Abortion is personal for physicians and healthcare workers, not just professional. We must help protect abortion access.
Being alive in 2022 means facing never-ending attacks on human rights. With the most conservative Supreme Court since the 1930s, there now seems to be little standing between those of us with a cervix and the autonomy over our own bodies.
When Amy Coney Barrett was confirmed to the Supreme Court in 2020, many believed it would only be a matter of time before the precedent set by Roe v. Wade, securing the right to abortion, would be overturned. According to the Guttmacher Institute, in 2021, 19 states enacted 108 abortion restrictions, more than in any year since 1973. Prior to the end of 2021, the Supreme Court heard arguments related to two such bills: Senate Bill 8 (S.B. 8) in Texas and Dobbs vs. Jackson Women’s Health in Mississippi. The verdict on Dobbs is expected to be delivered this summer.
In the meantime, those who live in Texas and need abortions have been traveling to adjacent states to get them. That barrier to care will only become worse as more states enact restrictions. These types of restrictions on healthcare disproportionately impact Black and Indigenous people of color as well as members of the LGBTQIA+ community and those with lower incomes. Texas’s S.B. 8 enables any individual to bring civil lawsuits against those who perform abortions, a novel approach which some say empowers vigilante justice.
Now, in the spring of 2022, it seems there is constantly news of another state proposing legislation to restrict access to abortion. Earlier this month, Oklahoma legislators passed a law banning abortion in all cases except when needed to save the life of the pregnant person in a medical emergency. And last week, Kentucky became the first state since Roe v. Wade in 1973 to effectively ban all abortion services in the state.
Abortion Is Common Among Physicians and Medical Students
As two physicians and a medical student, we find this all incredibly disturbing. None of us performs abortion, but all three of us understand how critical abortion is, not just for the population at large, but for our physician colleagues.
In a study published last month in Obstetrics & Gynecology, we shared data we collected in the spring of 2021 on the ways physicians and physicians-in-training build their families. We had a self-selected sample of over 1,700 people who want to have biological children. But even in this group over 11 percent of participants had abortions. Among the small subset of participants who were in medical school, nearly one in six had had an abortion. Given the selection bias in the sample, these are likely underestimates of the true rate of abortion in the physician workforce.
Abortion Is an Intrinsic Risk of Fertility Treatments
People may pursue abortions for any number of reasons, including simply not being ready or not having the appropriate resources to bring a child into this world. In addition, abortion is a part of building their family for many, sometimes due to the use of assisted reproductive technology (ART). Judge Barrett has in the past supported a group, St. Joseph County Right to Life, which favors the criminalization of doctors who support the discarding of embryos created in the in vitro fertilization process. Since women physicians have approximately twice the rate of infertility as non-physician women, our chances of needing an abortion related to fertility treatments are considerable.
If this group has their way and physicians are criminalized for discarding embryos or being involved in the care of someone who has a miscarriage, fertility doctors will no longer be able to support people building their families using ART. That means the over 81,000 babies born in 2018 in the United States as a result of ART would never have been born.
These babies aren’t just statistics. You either know or know of some of them. Celebrities such as Chrissy Tiegen, Brooke Shields and Emma Thompson have all used IVF. Would you wish to erase their families?
Abortion Access Is Critical for Women’s Careers
Importantly, abortion preserves the ability of women to build their careers and remain active members of the workforce. In our study, several participants commented on why they had abortions. One person said:
“I had an abortion at 19 that absolutely made my future life, career and family possible. My family planning included [the abortion], a diaphragm, Plan B, natural family planning and a fundamentally flexible approach to managing my fertility throughout.”
It’s important to recognize most people are less fortunate than the physicians and trainees in our study, with fewer resources and less social support. It should be the choice of any person with a cervix, not the choice of any legislative body, whether or not to have an abortion.
It is critical for all doctors and healthcare workers, not just those who perform abortions, to clearly state that abortion is healthcare. Abortion is not a niche procedure that is rarely performed. It should not be relegated to closets and alleyways, as it was in the pre-Roe era. If the current attacks on abortion rights are successful, the number of abortions performed will not decrease—the number of safe abortions will. If we, as physicians, want to support our patients’ and colleagues’ health, we must support abortion.
Next They Will Come for Plan B and Birth Control
Even those who do not favor abortion for religious or other reasons should be concerned about the current legislative trends. If Roe v. Wade is overturned, it is likely legislators will try to eliminate access to Plan B and birth control. This process has already started, with Republican Senator Marsha Blackburn declaring Griswold v. Connecticut, the ruling that asserted the right to contraception, to be unconstitutional. Restricting access to Plan B and birth control will cause further irreparable harm to women’s health and careers. But the burdens of these restrictions won’t fall solely on women, the lives and careers of men who partner with women will be affected as well.
Restricting Access to Abortion Will Likely Exacerbate the She-Cession
All of this is happening against the backdrop of the pandemic. According to the World Economic Forum, the first year of the pandemic set back global gender equity by almost 40 years. The pandemic-induced recession is the first recession in which women lost more jobs than men, leading many to dub it a she-cession. As economic recovery has progressed, men have recovered more jobs than women, particularly in retail, education and health. The last thing women need now is to have governments dictating when we will leave the workforce due to having children.
Take Action: Abortion Is Healthcare
We call on everyone but especially physicians and all healthcare worker colleagues to stop hiding behind vague labels such as “reproductive health” and say the word: abortion. We must end the stigma against this commonly-performed, commonly-needed procedure. Abortion abortion abortion. Say it until you can say it without discomfort. Then keep saying it.
Call your members of Congress, and talk to your patients about their concerns.
Talk about abortion with your colleagues, not as a medical procedure they need to know about for exams but as one they may themselves need. Let them know you stand with them and firmly assert that abortion is fundamental healthcare. If you are not willing to do that, then you are failing everyone you know who has a cervix.
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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