As the human rights crisis in the U.S. intensifies, every healthcare worker has a role in protecting people who need abortion care.
Access to safe, legal, high-quality abortion care without burden or restriction is a fundamental part of comprehensive reproductive healthcare. Unburdened access to abortion saves lives. It allows people to realize the fulfilled lives they deserve, and to retain autonomy over their reproduction.
This is particularly important for Black, Indigenous and Pacific Islander communities who are dying from childbirth-related causes at disproportionate and alarming rates due to racism and health inequities. Communities who already face significant structural disinvestments from resources and rights that have perpetuated multiple oppressions, including healthcare, mass incarceration, an inequitable justice system, voting rights, economic inequality—and now, the elimination of reproductive freedom. Stigma and politics have played an unnecessary, and frankly dangerous, role in attempts to systematically remove access to abortion. As the human rights crisis in the U.S. intensifies, every healthcare worker has a role in protecting people who need abortion care.
Getting an abortion was already incredibly difficult for many, thanks to hundreds of abortion restrictions passed in the decades since Roe, from mandatory waiting periods to bans on public insurance coverage. These medically unnecessary restrictions compound the multiple oppressions faced by communities of color, undocumented people, those with low-incomes, LGBTQIA+ communities and others our society marginalizes. The Supreme Court’s gutting of the already insufficient protections inRoe, will have detrimental effects on millions of people, particularly those who live in states that are acting immediately to ban abortion.
While every healthcare worker does not work directly in reproductive healthcare, we all care for people who have reproductive health needs and deserve the right to exercise their reproductive autonomy. This means every healthcare worker must be prepared for the impending fallout to care for patients comprehensively and holistically. It is our professional and ethical duty.
We need to educate ourselves, our colleagues, the public, and our patients. Overlapping restrictions and apocalyptic headlines sow confusion and fear. That chilling effect is not incidental; that’s exactly what they are intended to do. Fear, myths and misinformation prevent people from taking action. We must empower ourselves, patients, and the public with accurate, actionable information to access the resources they need. It’s important to understand the current laws and places to get care, whether you might encounter someone who needs an abortion at a primary care office, a school health center or an emergency room.
Every healthcare worker must be prepared for the impending fallout to care for patients comprehensively and holistically. It is our professional and ethical duty.
Healthcare workers need to also collectively be up to date on the latest evidence and leave talk of ‘coat hanger’ abortions behind. There are safe options for ending a pregnancy with medications, including reputable online sources where people can order them. People can take charge of their abortions as research shows that they can accurately determine how far along they are in their pregnancies and take the medications safely.
While medication abortion isn’t enough to provide everyone the care they need, it’s important for people who can’t or don’t want to go to a clinic. It can be a lifeline for someone who can’t take multiple days off from work and arrange childcare to travel to another state multiple times to comply with their waiting periods. It can be an essential resource for an undocumented person who fears crossing state lines and running into border checkpoints.
As healthcare providers, we owe it to our patients who may want to manage their own abortions to help them by providing pregnancy options counseling, informing them about medication abortion options, letting them know what to expect, explaining when they should seek help and providing compassionate post-abortion care. While managing your own abortion with pills is very safe, people may seek reassurance from a healthcare provider.
The biggest risk for someone ending their own pregnancy is criminalization. An Indiana woman faced a 20-year sentence for feticide after taking drugs to induce an abortion before her sentence was overturned. A mother in Pennsylvania was sentenced to up to 18 months in prison for buying abortion pills for her daughter online, because a clinic was too far away, and they didn’t have insurance. Most people who have faced criminal charges for ending pregnancies were reported to law enforcement by someone who worked in a healthcare facility. The burden of criminalizing pregnancy outcomes falls on those who are too often swept up in our unjust system—people of color, immigrants, people without resources.
While managing your own abortion with pills is very safe, people may seek reassurance from a healthcare provider.
As healthcare workers, we hold a significant amount of power to prevent patients from being unjustly criminalized for exercising their human rights. The treatment for someone who comes into a doctor’s office or ER after managing their own abortion is no different from treating someone experiencing a miscarriage. There’s no way for us to know if someone took pills to induce a miscarriage unless the patient tells us. We should not pry for information about pills or where they got them, or any other information that is irrelevant to treatment and could put them at risk or perpetuate the stigma and trauma they have experienced.
While we do not know right now what the future holds for criminalizing clinicians or patients in restricted states, in this moment we have absolutely no duty to report patients to law enforcement or child protective services, and in fact we would be violating patient privacy laws by doing so. All healthcare facilities should have a clear policy against reporting patients seeking post-pregnancy care to law enforcement in line with their state laws and ensure that all employees adhere to it.
As healthcare workers, we all have a professional and ethical duty to step up in response to this crisis, whether we’ve thought of ourselves as participating in abortion care before or not. Not doing so only supports the Supreme Court’s action of putting millions of lives at risk and perpetuating injustices and human rights violations.
Not acting in this crisis goes immediately against one of the first oaths we made joining the health professions: Do no harm. We don’t know what the future will look like exactly, but we do know that we must wield our collective power to advocate for and provide everyone with the compassionate, dignified reproductive healthcare they deserve.
Sign and share Ms.’s relaunched “We Have Had Abortions” petition—whether you yourself have had an abortion, or simply stand in solidarity with those who have—to let the Supreme Court, Congress and the White House know: We will not give up the right to safe, legal, accessible abortion.
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