Post-Dobbs America: The Devastating Impact on reproductive healthcare
The Fallout from Dobbs: More Than Just Abortion
The Dobbs decision in 2022 overturned Roe v. Wade, eliminating the constitutional right to abortion. But the consequences go way beyond that single issue. It's a complete upheaval to women's healthcare in the US, impacting contraception, IVF, maternal mortality and even emergency care for pregnant women! Three justices appointed by Donald Trump voted to overturn Roe v. Wade; handing a major win to anti-abortion activists. This pivotal moment profoundly shifted the landscape of women's healthcare and the future, leading to some immensely unexpected, devastating effects.
While abortion remains legal in many states, a potential Trump-Vance administration could mean a federal ban. Even without one, existing state laws already damaged reproductive care, which is even more worrying for patients who need additional care, particularly with existing medical issues! Even without federal legislation to intervene at all levels, a potential federal ban brings its own extremely worrisome consequences for people who might have medical conditions; thus access to emergency services, preventative care and other preventative measures all become extremely risky!
The Assault on Abortion Access: A State-by-State Crisis
Since Dobbs, 41 states imposed some abortion limits, 13 having total bans. This caused various horrifying effects that really impacts individuals differently depending on their state of residence. Women faced complications, fertility loss, and even death trying to navigate those complicated new laws. This created yet another issue – because these complicated, sometimes even deliberately ambiguous state-level regulations greatly impacted those suffering from miscarriages! Women suffered horribly– not merely because losing a child is extremely hard; many ended facing criminal charges using medication abortion– particularly through the two-pill regimen– demonstrating the severity of the risks for individuals.
Mifepristone, one of those pills, faced restrictions before the Supreme Court (a June decision) preserved access. But this doesn't make it entirely safe – a January 2023 letter by JD Vance and other Congress members urged enforcing the Comstock Act (an 1873 law aiming for "sexual purity"). And the influential Project 2025 think tank plans to bring back that antiquated, problematic law! Even some Supreme Court justices (Clarence Thomas and Samuel Alito) hinted at this outdated legal precedent, in oral arguments, resulting in these ongoing complications that negatively impacted many individuals.
Louisiana reclassified those abortion pills as “controlled substances” last October; delaying crucial care, alarming many, and potentially influencing other states. Currently however; medication abortion is largely available and this comprises about 63 percent of all abortions last 2023 (Guttmacher Institute), while women in fourteen states needing that medication need to seek care in other places. An incredible 171,000 patients left home states for abortions in 2023 alone!
The OB-GYN Exodus: A Growing Shortage and Maternal Care Deserts
Doctors too are impacted. Stricter regulations lead many to move practices entirely! Dr. Kylie Cooper, a maternal-fetal medicine specialist, moved from Idaho to Minnesota. The restrictions made treating pregnant women with critically ill fetuses impossible. This really highlights those aspects which might only appear after deeper review – the actual severity of impact; created by laws aiming to solve a completely different issue yet ending with very serious repercussions!
Idaho alone lost 22 percent of its OB-GYNs in the first 15 months after that abortion ban. This kind of thing isn’t unique to Idaho; nationwide this creates major consequences. By 2030, the US faces a 5,000 OB-GYN shortage; and it might only exacerbate existing issues related to the distribution of medical professionals across various geographies which severely impacted communities! Those areas deemed as maternal care "deserts" lack both doctors and hospitals capable of offering quality care to patients (March of Dimes). This will bring catastrophic effects in the coming future if not changed entirely.
Contraception Under Siege: Eroding Access and Increased Sterilization
It doesn’t end there; contraception too is at risk! Some 19 million American women have insufficient access to birth control (Power to Decide). One year after Dobbs, restrictive states saw major declines in emergency and oral contraceptive prescriptions (compared to states with moderate limits). And it isn’t simply about limitations alone; attacks against contraception by anti-abortion groups, with several state legislatures introducing bills limiting access – despite broad public support (including Republicans). Some abortion legislation, states defining pregnancy at fertilization (instead of implantation) puts methods like IUDs and emergency contraceptives at serious risk; because this method prevents implantation; creating the possibility that the use could fall under an existing abortion legislation and these consequences have yet to play out in the coming years. Yet the worst aspect isn't merely restrictions: Several leading Republicans questioned even long-standing court rulings related to contraception – raising serious issues surrounding the fundamental elements which created access!
This leaves some people facing difficult and tragic situations with very limited choices and dire consequences involved. Many women opted for sterilization; the most extreme measure available. Nicole Blackmon, who legally challenged Tennessee’s abortion laws, lost two children; once because the doctors deemed it safer to terminate but the Tennessee laws didn't provide exception for lethal conditions – the resulting tragic end was a stillbirth at 31 weeks! And this pushes Blackmon into making the very hard and risky decision to use permanent sterilization. This increase in sterilization among those aged 18-30 rose sharply (58 per 100,000 visits, post-Dobbs), peaking in states that banned abortion (JAMA).
IVF in Jeopardy: Legal Gray Areas and Uncertain Futures
Even IVF isn't safe. An Alabama Supreme Court decision, determining that destroyed frozen embryos are children, resulted in massive legal challenges. Though Alabama's legislature fixed that issue; it renewed fears about “fetal personhood” arguments; and this could change how IVF works— potentially making access challenging or unavailable. It also impacts others – infertile couples, LGBTQ+ individuals, single people, and those needing genetic screenings.
Samantha Castro and her husband used IVF after their daughter (who survived early prognosis and lived only 3 years despite multiple surgeries!) died. They carried a recessive trait for a fatal dwarfism, and IVF was the best way to avoid those kinds of potential difficulties in the future.
Those laws created incredibly difficult, risky and ambiguous areas. Even those freezing embryos ask “What happens if we don't want more children?” and even these kinds of seemingly simple situations remain immensely unclear.
Ongoing Battles and Uncertain Futures: What Comes Next?
Legal challenges to abortion restrictions are still underway! But several states consider those supporting abortions (across state lines) criminal behavior, implementing measures similar to “abortion trafficking” laws, which creates an atmosphere of fear for women everywhere! Georgia recently overturned its six-week ban, while Tennessee faces cases involving those denying abortion with severe complications.
The A-Word; highlights this catastrophic outcome of Roe v Wade’s overturn! The ongoing impacts continue to deeply impact lives and potentially harm others and it raises the critical question— it is no longer about abortion – it’s about who these restrictive regulations impact!
