Surge in complications from unsafe abortions likely post-Roe, doctors warn
Top doctors in the US warn that surgeons should be prepared to treat more patients with complications from self-managed abortions and forced pregnancy after the overturning of Roe v Wade.
In a recent opinion piece published in the BMJ, 17 experts from medical centers and universities including the University of Chicago, Duke Medicine and the University of Pennsylvania urged surgeons to be prepared to treat medical consequences related to a person’s inability to access an abortion.
“In the aftermath of the supreme court’s Dobbs v Jackson Women’s Health decision, acute care surgeons face an increased likelihood of seeing patients with complications from both self-managed abortions and forced pregnancy in underserved areas of reproductive and maternity care throughout the USA,” read the op-ed.
The Dobbs v Jackson case eliminated the nationwide abortion rights established by Roe v Wade in 1972. While many states still provide access to abortions, many others now generally prohibit the termination of pregnancies.
Physicians noted that self-managed abortions with pills such as mifepristone are extremely safe and used across the country to help provide access to abortion services.
But physicians warned that people in underserved medical communities in states that ban abortions may be more likely to attempt a self-managed “by ingestion of toxic substances or by self-inflicted physical injury”.
“Depending on their location and state laws regarding abortion access, trauma and acute care surgeons may find themselves providing care for people [affected] by the Dobbs ruling who undergo [self-managed abortion] and suffer injury as a result,” the op-ed noted.
“While we should strive to prevent such injury by advocating for the protection of access to safe abortion care, surgeons should also prepare to treat resulting complications.”
Doctors noted that surgeons must act to protect patient privacy and legal safety, especially as conservative states have weighed prosecuting pregnant people who seek an abortion in a state that prohibits it.
“The patient’s legal safety should also be of utmost concern and underscores the significance of knowing your state laws around this issue,” the op-ed noted.
“Providers have the ethical duty to protect patient privacy and to not report these complications which implicate self-induced abortion to law enforcement in states where this is prohibited.”
Providers also warned that surgeons may have to deal with the medical complications associated with forced pregnancy, especially given higher rates of maternal morbidity and mortality in the US.
“Again, in those states that restrict access to abortion care, maternal morbidity, and inevitably mortality, will increase and require physicians from all fields to expand their ability to care for these needs,” read the op-ed.
Physicians warned that the consequences of abortion bans will most affect marginalized communities, including people of color and those from lower socioeconomic backgrounds, who are overrepresented in patients seeking abortion services and are more likely to live in areas where abortion access is restricted.
The op-ed urged medical professionals to become educated on how to treat pregnant patients who may face health consequences as a result of not being able to access an abortion.
At least 22 states have taken some action to limit abortion access, with 12 states banning the procedure from conception.
Medical providers in states that have banned abortion have stated that they are often delayed in providing life-saving treatment due to bans on the procedure.
A recent study from Texas showed that even with high-risk pregnant patients, doctors were forced to wait until some were “at death’s door” before providing pregnancy termination services.
A separate study from Texas found that delays in miscarriage care due to anti-abortion laws resulted in severe health consequences, including admission into an intensive care unit and a hysterectomy.
Meanwhile, states have begun enshrining abortion protections amid the continuing battle over reproductive rights.
Minnesota on Saturday became the first state to pass a bill that would codify abortion rights following the Dobbs decision.
“This is a crucial first step in establishing rock-solid protections for everyone in Minnesota to make their own decisions about their reproductive destiny,” said Abena Abraham, campaign director for the advocacy group UnRestrict Minnesota, in a statement, according to the Star Tribune.