This Is How It Should Work

“I feel like I am at the spa!” said one of my patients, who had traveled to California to receive abortion care after her home state’s restrictive laws controlled her bodily autonomy. Tina, the name I use for this patient instead of her real one, is a therapist with a baking hobby. She appreciated our patient-centered care, the warm blanket, the support, and especially the kindness. After navigating the complex nuances of traveling for abortion care, she was overwhelmed by our team’s respect and nonjudgmental approach. We are proud of this care in California since THIS IS HOW IT SHOULD WORK.

I am a double board-certified obstetrician and gynecologist practicing the full scope of sexual and reproductive health care, including abortion care, in California. It has been one year since the devastating Dobbs decision, but abortion access was already under attack—this decision just made it even harder. As a health care professional, I put full trust in my patients to know what their bodies and lives most need. The need for an abortion does not exist in a vacuum, but rather, it occurs in the context of the life we are living. All my patients, irrespective of zip code, deserve to be able to make decisions about their futures and receive timely, compassionate care without barriers, delays, shame, or stigma. We need to provide health care using an indivisible human rights framework in which everyone is entitled to it.

California is proud to have a multidisciplinary coalition known as the Future of Abortion Council, of which I am a member, to protect abortion access. We now have shield laws that are designed to protect those who seek and provide abortion care, we have increased funding for people who need abortions, and voters enshrined abortion and contraception access into our state constitution.

My colleagues and I are affected every day by the restrictive laws and are suffering moral injuries because of the interferences in our physician–patient relationships. We went to medical school, yet we are being tasked with legal quandaries. Personally, I have helped patients delete text strings referencing their abortion, and I have navigated medically necessary follow-up in their restrictive home state. My colleagues have risked fines and imprisonment as they had to decide how sick is “sick enough” before their patients can access abortion care that was legally restricted to “life threatening.”

Even while being in a protective state, I have noted an uptick in the threatening rhetoric. I no longer post my children’s faces on social media, and I check my back seat before getting in my car. Yet, in spite of the emotional distress of providing abortion care in this country at this time, we continue to show up and stand up for all our patients and provide a care experience like that of Tina. We must center Tina and all others like her and lift up their needs and priorities. This is our call to action.

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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