New UT Austin study shows worse care for pregnant Texans after Roe v. Wade was overturned
Researchers from UT Austin and the University of California San Francisco found doctors were scared, confused and offered worse care to patients in the months after the Supreme Court overturned Roe v. Wade. That 2022 decision in Dobbs v. Jackson Women’s Health Organization meant that there weren’t any federal protections for abortion, and states got to decide their own laws around abortion access.
Kari White is part of UT Austin’s social work school and the lead investigator of the Texas Policy Evaluation Project (TxPEP), a group of researchers who study the impact of state policy on abortion and maternal health. She coauthored the study. She said the impact of abortion legislation on care in Texas started back in 2021, with the passing of Senate Bill 8, the six-week abortion ban.
“We had already seen poor quality care, compromised care, following the implementation of SB 8,” White said. “With many other states implementing six-week bans that had also very narrow exemptions for the circumstances under which abortion was provided, we knew that we were likely to see more of these cases.”
White and other researchers gathered stories from 50 physicians from states with abortion bans, like Oklahoma, South Dakota and Texas. They found that pregnant patients with bleeding complications, ectopic pregnancies and early miscarriages all had worse outcomes because doctors were concerned that providing care would go against the law.
“It’s another example of the ways in which a variety of pregnancy experiences are being pulled into the dragnet of these abortion bans and compromising health care for people,” White said.
Doctors recounted patients having to travel to other states to get care, or who were refused care outright by colleagues.
“They are being forced to watch their patients get sicker before they can intervene,” White said. “Some of the clinicians are in tears about their inability to provide care or seeing the very real risk of a patient dying in front of them…as a result of these laws.”
Two doctors and five patients are also suing the state of Texas because they were denied access to abortions when experiencing medical emergencies during their pregnancies.
White also wants to underline that these bans also usually are connected to states with worse maternal health outcomes, like Texas. It has one of the top ten rates for maternal mortality in the country. According to the state’s Maternal Mortality and Morbidity Review Committee, 90% of maternal deaths in 2019 were preventable, and due to factors like serious bleeding and mental health conditions.
“People are already have poor health when they’re becoming pregnant, and are trying to seek care in a service and policy environment that is unable to provide them with the best possible care,” she said.
It’s something Dr. Ghazaleh Moayedi in Dallas has had to navigate as an OBGYN who also provided abortion services.
“My job radically changed before Dobbs, since SB 8,” she said. “For us in Texas, that had been the critical point. Dobbs was just more fuel on the fire.”
She said she had been traveling out of state to Oklahoma after SB 8 to care for patients, but stopped for a while because she wasn’t sure if she’d be arrested for taking care of Texans in other states. She’s not the only person grappling with this.
“I’m still seeing physicians telling people they can’t take care of them, not wanting to intervene, discharging people and telling them not to come back,” she said. “Even in the setting of clear policies, among physicians there’s a lot of confusion about what to be doing.”
Last summer, she thought about leaving Texas, but wasn’t sure if another state would be any better. She decided to stay to continue advocating for what she believes in.
“I’m focusing on what can I do here, from my position point in Dallas, in Texas, to make the future we all deserve possible,” Dr. Moayedi said. “Maybe I’m not going to ever be able to provide abortion care in Texas again, but certainly if folks like me just leave, we’ll never have abortion care.”
Doctors owe it to their patients to understand the political and historical contexts they’re operating in, said Dr. Moayedi, to support their needs.
“Health care is not apolitical,” she said. “If we don’t understand history, if we don’t critically understand the context of the care that we provide, we’re going to participate in harm. Our history as a medical profession is actually deeply embedded in violence, so it is important that we educate ourselves and understand that history so we can disrupt it.”
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