Born into a world in which Roe has always been the law of the land, Indiana University medical students Sydney DiGregory and Lucy Brown find themselves at a crossroads.
The two fourth-year students plan to enter the field of obstetrics and will soon choose where to spend four years of their lives in training.
Last week, the Supreme Court made that an even more wrenching decision with a ruling that will likely bifurcate the country into states where abortion is legal and states where it is outlawed. So now when students like DiGregory and Brown apply for residency, states with abortion rights will be front and center.
So Wednesday night the two young women addressed a rally of hundreds of health care providers and other abortion-rights supporters who gathered on the green in front of Eskenazi Health to protest the recent Supreme Court ruling. Speaker after speaker painted a picture of what the decision could mean for many in the medical profession, from those who have practiced for years to future providers.
“We will have to make essential compromises about our future,” DiGregory said. “It threatens all of our rights to decide how and where to perform our professional obligation. It seems like the trajectory of our lives is in the hands of state legislatures.”
‘Abortion is health care,’ crowd chants
The Indiana General Assembly will hold a special session July 25 — lawmakers Wednesday pushed it back two weeks from the initial July 6 start date — by in which lawmakers will discuss inflation relief along with abortion restrictions. Legislators have declined to give specifics about what the measures they will consider, but have made it clear that they want Indiana to limit abortions if not ban them outright.
The protesters, many dressed in blue scrubs and white coats, carried signs, bullhorns and a few cradled babies in their arms. Many in the crowd like DiGregory and Brown were still in medical school; others had been in health care for decades.
All came to support the concept that “abortion is health care,” the dominant chant as the crowd snaked around the green in a circle that nearly stretched end to end. Fewer than a dozen counter protesters stood silently by, holding signs of their own.
Speaker after speaker detailed how restricting abortion would have what they described as devastating effects on both providers and the patients for whom they care.
Restricting abortions will affect more than just the patients, said Dr. Carrie Rouse, a maternal fetal medicine specialist with IU Health, who defined her job as meaning that she may see patients on the worst day of their lives.
The medical risk to losing abortion access
If abortion policies shift, patients will die of pregnancy-related complications after being denied access to abortion, she said. Others may develop uterine infections that lead to sepsis and require intensive care or blindness if they experience severe hypertension as a pregnancy complication.
“Access to abortion services is part of comprehensive health care,” she said, a message for state legislators: “Stay out of my clinic, stay out of my exam rooms.”
More:‘It’s your problem not mine.’ Hoosiers share why they had abortions after Roe reversed.
Indiana already has the third highest maternal mortality rate in the country; limiting access to abortion will likely lead to a dramatic increase, said Dr. Brett Barnes, an anesthesiologist who often treats patients undergoing reproductive health procedures.
Studies suggest that 80% of maternal mortality deaths are preventable, Barnes said. As more states overturn Roe, more pregnant people will find themselves at risk.
“Women will die without access to care,” he said. “A woman’s health, not politics, should guide important medical decisions during pregnancy.”
As a second year internal medicine resident treating numerous COVID-19 patients, Dr. Molly Lee has often found herself faced with family members of patients pleading with her, ‘Isn’t there something else you can do?’
With COVID-19, doctors are already doing all they can, Lee said. But in the future, she said, she may have similar conversations with the family members of pregnant patients whose lives might be saved by what could become an illegal procedure.
“How do we explain to those same families that ask us to do everything that yeah, there is more we can do,” she said. “But the procedure has been forbidden.”
Allowing her to suffer not an option
Second-generation labor and delivery nurse Corrina Morris shared the heartbreaking work of caring for patients who have made the difficult decision to end their pregnancies due to complications to the fetus.
Some, she said, have already chosen a name. Some are saving to buy an expensive car seat, money that now goes to bury the fetus. Some may have developed life-threatening illness and the medication they must take to save their own lives will irrevocably harm their fetus.
“Loving parents do what is best for their children,” she said. “My patients have already endured so much to obtain this safe, legal and merciful procedure. They should not have to also bear the burden of convincing their legislators that their grief is valid and their choice is kind.”
Nurse Danielle Spry has been both patient and provider. Spry, a nurse for the past 12 years, was delighted in 2019 when she learned she was pregnant with her second child, Charlotte. She and her husband sold their house and started building a new home.
Then, at her 20-week appointment the ultrasound revealed Charlotte had a large hole in her diaphragm, pressing together her abdominal organs. Her heart was deformed and her lungs would not develop. If Spry carried the pregnancy to term, Charlotte would suffocate once she exited the womb. With the clock ticking, Spry and her husband had only six days to decide what to do.
“My husband and I knew that as much as we loved her and as much as we wanted to bring her home allowing her to suffer was not an option,” Spry said.
At 21 weeks and six days, the latest Spry could do so under Indiana law, she underwent a dilation and evacuation procedure. Now she works in labor and delivery.
‘I need to stay doing this’
States like Indiana, however, may wind up losing some who seek careers caring for those who became pregnant, said Dr. Nicole Scott, who heads the obstetrics-gynecology residency program for Indiana University School of Medicine.
About half of all OB/GYN residents, or about 3,000 people, will now train in states that will not allow abortion, she said. Programs like those in Indiana will now have to send residents 100 miles away to an abortion-friendly state for training.
More:Indiana poised to limit abortion access after Supreme Court ruling overturning Roe v. Wade
Fewer people may opt to enter OB/GYN as a specialty and fewer people may choose Indiana as a place to do their residency, she said.
“As an educational and research institution, we will not attract the best of the best students and trainees in a state that takes away rights of over half the population,” she said.
Those already in the labor and delivery field say that if anything the discussion over Roe has confirmed their commitment to be the bedside of pregnant people.
Anna Bailey, a labor and delivery nurse, who attended Wednesday’s rally along with two colleagues said she had expected the ruling would arrive some day but not this soon.
“It solidified the fact that I need to stay doing this,” she said.
But her friend added that all of the controversy surrounding abortion and the potential policies that state legislators might impose can sometimes lead to second thoughts.
“It does scare you about what repercussions might come when you’re doing your job,” said Breanna Schultz, a labor and delivery nurse for two and a half years.