The author — a retired physician — says the recent U.S. Supreme Court ruling upholding FDA regulation of the abortion pill mifepristone was a rare and welcome example of science and facts driving reproductive healthcare policy. Photo: Getty Images
The U.S Supreme Court’s recent unanimous decision to uphold the FDA requirements on mifepristone, the first drug used in a longstanding common, safe, and effective medication abortion regimen, was a welcome triumph of science over politics.
The fact that this case made it to the highest court in the land, though, shows just how political, and ungrounded in science and facts the debate on abortion access has become. And while the struggle over abortion rights is political, the ramifications of banning or restricting abortion have real impacts on our access to and the quality of our healthcare.
Just look at the impact of bans on the population of OB/Gyns in some states.
I am a retired internist who moved to this area almost two years ago to be near family. When I began to consider the transition, one of the things that I did not worry about was medical care. I believed that living in an area that was home to two top-ranked medical schools and facilities would be sufficient.
That was before I realized what was being done to gut women’s health care in this state by anti-abortion policies like last year’s SB20. This new state law lowered the allowable number of weeks for an abortion from 20 to 12 and added significant non-medical based restrictions, greatly hindering a person’s ability to get abortion healthcare.
I practiced medicine in southern California where I did not have to think about anything other than making the right decision with my patients about their medical care. If I had a pregnant patient, I could refer based purely on how they felt about the pregnancy. Often this referral could be to the same OB/Gyn for either pregnancy care or termination. I did not fear that my patients might die because an individual with no medical training was making decisions for them. I did not fear that by counseling a patient who was unsure about contraception or pregnancy that I could be held liable for doing something illegal. As an internist, I did not perform procedures, but referred those who needed them. I did not worry that I might have a physician who was not trained in techniques that might be needed to save my life or my daughter’s life.
Now that I am happily living in North Carolina, I have learned that many of our rural areas are deserts when it comes to care. Rural hospitals cannot support OB units. The people in these areas now deal with the prospect of taking several days away from home if they need an abortion, but they are also faced with a lack of care for high-risk pregnancies. Not infrequently, these are less financially well-off individuals who will end up not getting the care they need since they can’t afford time off work or have responsibilities that preclude easy travel.
We are already seeing stories of women with wanted pregnancies placed in life-threatening situations due to untreated complications because physicians are afraid of legal repercussions.
While I understand that there are some faiths that view abortion as sin or unacceptable, my religion, Judaism, does not. As a Jew, I believe that life begins at the first breath. Prior to that, a fetus is not considered a human being, but the health and well-being of the woman is primary. This country was founded on the principle of the separation of church and state, and this should apply here as much as in schools and workplaces. No one should be forced to have an abortion, just as no one should be forced to carry an unwanted or non-viable fetus to term.
A study was printed in the Journal of the American Medical Association (February 2024) looking at trends in post-medical school residency applications for OB/Gyn programs. It showed a small but significant drop in applicants to programs in states with more restrictive laws. Another study in 2023, done by the Lumina Foundation (part of Gallup), showed that in general, students, not just med students, stated that reproductive health policies affected their choice of which states to live in for higher education.
Given all these things, I worry what will happen in the future. Will we face a time when no one knows how to do a D&C to look for cancer since this is a similar technique to an abortion? Will we have a further increase in maternal and neo-natal mortality because physicians will not want to come or stay here? Will our internationally respected schools become second or third tier institutions? And on a personal note, what will happen to my daughter if she were to have complications of a wanted pregnancy?
Our state’s lawmakers need to take a page from the recent U.S. Supreme Court’s mifepristone ruling and leave science and medicine to the experts in those fields, not to politicians driven by ideology.
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