Despite the supreme court’s negligence and error of law, as evidenced by the release of the Dobbs decision that was overturned Roe v. calf, abortion is still legal in California (where I work) and only 20 other states where abortion is “likely to remain legal.” But that doesn’t mean we, Oasis State abortion providers, aren’t already trying to navigate a swirling stream of patient care chaos.
This morning I woke up to a deluge of emails from colleagues in neighboring states trying desperately Finished Care of patients who are already in the process of abortion. Yes, that’s right – patients who have already made appointments, taken time off, paid for childcare for their children at home and even scheduled surgeries in the operating room suddenly can no longer provide this care and have no point of contact.
Part of the chaos looks like this: With sudden and instantly enforced trigger laws popping up across the country today, providers, attorneys, legal experts, friends and neighbors are making last-minute changes to do whatever they can to accommodate the women in dire need of care require. Why? Because abortion is and always has been a community issue. No one goes through an abortion without the love, support, kindness, and compassion of another person, even if it’s just the caregiver holding their hand afterwards. It will continue like this in the hard days that follow.
Here is an example of such a call for help today (retransmitted without a patient ID and with the sender’s permission):
“We have a patient with a history of five previous cesarean sections aged 21 weeks who was diagnosed with anencephaly yesterday. I can’t do her D&E anymore [dilation and evacuation] on Saturday. She has no funds but we have abortion funding for her that can assist with travel if the patient is willing/able to leave the state. Can someone who thinks they can help direct me or call me?
Anencephaly is a life-threatening condition in which the skull does not fully form and the fetal brain is completely exposed. Five cesareans is a risky surgical condition with an increased risk of massive bleeding, placenta accreta, and even hysterectomy. This woman has five other children at home and already has limited means. That is the kind of real-life situation that we as a community of people are facing right now.
Another text message from a friend this morning read:
“The Attorney General just signed our withdrawal order. Abortion is now illegal in Missouri. We managed to treat one more patient this morning.”
This could be the last legal abortion in Missouri before a major wave of “abortion tourism” is expected in the coming weeks and months.
We have no idea how many people are coming our way. Best estimates from an NBC News analysis by the US Census Bureau and the Guttmacher Institute — a research and policy organization working to advance sexual and reproductive health and rights — suggest that around 300,000 women in the US are directly affected by will be affected by this judgment. The Guttmacher Institute also estimates that there are around 32 million women of childbearing age in the 26 states that are set to ban abortion.
For providers like me, this means a huge restructuring of how we envision all women’s health delivery. While I will absolutely rise up to meet that need and offer abortion treatments to anyone who can reach me, I will also have much less time to deliver babies, do routine cancer screening, and perform surgeries for ovarian cysts/fibroids/abnormal bleeding . All women’s healthcare will be affected, no matter where we live.
I have helped people who have traveled from Texas to seek treatment and their desperation is palpable. They feel scared, tired, anxious and betrayed by their government officials.
Last month I was caring for a mother of two who was only 12 weeks pregnant with her third pregnancy and who had just learned of a fatal fetal abnormality. She was devastated to learn that her fetus would not survive delivery and that it would be illegal and impossible to safely manage this pregnancy in her home state of Texas. When she came to my clinic, I also diagnosed her with placenta accreta, a life-threatening condition. We gave her excellent care and saved her life, but she was only able to receive this care because of her financial and social privileges.
Communities of color are more likely to be caught in cycles of poverty and as a result are often forced to delay access to abortion services because they need time to secure funds, arrange childcare and take time off from work. These systemic barriers also make them less able to travel abroad to get the care they need. What does white supremacy have to do with abortion and today’s Supreme Court ruling? All.
Here is my mind and my heart today. As an ob/gynecologist performing abortions, I am committed to ensuring everyone’s immediate care needs are met and pray that they can reach me through organizations and resources like those listed below.
The M+A hotline, the miscarriage and abortion hotline, can be reached by phone or SMS and connects you with doctors who can provide you with expert advice on how to treat your miscarriage or abortion yourself.
Plan C, updated information on how people in the US are accessing abortion pills online.
The If/When/How’s Repro Legal Helpline provides legal information, support and advice from attorneys for people who have been interviewed by the authorities or who fear this because they have performed an abortion.
dr Jenn Conti is an internationally recognized health expert, medical journalist, and OB/GYN.
https://www.thedailybeast.com/people-fleeing-abortion-ban-states-are-desperate-for-our-help?source=articles&via=rss People fleeing countries that ban abortion are desperate for our help