I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

The major implications of the Dobbs v. Jackson Women’s Health Organization decision, overturning Roe v. Wade, have centered on state-based rulings to remove a person’s right to abortion, thus preventing clinicians from supplying lifesaving health care and undermining an individual’s autonomy over their body. Further, as states eliminate this essential option in providing reproductive care, another important damaging impact of the Dobbs decision is beginning to be recognized. Namely, where abortion is outlawed, abortion-related medical care is no longer taught to the next generation of physicians.

The U.S. has the highest infant and maternal mortality rates among high-income, developed economies. Moreover, the March of Dimes reports that over 2.2 million women of reproductive age reside in areas lacking access to obstetric care, providers, or birthing centers, known as “maternity care deserts.“ Yet in the aftermath of the Dobbs decision, various states have passed or proposed laws aimed at penalizing doctors involved in abortion, including hefty fines, license revocation, imprisonment, and felony charges. For instance, in Texas, medical practitioners who violate the state’s abortion prohibition can face a maximum sentence of life imprisonment.

The “free for all” abortion regulations that exist state by state after the Dobbs case has created a rapidly evolving, dangerous legal terrain for abortion, with lawsuits against doctors often adding to the ambiguity of what is permissible in different regions and what is taught in medical school. However, without proper training of medical students in early pregnancy loss management, coupled with the already documented deficit in obstetrician-gynecologists, the availability of care has already worsened in the aftermath of the Supreme Court’s decision.

As a female student of color at Yale University on the pre-medical track, I aim to become a doctor who can respond to the medical needs of patients, including when and how abortion care will save a woman’s life. I also am acutely aware of the maternal health crisis that is currently plaguing our health care system, and I want to solve this crisis. By volunteering at local clinics and hospitals and shadowing doctors and nurses, I came to realize that addressing the complex maternal health crisis requires expanded, not reduced, access to health care services. It is critical for the U.S. Congress to understand that many students applying to medical school believe that abortion training is indispensable and will avoid moving to states where it is not taught. As indicated by a recent survey in 2022, the reversal of Roe v. Wade influenced at least half of medical school applicants across the United States to exclusively apply to schools in states that did not ban abortion.

I want to join the next generation of health care providers who will work tirelessly to improve maternal health outcomes and ensure that every woman has access to safe, high-quality health care during pregnancy and childbirth. When selecting states for my medical education, it has been a crucial consideration to me that I am trained in inclusive maternal health care to ensure that I can provide the best interventions possible for women. The practice of abortion itself will not disappear. Rather, patients will suffer primarily in states with limited to no abortion access, because the availability of safe and compassionate care for individuals experiencing pregnancy loss in those states will not be possible. To ensure I can provide comprehensive care for women, I need to rule out the states with restrictive regulations regarding abortion after the Dobbs decision in my search for medical education.

Nandini Erodula is a postgraduate student.

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