recounts being pregnant with identical twins whose circulatory systems were connected in a rare condition called twin-to-twin transfusion syndrome. Doctors couldn't "unfuse" the fetuses because one twin also had several other confounding problems: selective intrauterine growth restriction, a two-vessel umbilical cord, a marginal cord insertion, and, possibly, a parasitic triplet.

Ultimately, national anti-abortion politics—not medicine or her own choices—determined the outcome of Grabman's pregnancy. At every juncture, anti-abortion politics limited the care available to her, the doctors and hospitals willing to treat her, the tools doctors could use, and the words her doctors could say. Although she asked for aggressive treatment to save at least one baby, hospital ethics boards blocked all able doctors from helping her.

Challenging Pregnancy is about Grabman's harrowing pregnancy and the science and politics of maternal healthcare in the United States, where every person must self-advocate for the desired outcome of their own pregnancy.