The Supreme Court’s decision in Dobbs v. Jackson Women’s Health overturned Roe v. Wade and the Constitutional right to abortion. Colorado physicians knew this decision would have a profound impact on our ability to practice medicine, even though we live and work in a progressive state. Two months later, the Dobbs decision means life as we know it has been turned upside down in the reproductive health care world, for ourselves, and for the patients we serve.
Abortion bans are already causing a flood of patients to Colorado, and as more of these ‘trigger bans’ kick in, the volume will only increase. As a result of these careless abortion ban laws in so many states, we are seeing pregnant people with miscarriages and ectopic pregnancies being forced to travel across states’ lines to get care. These dangerous medical conditions should be treated where the patients live.
A patient recently drove 18 hours from rural Texas, with her husband and two children, to Colorado with a known ectopic pregnancy. If that tubal pregnancy had ruptured during the rural drive, she could have bled to death.
Post Dobbs, we are caring for women from all over the country. We have seen an influx of patients traveling for routine care: annual exams, contraception, and hysterectomies. This decision is affecting people seeking all types of reproductive care, not just abortions.
We are seeing a capacity level that is beyond what we are built to serve. This is not sustainable both physically and mentally. Burnout is already at the forefront of our medical specialty, in addition to years of staff shortages.
With the increasing volume of people traveling from other states for care, we are leaving those that live here with major delays in care. This strain was prevalent over the last several years with the population increase in our state without much change in the health care infrastructure.
This is not the America that I want to live in. I say this as a woman, a mother, and as a female physician who practices in reproductive health care. My OBGYN colleagues in our region are in absolute despair. They feel helpless for their patients, knowing that these restrictive bans harm our communities by increasing barriers to health care, and many are left without the ability to get the care they need.
Beyond patient demand and the overwhelming sense of disbelief that this is American medicine, we as Colorado providers face so much legal uncertainty and security concerns. Which provider will be named in a lawsuit first? When will the protestors show up at our homes? We need protection to be able to practice medicine without fear and to go home and feel safe with our families.
We know that making abortion illegal does not decrease the number of abortions. It only increases the number of unsafe abortions. Increasing access to affordable contraception will decrease the number of abortions. We have addressed some of the access issues in Colorado. Our coalition has worked to help Coloradans have better access to contraception for the prevention of unintended pregnancies by passing legislation for pharmacist-prescribed birth control. In addition, patients can now get a 12-month supply of birth control pills, patches, or vaginal rings.
Unfortunately, major national pharmacy chains are refusing to comply with Colorado law because it is not required in all states. Pharmacists also like to change a birth control prescription from a 3-month supply to a 1-month supply. The more times they dispense, the more money they make. Getting to a pharmacy every month can prove very difficult for many people, especially those who are already in marginalized communities with limited resources.
We also need to expand access to abortion care training for medical providers. I am very concerned that we are about to lose a generation of physicians and nurse practitioners who simply do not know how to perform abortions. This skill is critical to the full scope of our medical practice and reproductive health care — as we have learned from states with abortion bans that are unable to provide miscarriage treatment, and those patients are now coming here.
A colleague in our coalition recently reminded us that “we are in a marathon, not a sprint,” and that we need to “pause our panic.” These words may be true, but they are hard to digest as our community feels that we are treading water with rising levels, there is no flood gate to stop the flow of water, and no lifeboat is in sight.
This is a public health crisis. Public policymakers and elected officials must rise to the occasion, ensure we as providers have the protection, resources, and training we need, and ensure our patients feel safe seeking the care they need and deserve where they live.
Dr. Emily Schneider is a private practice OBGYN in the metro Denver area. She serves as the Chair of the Colorado Section of ACOG, the American College of Obstetricians and Gynecologists.
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