The Challenge of Emergency Abortion Care Following the <i>Dobbs </i>Ruling

MacDonald, Andrea; Gershengorn, Hayley B.

doi:10.1001/jama.2022.17197

Cited by 14 publications

(2 citation statements)

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“…Although some have argued that access to reproductive care is not within our purview, legislative interference in reproductive rights can similarly “cause and/or aggravate a wide spectrum of diseases and conditions” ( 21 ) and “help prevent lung disease before it starts” ( 22 ). This includes potential impact on patients whom we in the pulmonary and critical care community treat daily, such as patients living with pulmonary hypertension ( 23 ) and cancer ( 24 ) and pregnant women who become critically ill ( 25 ). This legislative limitation on access to health care therefore directly impacts our medical practice and adversely impacts our patients.…”

Section: Argument 4: Advocacy For Equitable Access To Evidence-based ...mentioning

confidence: 99%

Medical Societies Must Choose Professional Meeting Locations Responsibly in a Post-Roe World

et al. 2023

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Section: Argument 4: Advocacy For Equitable Access To Evidence-based ...mentioning

confidence: 99%

Medical Societies Must Choose Professional Meeting Locations Responsibly in a Post-Roe World

et al. 2023

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“…In their Viewpoint, critical care specialists MacDonald and colleagues emphasize the importance of early recognition and timely treatment of events that increase a pregnant patient’s risk of adverse outcomes or death . This central tenet of critical care medicine is highly relevant for the evidence-based care of pregnant individuals who need emergency termination of pregnancy.…”

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confidence: 99%

Health Care Access and Reproductive Rights

Brubaker

Bibbins‐Domingo²

2022

JAMA

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Evidence-based care for early pregnancy is well established and includes strong evidence for safe abortion as part of the reproductive health care spectrum. 1 Legal interference to provision of safe, accessible abortion diverts the time, attention, and skills of clinicians from other pressing health concerns, especially improving maternal health and birth equity. The rate of maternal mortality in the US, already unacceptably high, surged from 20.1 deaths per 100 000 live births in 2019 to 23.8 deaths per 100 000 live births in 2020; the increases were significantly higher for Black and Hispanic people. 2 Maternal deaths (during pregnancy or within 42 days of the end of pregnancy from any cause related to or aggravated by the pregnancy or its management) are anticipated to increase as evolving abortion restriction laws undermine physicians' ethical and professional mandate to prioritize patients' well-being.Nationally, Black individuals are 3 times more likely than White individuals to die of pregnancy-related causes. 3 Legal interference with evidence-based abortion counseling and care will disproportionately affect Black and Hispanic individuals as well as all persons for whom low income, lack of health insurance, or other life circumstances (eg, related to employment, transportation, or family care responsibilities) pose a barrier for access to legal abortion services. Current estimates are that two-thirds of maternal deaths are preventable; the proportion of preventable maternal deaths will increase following the Supreme Court decision in Dobbs v Jackson Women's Health Organization.Beyond reproductive care, legal interference with clinical care makes it difficult for other groups of patients to receive evidence-based care, including access to medications such as methotrexate (widely used to treat rheumatoid arthritis), isotretinoin (used to treat nodular acne), and valproate (used to treat seizures). In addition, the Dobbs decision may create a barrier to an essential component of cancer care for adolescents and young adults with new cancer diagnoses, such as lymphomas, leukemias, sarcomas, and breast or reproductive tract cancers. These patients may no longer have access to standard fertility preservation techniques (eg, genetic testing, sperm and embryo cryopreservation, and embryo disposal). 4 The legal interference may have implications beyond current practice as clinicians-faced with a markedly heightened risk of criminalization by providing routine outpatient, inpatient, emergency, or critical care-alter their current pattern of care.

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Strengthening the Safety Net to Mitigate Reproductive Health Inequity After Dobbs

2024

Achieving Health Equity

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The Challenge of Emergency Abortion Care Following the Dobbs Ruling

Abstract: This Viewpoint discusses how limited or blocked access to legal abortion will affect the provision of emergency and critical care, including negative effects on patient health, legal intrusion into the patient-physician decision-making process, and concerns about legal jeopardy.

Cited by 14 publications

References 9 publications

Medical Societies Must Choose Professional Meeting Locations Responsibly in a Post-Roe World

Medical Societies Must Choose Professional Meeting Locations Responsibly in a Post-Roe World

Health Care Access and Reproductive Rights

Strengthening the Safety Net to Mitigate Reproductive Health Inequity After Dobbs

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