Protecting Health after <i>Dobbs</i>

Clark, Brietta R.

doi:10.1002/hast.1441

Cited by 3 publications

(2 citation statements)

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“…The recent US Supreme Court Decision of Dobbs v. Jackson Women's Health Organization overturned previous court decisions that protected a person's right to access an abortion 4 . The loss of legal protections for the termination of pregnancy has created an unprecedented impact on the ethical boundaries which clinicians encounter in the care of pregnant persons undergoing pregnancy complications such as ectopic pregnancy, missed abortion, incomplete abortion, and threatened abortion 5 . Although many disruptions in an evidence‐based standard of care existed pre‐Dobbs, this same concern is now heightened on a national scale.…”

Section: Introductionmentioning

confidence: 99%

“…4 The loss of legal protections for the termination of pregnancy has created an unprecedented impact on the ethical boundaries which clinicians encounter in the care of pregnant persons undergoing pregnancy complications such as ectopic pregnancy, missed abortion, incomplete abortion, and threatened abortion. 5 Although many disruptions in an evidence-based standard of care existed pre-Dobbs, this same concern is now heightened on a national scale. In essence, the issues of delay and denial of care documented in Catholic health care systems provide a preview of how post-Dobbs care will play out.…”

Section: Introductionmentioning

confidence: 99%

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Ethics, Abortion Access, and Emergency Care Post‐Dobbs: The Gray Areas

Tillman,

Eagen‐Torkko,

Levi

2023

J Midwife Womens Health

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Clinical management of emergency pregnancy care, such as ectopic pregnancy or heavy bleeding with pregnancy of unknown location, includes upholding legal and ethical standards. For health care providers unwilling to provide evidence‐based life‐saving abortion care due to personal beliefs, clear guidance dictates disclosure of these limitations to the patient and colleagues, followed by immediate referral for appropriate care. However, this decision‐making pathway may not be engaged due to a variety of factors: providers’ beliefs preclude adherence to referral responsibilities, political discourse confuses patients as to their options and rights, and a constantly changing state and national legal landscape leads providers to question their ability to practice to their full scope of clinical care. Although this disruption of evidence‐based standard of care existed pre‐Dobbs, the moral disorder is now heightened. This Clinical Rounds highlights a patient vignette describing the risks of abortion restrictions for patients and providers alike, particularly when an individual provider's concerns for violating institutional guidelines sets a precedent for nursing response and forecloses on collaborative input or ethics consultation. The history of physician‐only abortion exceptionalism and exclusion of nurses and midwives despite a significant history of nurses and midwives in abortion care grounds an argument for focusing on the impact of unethical and substandard care on the interprofessional care team leading to moral distress and negative patient outcomes. Patient‐centered models of care, such as frameworks common in nursing and midwifery, offer opportunities to consider how all providers practicing to their full scope in interprofessional and collaborative ways, such as in emergency rooms and labor departments, might mitigate obstructions to abortion care that risk pregnant people's lives.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ethics, Abortion Access, and Emergency Care Post‐Dobbs: The Gray Areas

Tillman,

Eagen‐Torkko,

Levi

2023

J Midwife Womens Health

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Impact of the Dobbs Decision on Medical Education and Training in Abortion Care

Lambert¹,

Horvath²,

Casas³

2023

Women's Health Issues

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Intrauterine devices are a safe form of contraception in users with solid organ transplantation: A single‐center experience

Amaya,

Wolff,

Ross

et al. 2023

Transplant Infectious Dis

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Patients who undergo organ transplantation are advised to use contraception for health optimization, yet limited data exists on safe contraceptive options for this population. This study investigates the infection risk of intrauterine devices (IUDs) in patients who have received a solid organ transplant by evaluating the incidence of pelvic inflammatory disease (PID). We performed a retrospective chart review of subjects with a solid organ transplant who used an IUD between the years of January 2007 to February 2021. We included subjects ages 22–55 years at the time of IUD placement. We abstracted demographic information, transplant type, IUD type, immunosuppressive medications, screening for sexually transmitted infections, and diagnosis of PID. We identified 29 subjects that met the inclusion criteria. Six subjects had a copper IUD (21%) and 23 had a levonorgestrel IUD (79%). The most common organ transplanted was a kidney (n = 10) and liver (n = 10) while five subjects had multiple organs transplanted. Twenty‐five (86.2%) subjects took immunosuppressive medications at the time of IUD insertion. Twenty‐four (82.8%) patients had their IUD placed after transplantation. The average time of IUD use was 2.5 years. . In our study of IUD use in patients with solid organ transplantation, no patients developed PID. IUDs are a safe contraceptive option for immunosuppressed transplant patients. image

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Protecting Health after Dobbs

Cited by 3 publications

References 0 publications

Ethics, Abortion Access, and Emergency Care Post‐Dobbs: The Gray Areas

Ethics, Abortion Access, and Emergency Care Post‐Dobbs: The Gray Areas

Impact of the Dobbs Decision on Medical Education and Training in Abortion Care

Intrauterine devices are a safe form of contraception in users with solid organ transplantation: A single‐center experience

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