We must all continue to normalize miscarriage and abortion care as essential components of reproductive healthcare—but especially those of us going into obstetrics and gynecology.
March 18 will be a regular Friday for most Americans. But for the thousands of medical students across the United States, the stakes could not be higher. For us, the past 20 years of education have culminated in Match Day, the day in which graduating medical students discover where they will continue their medical training in their chosen specialties.
This is a day of mixed emotions as some students celebrate going to their first-choice residency program while others are devastated when they do not match. For those of us going into obstetrics and gynecology, the pressure and nerves of Match Day are far greater this year. The upcoming Supreme Court case, Dobbs v. Jackson Women’s Health Organization, which challenges Mississippi’s state law banning abortion after 15 weeks of pregnancy, threatens the very foundation of reproductive care in the U.S.
This uncertain political landscape surrounding reproductive rights will affect the quality of our training and the care that we can provide for our future patients.
As we approach the end of medical school, we can’t help but reflect on our most interesting and unique experiences with patients. We vividly recall the case of a patient we saw who experienced a miscarriage. Although considered to be an underestimation, one in six pregnancies will end in miscarriage. However, its prevalence does not diminish the trauma and grief that patients often experience.
We tend to vilify those who need abortion care and victimize those who need miscarriage care. In reality, the people experiencing abortions and miscarriages are within the same community or they are even the same person.
Our patient was devastated by the news. While we helped grieve with her, we were able to offer her all of the appropriate medical options. She was able to make the decision that was right for her at the time. When her pain worsened, and she wanted a different treatment option, we had the training and ability to take care of her as soon as possible. Although not commonly discussed, the treatment for miscarriages is one of many things that will be affected if the Supreme Court overturns Roe v. Wade.
In this story, the procedures and the medications offered to this patient are essential components of miscarriage management. In a parallel story, they are the cornerstones of abortion care. Both are equally important and currently under threat. The upcoming Supreme Court case is not just about abortion—it will directly impact reproductive health as a whole.
Dobbs v. Jackson Women’s Health Organization directly threatens the current 50-year Supreme Court precedent, set by Roe v. Wade, which protects the right to an abortion up until a fetus could survive outside of the womb, typically around 24 weeks. If overturned, individual states can implement laws banning or limiting access to even very early in gestational age. Currently, 12 states have passed such laws and many more are likely to follow if this precedent is overturned.
In the short term, overturning Roe would devastate patients’ access to abortion. In the long term, it would limit every person’s ability to access comprehensive reproductive care as medical providers would not receive adequate training related to abortion care, miscarriage management, and pregnancy complications. Even prior to the Supreme Court case decision, a recent study suggests that ob-gyn residents without abortion training feel less prepared to treat miscarriages.
Although not commonly discussed, abortion as a treatment for miscarriages is one of many things that will be affected if the Supreme Court overturns Roe v. Wade.
If Roe is overturned, this phenomenon would only worsen, creating a generation of ob-gyns without adequate training in vital aspects of reproductive care. Regardless of our stance on abortion, this case will inevitability impact every person who seeks out reproductive care.
As a society, we tend to vilify those who need abortion care and victimize those who need miscarriage care. In reality, the people experiencing abortions and miscarriages are within the same community or they are even the same person.
These individuals are making the best decisions for themselves and their families. Statistically, we all know, have been, or will be someone who experiences a miscarriage or abortion. We must all continue to normalize miscarriage and abortion care as essential components of reproductive healthcare. As trainees, we are incredibly excited to head into the field of obstetrics and gynecology to normalize all patient experiences, advocate for our patients, and provide comprehensive and inclusive care to our future patients.
While Match Day on March 18 will be an incredible milestone in our careers, the course of our training will not truly be set until the Dobbs decision is released.
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