Here’s How It’ll Impact Reproductive Healthcare

Topline

The Supreme Court overturned Roe v. Wade on Friday and gave states license to ban abortion—and many already have—which experts warn could have far-reaching and dangerous implications for treatments like miscarriages and the entire field of reproductive medicine.

People suffering miscarriages and other complications could face issues accessing medications and … [+] treatment.

AFP via Getty Images

Key Facts

Many of the procedures and medications used to perform abortions in the U.S. are also crucial for treating miscarriages, Seema Mohapatra, a health law and bioethics expert at Southern Methodist University, told Forbes.

That means the legal restrictions to abortion—alongside the fear of being prosecuted or suspected of facilitating one—also threaten to limit access to these procedures for treating miscarriage.

This could prevent medical staff from offering optimal treatment to their patients, Mohapatra warned, pointing to reports from Texas where miscarrying patients are struggling to obtain their prescribed medication.

Widespread bans on abortion would also severely curtail where doctors are able to undertake abortion training, which are a requirement for OB/GYN residency programs (residents with moral or religious objections may opt out) and must be offered at another institution if unavailable.

Nearly half of residency programs are located in states that are expected to ban abortion if Roe v. Wade is overturned, according to a study conducted by researchers at UC San Francisco and UCLA, with “at most 56%” of obstetrics and gynecology residents expected to have access to abortion training if that happens, down from 92% in 2020.

Abortion bans could compromise the ability of states to recruit trainee doctors or secure places for them to train out of state, limit doctors’ hands-on experience with abortion training and provision that is useful for treating miscarriages, and possibly skew the states where OB/GYN specialists choose to live, train and work.

Key Background

Abortion is likely to be banned in 26 states now that Roe has been overturned, with 13 states having “trigger laws” in place that have already outlawed abortion or will in the coming weeks. Many only contain exemptions for medical emergencies or when the life of the mother is at risk, leading to worries among healthcare providers about the vaguely written laws and what the bar is for when abortion is acceptable. Bans on medication abortion are also likely to become more prevalent if Roe is overturned—at least 20 states have introduced bills this year that would restrict or ban abortion pills so far this year, per the Pew Charitable Trusts—which could impact miscarriages, given that two of the same drugs targeted in medication abortion bans are also used for miscarriages. Those unintended consequences are already being felt in Texas, where the state’s ban on abortion after six weeks and on medication abortion are already resulting in reports of pharmacists refusing to fill prescriptions for drugs prescribed for miscarriages or ectopic pregnancies.

Contra

Anti-abortion rights advocates have denied that Roe being overturned will have a negative impact on maternal healthcare or the ability of medical providers to provide care, arguing that training to perform miscarriages and treat ectopic pregnancies is separate from abortion even when some of the same methods or medications are used, and that complications are exceedingly rare. If Roe is overturned, “the ruling will in no way impact the training of OB/GYNs to perform medically necessary procedures nor impact our ability as OB/GYNs to treat women for complications resulting from miscarriage or ectopic pregnancy,” Dr. Ingrid Skop, senior fellow and director of medical affairs at the anti-abortion Charlotte Lozier Institute, told Forbes in an email. “To say otherwise is simply scaremongering.”

Surprising Fact

If abortion were banned nationwide in the U.S., pregnancy-related deaths would increase by approximately 7% in the first year and by an estimated 21% in subsequent years, according to research published in Demography. The study only considered the risk of mortality from continuing a pregnancy versus having a legal abortion and did not consider the impact of a potential rise in unsafe abortions.

Crucial Quote

Mohapatra told Forbes it is not necessarily going to be obvious to patients that the standard of care has changed or lessened in states banning abortion. It just will. “Medical providers in hospitals aren’t necessarily going to say ‘we aren’t going to give you this because of these laws,’” Mohapatra explained. “It’s just not going to be offered.”

News Peg

The Supreme Court overturned Roe v. Wade on Friday as part of a case concerning Mississippi’s 15-week abortion ban and whether states can restrict the procedure even before a fetus is viable. Justice Samuel Alito delivered the court’s opinion, which said Roe was “egregiously wrong” and argued the case should be overturned because the right to an abortion is not expressly stated in the Constitution or “deeply rooted in this Nation’s history and tradition.” Four justices—Clarence Thomas, Neil Gorsuch, Brett Kavanaugh and Amy Coney Barrett—signed on to Alito’s opinion, Chief Justice John Roberts issued a separate concurrence agreeing with the judgment and court’s the three liberal justices dissented. The decision came after Politico leaked a draft opinion from February suggesting the court would take such a step and overturn Roe entirely, prompting a wave of outcry from the abortion rights advocates and increased efforts from states to both restrict and shore up abortion access.

Chief Critic

Leading medical organizations and journals have resoundingly denounced the draft opinion signaling the Supreme Court may overturn Roe, with the American Medical Association saying the opinion “would lead to government interference in the patient-physician relationship, dangerous intrusion into the practice of medicine, and potentially criminalizing care.” The organization’s House of Delegates, made up of physicians and medical students, adopted a policy in June that opposes government restrictions on reproductive healthcare like abortion and contraception, considering such bans a “violation of human rights.”

Here’s How It’ll Impact Reproductive Healthcare — Beyond Abortion