Demoralization after Dobbs

As we approach the one-year anniversary of the Dobbs v. Jackson Women’s Health Organization decision, I can’t help but reflect on the moral injury and demoralization this has caused. Obstetrics and gynecology called to me when I was a medical student. The ability to care for someone throughout the course of their lifetime was my calling. It wasn’t until residency that I realized that I didn’t just love obstetrics and gynecology—I was passionate about it.

In residency, I had my first exposure to abortion care, and I knew from the outset of the very first abortion I performed that I wanted to incorporate this into my clinical practice. Now, nearly 10 years later, I’m a board-certified complex family planning specialist and practicing generalist. My ability to care for patients in EVERY aspect of their reproductive health care is vital. The politicians who continue to place legislative restrictions on this care DO NOT get to have the moral high ground in this and cannot get to solely claim they are “pro-life.”

The lens of reproductive justice makes me more pro-life than they will ever be. I want people to have children when and if they are ready, not be pregnant if they don’t desire, have the number of children they would like to have, and be able to respectfully parent the children they choose to have. I am not only pro-life but also pro-patient. Exam rooms need to remain a sacred place. The ability to walk into a room and talk to someone you barely know, exposing your needs, desires, wants, emotions, and fears, needs to remain protected.

The absence of this, allowing legislators to dictate what type of health care I can offer based on their morality, detracts from my patients’ ability to dictate what happens to their body. Bodily autonomy remains a key pillar of ethical medicine. Lack of patient autonomy causes a moral injury to me because I’m not able to provide the full scope of services I’ve spent my life training to do. Forced birth is anything but moral.

As a generalist, I’ve cared for many patients for whom I’ve both delivered healthy pregnancies AND performed terminations. I’ve held their hands through both with dignity. Why do a legislator’s morals get to dictate what happens in my exam room, especially when they’ve likely NEVER been in those rooms where difficult conversations happen? I must trust that my patients know what is best for them and then seek to provide the care they deserve and desire.

Legislative interference into the practice of evidence-based medicine must stop. Abortion care is essential health care. We are moral. Our patients are moral. Abortions are moral. Legislators dictating health care decisions are immoral. I will continue to advocate for myself, my patients, and our profession by speaking out against this unjust interference. We deserve better.

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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