Treating Patients amidst Chaos

As a physician practicing in a haven state, I am both fortunate to be able to provide comprehensive abortion services to our patients and heartbroken to see how far patients need to travel to reach us and plagued by the endless question about how many patients were never even able to attempt the trip.

One patient I saw drove 10 hours from Arkansas to Chicago, and when we did her initial ultrasound, we didn’t see a pregnancy in her uterus. Concerned about an ectopic pregnancy, I sent her to our nearest emergency room stat to check the pregnancy hormone level. She texted from the ER saying it was going to be a nine-hour wait, and she needed to be in the car soon to get home that night.

We had her return to the clinic, and I gave her the medication for an abortion, hoping that she had a pregnancy in her uterus that was just too early to see and not an ectopic pregnancy. Trying to negotiate the required time-sensitive lab follow-up for the patient at home was complicated for her, and the unknown outcome with potentially life-threatening complications added extra anxiety in an already stress-filled trip.

Had she been able to seek abortion care at home, without tight travel timeline restrictions, she would have been able to receive a diagnosis and treatment without delay. These restrictive laws harm patients and put their lives at risk by worsening inequities in health care access. I mourn for those who never have the resources to even reach our clinic.

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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