I remember the weeks surrounding the Dobbs decision. We had prepared for the hypothetical rulings the Supreme Court could hand down, but it didn’t stop the fear or anxiety that we felt when providing obstetric care in Wisconsin after the ruling. We cared for patients with ruptured membranes or severe bleeding prior to viability, and we had to wonder, is this sick enough? How many units of blood can we transfuse before we intervene?
After a call about a previable patient with ruptured membranes, I felt a wave of relief when she spontaneously delivered on arrival, saving herself and us from traversing the tangled legal web of abortion access. I remember a patient who needed lifesaving abortion care. In accordance with our hospital policy, I called colleagues and the chief medical officer for approval. The situation was dire, and there was no dissent, but I remember looking around at the operating room nurse, the anesthesiologist, and the scrub tech and wondering, did they agree? I felt guilty worrying about myself and my family while caring for the patient in front of me.
In my role for ACOG as Wisconsin Section chair, I became increasingly visible in the media, sharing with the public my experience as a physician and the myriad reasons that patients require abortion care. My foot tapped nervously during a television interview with Wisconsin PBS, and I remember feeling I’d be more comfortable under the OR lights than in front of the camera lights. Obstetrician–gynecologists from across the country were asked overnight to share our experiences with the media with little to no training, and many of us feared what might happen if we divulged too much. How do we share these important experiences to help our patients without risking breaking confidentiality? We improvised; we did our best. Each conversation with a journalist got a little less scary.
One year has now passed since the Dobbs decision. It feels strange to recognize I’m part of a moment of history and feel obliged to bear witness to it. As educators, we struggle to teach students and residents about the care we need to provide now and to impart that this isn’t standard health care. I worry about what the next 10 years will look like. I worry about the sustainability of our workforce and the health of our patients. Medical care is unfortunately not black and white, and there is no one-size-fits-all approach to patient care. We are challenged daily by restrictive laws that limit our patients’ access to needed health care and threaten the livelihood of our physician workforce.
Disclaimer: Published submissions reflect the experiences of individual ACOG members and may not represent official organizational opinions of ACOG. This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. It does not constitute legal advice; clinicians should be familiar with and comply with federal, state, and local restrictions on abortion, including medication abortion, and are encouraged to consult with a lawyer when navigating local abortion laws and regulations. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. It is not intended to substitute for the independent professional judgment of a treating clinician.
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