In just two weeks, the Supreme Court will hear arguments in Dobbs v. Jackson Women’s Health Organization, a case regarding Mississippi’s proposed 15-week abortion ban. What makes this case so significant is that Mississippi is directly asking the Court to overturn Roe. If that happens, more than 20 states are poised to completely prohibit abortion, impacting approximately 25 million women and girls of reproductive age. And if the Court “just” further undermines Roe (instead of outright overturning it), millions more people will lose meaningful access to abortion care, as states pass even more restrictions on top of the hundreds that already push care out of reach.
This case matters to me personally because the fundamental principles of the medical profession that I embraced during my time in medical school are directly challenged by the Mississippi ban. My medical training taught me about the intricacies of providing care – the ethics of the profession, good communication tools, and what it means to effectively empower patients to take care of themselves – and this ban undermines them all.
First, the ban prevents physicians from being able to provide essential and safe healthcare and is not grounded in medical evidence. Mississippi attempts to justify the ban by arguing that at 15 weeks, a fetus is able to feel pain and an abortion procedure carries greater medical risks. Despite there being no evidence that viability occurs as early as 15 weeks, and several scientific studies have found that fetal pain perception is not possible until after the point of viability. Second, regarding the state’s assertion of medical risks associated with abortion, all of the evidence demonstrates that abortion is an extremely safe procedure. In fact, in more than 99%of cases, people receiving abortion care experience no serious complications. When laws enshrine things that are not based in evidence – and even worse, are flat-out inaccurate – it undermines one of the primary goals in the provision of high-quality health care.
The 15-week abortion ban also threatens the well-being of pregnant people by preventing or limiting their ability to get the care they need, leading to negative physical and psychological health outcomes. Landmark research in what’s known as The Turnaway Study found that, compared to those who were able to get an abortion, people who were denied abortion care were significantly more likely to experience gestational hypertension, suffer from chronic pain, and experience overall poor physical health years after the pregnancy. Those denied abortion care were also more likely to stay with abusive partners and to experience anxiety and a loss of self-esteem, as well as four times more likely to live under the federal poverty level.
Additionally, the ban strongly interferes with the patient-clinician relationship, as it constrains the ability for physicians and patients to have candid, honest conversations free from coercion and misinformation. Finally, the Mississippi ban violates the principles of medical ethics which include beneficence (do only what’s best for the patient), non-maleficence (do no harm), autonomy (respecting patient’s right to making informed decisions), and justice. The ban does not do any good as it does nothing to actively improve the patients’ health, it does do harm by endangering pregnant individuals, and it does not respect the patient’s right to make their own informed decisions.
Because the Mississippi abortion ban so clearly violates medical ethics and principles of evidence-based care, 24 groups of physicians, nurses, and other healthcare professionals, including the American Academy of Family Physicians and American Academy of Pediatrics, have articulated strong opposition to the law in an amicus brief.
Mississippi has thesecond highest number of abortion restrictions in this country and only one abortion clinic in the entire state. In addition, the state’s racist policies and practices include discrimination in housing and education, inadequate access to banks, refusal to expand Medicaid, suppression of Black voters, and lack of access to clean water. These factors contribute to Black Mississippians experiencing almost three times the poverty rate of the state’s white residents, as well as the highest mortality rate. Mississippi ranks last, or close to last, in almost every leading health outcome. Abortion access intersects with all of these issues – and they compound each other in ways that undermine people’s ability to be healthy and thrive in so many different dimensions of their lives.
When we discuss accessibility to abortion in this larger framework, we must realize that Roe and Casey were just the beginning. Even with legalization and constitutional protection, abortion is still not accessible to communities that systems and institutions oppress, including low-income and Brown and Black people. Therefore, we must recognize that the Mississippi abortion ban – and any action the Supreme Court takes to further undermine Roe – will have a disproportionate impact on these communities and will further exacerbate existing health, economic, and social inequities created by systems built upon racism, classism, sexism, and transphobia.
We must stand together against the Mississippi 15-week abortion ban. Healthcare professionals have the privilege to better humanity through providing equitable, safe, and effective healthcare; abortion bans like the one in this Supreme Court case threaten our ability to do so and put people’s health at great risk. We call on healthcare providers and physicians-in-training to understand both the medical ethics issues and systemic issues at play in this case. Join us in raising your voice and using the power of the white coat to speak out about what is at stake and why this is so important. No matter what the Supreme Court decides to do, we will keep fighting to ensure access to abortion care – together.
