When Roe Ends, It’s Abortion Opponents Who Will Miss It The Most

32089528650_07135abe89_h.jpgPresident Donald Trump announced a new conservative justice to serve on the Supreme Court – one who is virtually guaranteed to overturn Roe v. Wade. As one of the few abortion providers in the state of Arizona I’m already well versed in what a post-Roe America will look like. Thanks to an onslaught of state laws that restrict when and how I am allowed to end a pregnancy, and political and financial pressures that have limited the number of medical professionals willing to learn how to perform abortions, terminating a pregnancy for any reason is already extremely difficult here. Removing that last fig leaf of legality may not have much impact on those who are marginalized already by race, geography or economics. But it will be a wake-up call on those who long claim to oppose abortion, yet still demand it be accessible for themselves when the time comes that they are the ones who need it.

Make no doubt about it  – a significant number of those who come through the doors of my clinic consider themselves ”pro-life.” They explain to my staff in great detail how they oppose the right to choose, even as they themselves are making that very same personal choice. They sneer at the other patients around them, believing that their own cases are completely different because the other women are avoiding responsibility whereas they just can’t be pregnant right now. They insult my colleagues for doing their jobs, they malign my clinic because it is a place that exists just to perform abortions, they tell us they would prefer to be in a hospital or a doctors office or anywhere that separates them from the rest of the people doing exactly what they are doing – ending an unwanted pregnancy.

And yet they get the abortion. Every time. And then they leave and still they consider themselves “pro-life.”

Just like before Roe, making abortion illegal will not end these abortions, not even for those who will have voted for just such policy. A politician looking for an abortion for his mistress will find a doctor who will do it secretly. That well-connected Christian family who doesn’t want their pregnant daughter to lose her chance at a good future will find a physician willing to terminate her pregnancy just this once. The GOP business owner who thought she was done having children until that one surprise showed up will be able to find a way to take care of that through a contact if she looks hard enough.

But as for the others – the ones who oppose abortion in every circumstance except their own? They are the ones most likely to feel the impact of Roe when it falls.

Some would say they brought it on themselves. They would argue that this is what the right deserves for taking away a person’s legal right to bodily autonomy. But as a physician – and as a person who believes that carrying a pregnancy is something that cannot be forced on another human being against that person’s will – I will never support taking away any person’s right to terminate a pregnancy.

No, not even for the people who advocated to take it away themselves.

Dr. Gabrielle Goodrick is the owner and medical director of Camelback Family Planning, one of only four private abortion clinics left in Arizona. She also serves on the board of NARAL Pro-Choice Arizona.

An Open Letter to Doctors – Safe Abortion Is In Your Hands Now, Are You Ready to Step Up?

cropped-cbfp-gabrielle-goodrick-mdRoe v. Wade is in immediate jeopardy and we are now staring into the face of a country without legal abortion, and regardless of where you stand on the issue it is imperative that you understand that it is you who are now in professional jeopardy. As an abortion provider from Arizona, a state with some of the most conservative abortion laws in the nation, let me tell you what you can expect if abortion becomes illegal either in your state, or across the nation as a whole.

Expect every medical decision to be questioned. Do you have a patient who needs a D&C to finalize a missed miscarriage? Misoprostol to expel the remains of an embryo? It is not unreasonable to expect that your files will be subject to scrutiny if all abortion is banned. Anti-abortion officials will be checking to ensure no physician is attempting to slip in a clandestine abortion by calling it miscarriage management. A missing piece of documentation, a lost ultrasound proving fetal demise prior to follow up, anything suspect could land you in jail or get your medical license revoked.

Expect more pregnancy complications in your offices. The inability to access abortion care means patients who continue unwanted pregnancies without adequate prenatal care, or without full recovery from a prior birth. It means patients with weak hearts, high blood pressure, previous complications from prior births or other risk factors who are forced to put their health in jeopardy because abortion will only be available for those whose lives are at immediate risk.

Expect patients with incomplete medical histories. When abortion becomes illegal, those who have them or attempt them will hide them from you out of fear of prosecution, or because they worry you will not provide your best care if you know what they have done. Never again will you be able to simply take a patient at their word about their medical pasts. Their history will be guesswork and assumptions, and you will be forced to fly blind.

Expect to be the last generation to know full spectrum women’s reproductive healthcare. For those of you who have been trained to terminate a pregnancy, you well may be some of the last to do so. For those of you who haven’t – because you believe your faith would oppose it, because it was too difficult to access it in med school, or because your current hospitals won’t let you and it is more important that you stay in your financially secure job and not make any waves – understand that you are the ones who opened this door for good. No surgeon would be allowed to say, “I just don’t believe in removing gallbladders” and still be allowed to practice. Yet when it comes to abortion, you’ve now set the standard. You’ve allowed a procedure that is conducted more than any other in the nation to be moved to the fringes. You’ve encouraged medical schools to make it elective, and to cave to political pressures to block training and end fellowships teaching the skill.

Expect to be forced to encounter abortion face to face in the hospitals. For decades, those of you who do not perform abortions have been able to keep abortion in the distance and out of your practices. You’ve referred your patients to me and to clinics like mine and kept your offices free of it. Even in the rare case where an abortion was medically indicated and they preferred an office or a hospital, you sent them away for the procedure so you didn’t have to be involved. These patients will be yours, now. There will be no one else to provide it. It will now be in your hands. You will no longer be able to pretend it doesn’t exist.

Expect to fight your own hospital administration when eventually one of your patients does need care. When abortion is returned to the medical wards, it will be the hospital, not you, who will eventually decide what is in your patient’s best interest. They will be the one to decide if is it best to let a pregnant patient bleed out while labor is induced, rather than do a direct abortion and more quickly save her life. Decisions won’t be made based on medical best practices. They will be made based on hospital policy, political fear and financial interests. And as a result, more of your patients may die.

This is the landscape you will see if Roe is overturned and if abortion returns to being illegal. It’s the choice you physicians made when you refused to learn even simple abortion procedures, assuming providers like me would always be there if your patient really was in need. It’s the choice the hospitals made when they accepted that partnering with religious organizations was worth losing full spectrum reproductive healthcare like terminations, sterilizations and emergency contraception after a sexual assault as long as there was enough money involved in the partnership. And it’s the choice that medical schools and universities made when they chose to cower in the face of pressure from the right over abortion training fellowships or internships at reproductive health clinics, afraid of the financial consequences of losing donations or public funds.

This is the new normal unless you finally say “Enough is enough” and demand to treat each and every patient with whatever medical service she may need. You must stand up against it now – as this may very well be our last chance to save our profession.