September 9, 2024

Care Post-Roe: How Post-Roe Laws Are Obstructing Clinical Care

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Care Post-Roe: How Post-Roe Laws Are Obstructing Clinical Care

More than two years after the fall of Roe v. Wade, we at Resound Research for Reproductive Health worked with researchers at Advancing New Standards in Reproductive Health to release a report detailing how health care providers are still unable to provide standard medical care in states with abortion bans. This leads to more delays, denials of care, and worsened health outcomes.

This ongoing study documents a wide range of harm occurring among pregnant people in states with abortion bans. The latest report notes that longer-term effects could include loss of fertility, chronic pelvic pain due to infection or surgery, or heart attack and stroke related to uncontrolled hypertension, as well as effects on mental health. This has impacted both patients and providers and has deepened the existing inequities in the health care system for people of color.

The report provides a view over time into how patients have been impacted since the fall of Roe through 86 narratives submitted by their providers, from September 2022 to August 2024. The report also includes quotes highlighting the types of complications that providers observed. In addition to the harm experienced by pregnant patients, this report also chronicles the harm experienced by health care providers, who feel compelled by law to provide sub-standard care.

“This study shows that abortion bans are fundamentally degrading medical care – not just in a single state or for a certain type of patient but for people with a range of health conditions living anywhere these bans are in place. That a high proportion of patients described in the study narratives are Black and Latinx makes this even more concerning given the long-standing structural barriers to high quality care that these groups encounter in the US medical system,” noted Dr. Kari White, Executive Director of Resound Research and study co-author.

Excerpts from our interviews with health care providers:

“[Her physicians in the state with a ban] refused a D&E and did not offer her the procedure despite the fact that she had [post-traumatic stress disorder] from her last delivery. She ended up going into labor and delivering in the emergency department in [state with ban] before coming to [state with legal abortion] for care. She was willing to pay nearly $7,000 out of pocket for the care she would have received from us to avoid the trauma of an induction.”

“The burden placed on health care providers should also be noted… The degree of coordination between Ob/Gyns in different states was heroic; however, this effort took away from other patients that our providers were caring for. The fact that her own Ob/Gyn could not provide evidence-based, standard-of-care treatments because of a state policy is unacceptable.”

“Patient presented with previable [PPROM], was admitted. Due to laws, we can only provide expectant management until fetal demise or immediate threat to patient life. Despite her desire for a termination, we were forced to manage expectantly until she developed an intraamniotic infection, which progressed to sepsis requiring IV antibiotics for multiple days.”

Details
Date
September 9, 2024
Category
Abortion Care
Journal
ANSIRH
Authors
Daniel Grossman, MD; Carole Joffe, PHD; Shelly Kaller, MPH; Katrina Kimport, PHD; Elizabeth Kinsey, MD; Klaira Lerma, Natalie Morris, Kari White
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