A joint report from two university programs studying the impact of the Supreme Court overturning Roe v. Wade abortion rights protections last summer has some startling and disturbing findings, showcasing dozens of cases in which healthcare providers have been unable to provide patients with necessary care, including in dangerous or life-threatening situations.
The “Care Post-Roe Study” was published earlier this week by the University of California San Francisco (UCSF) Advancing New Standards in Reproductive Health (ANSIRH) program and the University of Texas at Austin’s Texas Policy Evaluation Project. Collecting 50 narratives from doctors and health providers across the U.S., the report “paints a stark picture of how the fall of Roe is impacting healthcare in states that restrict abortion,” its lead author, Daniel Grossman, said in a press release.
“Banning abortion and tying providers’ hands impacts every aspect of care and will do so for years to come,” Grossman, who also heads ANSIRH, added. “Pregnant people deserve better than regressive policies that put their health and lives at risk.”
The report details how abortion restrictions and bans have led to increases in “morbidity and complications that could result in serious impairment and risk of death.” As there is no nationwide data available yet for how these draconian laws have affected people’s lives, the report provides an important glimpse into what some pregnant people are having to deal with, when it comes to their own lives and the risks they face, as well as how frustrating the situation is for doctors, who are facing an emotional toll due to being powerless to help their patients.
The authors of the report also note that there were limitations in what they could uncover — including, for example, a lack of findings on the longer term effects some patients may endure (including the possibility of infertility) as a result of health complications caused by restrictive anti-abortion policies.
“This report confirms that our fears about abortion bans are valid,” said Chloe Zera, a maternal-fetal medicine specialist and associate professor at Harvard Medical School who wasn’t involved in the study. “As someone who cares for patients who have high-risk pregnancies, I need to be able to provide care consistent with evidence-based guidelines. This research underscores the completely preventable harm that is now happening to our patients because of barriers to abortion care.”
The anecdotes from physicians — some of whom shared stories anonymously due to fear of repercussions from their employers — provide a grim picture of what’s happening to pregnant people that desperately need abortion services in places that forbid or greatly restrict them. In many instances, patients’ care was delayed because doctors worried about what could happen to them if they recommended a medically necessary abortion..
Examples include: patients with ectopic pregnancies; individuals with severe underlying medical conditions that made having a pregnancy a high-risk situation; early miscarriages that couldn’t be resolved because physicians feared broad legal language forbade treating them; and complications that occurred prior to fetal viability, including hemorrhages, hypertension and pre-labor cervical dilation.
The most common complication among respondents in the study was the onset of preterm premature rupture of the membranes (PROM), in which a person’s water breaks before a fetus can survive on its own, creating a high risk of infection. The typical response to this outcome, before the overturning of Roe, was to induce a pregnancy or perform an abortion, especially when a pregnancy was before the 20-week mark. Both options are being avoided by doctors in states that have passed restrictive abortion laws.
In one example from the report, a doctor turned a patient away who was experiencing PROM, only to have them return a couple of days later with severe sepsis and bactermia.
“Her fetus delivers; she is able to hold [the fetus],” the doctor providing the account said. “We try every medical protocol we can find to help her placenta deliver; none are successful.”
The situation worsens. The woman “bleeds from everywhere” before she “miraculously” gets better, the report notes. The patient, thankful for the actions the doctor took in removing the fetus from her body, is apparently mindful of the consequences the doctor may face.
“She asks me: could she or I go to jail for this? Or did this count as life threatening yet?” the doctor recalling the event said.
PROM occurs in close to 1 in 10 pregnancies across the U.S.
Rather than compassionately responding to these and other stories of doctors in states where abortion bans and restrictions are harming people’s lives, one anti-abortion lawmaker defended the policies in a Washington Post article on the report .
“In situations where a doctor is acting in good faith, I believe they can act in that moment,” former Florida state senator Kelli Stargel, a sponsor of Florida’s 15-week abortion ban, said to The Post. The state has since passed an even harsher six-week ban.
The report concludes that the laws being implemented are preventing doctors from providing care that their patients may, in many situations, require. Even in states where abortion is banned but is still allowed in cases where a person’s life is at risk due to their pregnancy, vague language written by anti-abortion lawmakers makes it difficult for doctors or other types of providers to know, definitively, that the abortion services they need to provide are indeed legal.
“These preliminary findings from the Care Post-Roe Study document a wide range of harm to people with the capacity for pregnancy in states with bans or severe restrictions on abortion care,” the report states. “Clinicians must be able to use their medical judgment to provide evidence-based care for their patients and prevent medical emergencies, without risk of criminal prosecution.”
Some states where abortion bans are already in place may soon create even more restrictions, including penalties not just for physicians but also for the patients themselves that seek out abortions for whatever reason.
Alabama House Bill 454, introduced last week by Rep. Ernie Yarbrough (R), would allow state prosecutors the ability to charge pregnant people with murder if they obtain an abortion, whether from a physician or through abortion medication. The language of Yarbrough’s bill, however, is so tough that it would also allow the prosecution of individuals who had miscarriages if it’s determined (whether it’s factual or not) that they were negligent.
“From the moment a person is pregnant — whether they are aware or not — that person will now be in immediate danger of being accused of a murder,” said Robin Marty, Director of Operations for the West Alabama Women’s Center, responding to the introduction of the bill. “For a state with no sex ed, no birth control, no insurance and no hospitals to now order them to give birth to a healthy baby or go to jail is unconscionable.”
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