How Medical Providers are Navigating the Post-Roe Abortion Landscape
Abortion bans have left doctors on their own to navigate the ethical and legal landscape of providing abortion care. As a result, many are leaving states with abortion bans and restrictions. This has resulted in what are called maternity care deserts -- areas where there are no obstetrics providers, no hospital-based maternity care, and no other maternal care providers like midwives or doulas.
Some medical providers choose to remain in states with abortion bans, however. They include those featured in this ProPublica article. Here, Dr. Sarah Osmundson, a maternal-fetal medicine specialist at Vanderbilt University Medical Center, discusses how a Nashville hospital’s abortion committee navigates decisions around abortion care.
Dr. Osmundson and her colleagues began the committee in the fall of 2022. They help medical providers determine when an abortion is medically and ethically necessary. In the case of severe emergencies, doctors can reach out to the committee for guidance. While the committee developed their own protocols, some cases can be a source of conflict. These include health conditions that can cause a life-threatening emergency but not until the time of labor and delivery.
Not all medical providers reach out to the committee, and medical providers may not even inform their patients of potential risks. Still, the committee is there for those who seek assistance navigating the abortion landscape.
Recently, Dr. Osmundson has questioned whether the committee remains worthwhile. She fears that it might be requiring her and her colleagues to compromise their ethics and integrity. While she now favors shifting the decision-making power to lawmakers and administrators, her colleague Dr. Mack Goldberg, an abortion provider, believes in the committee's continued importance.
Not all hospitals have the resources to develop a committee to provide guidance in abortion care. Some medical providers have cultivated informal networks instead to make decisions together. They often do so without guidance from lawmakers who are hesitant to get involved.
Most medical exceptions in abortion bans only allow the procedure to “save the life of the mother.” But there is a wide spectrum of health risks patients can face during pregnancy, and even those that are potentially fatal could fall outside of the exceptions, depending on how the law is interpreted and enforced. Without clarification from legislators and prosecutors on how to handle the real-life nuances that have emerged in hospitals across America, doctors in abortion ban states say they are unable to provide care to high-risk pregnant patients that meets medical standards.
SOURCE: ProPublica • AUTHOR: Kavitha Surana • LAST UPDATED: February 26, 2024
