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Roe v Wade: Medical bodies declare support for abortion rights, as doctors and states face confusion

BMJ 2022; 378 doi: https://doi.org/10.1136/bmj.o1643 (Published 04 July 2022) Cite this as: BMJ 2022;378:o1643
  1. Janice Hopkins Tanne
  1. New York

Medical bodies in the United States have described their fearfulness at the unfolding situation facing women and doctors across the country as the fallout from the US Supreme Court’s decision to overturn Roe v Wade continues.

The American College of Obstetricians and Gynecologists, the American Medical Association, the American College of Physicians, and other medical associations have all criticised the decision to overturn the 1973 ruling that legalised abortion, which now leaves abortion regulation in the hands of individual states.1

“This is a dark and dangerous time for the women and doctors of America,” said Iffath Abbasi Hoskins, president of the American College of Obstetricians and Gynecologists. She called the court’s ruling “a direct blow to bodily autonomy, reproductive health, patient safety, and health equity in the United States.”2

Jack Resneck, Jr, president of the American Medical Association, called the court’s decision “an egregious allowance of government intrusion into the medical examination room, a direct attack on the practice of medicine and the patient-physician relationship, and a brazen violation of patients’ rights to evidence based reproductive health services. States that end legal abortion will not end abortion—they will end safe abortion, risking devastating consequences, including patients’ lives.” 3

Ryan Mire, president of the American College of Physicians, said, “With the final decision of the Supreme Court, access has already disappeared in the states with automatic bans on abortion, and it is likely to encourage other states to pass similarly restrictive policies. The decision is particularly concerning because it has the potential to be applied much more broadly than just to abortion services . . . the ACP is concerned that by eroding the constitutional right to privacy, the decision has the potential to restrict the ability of patients to access contraception or fertility treatments in some states, or to threaten other constitutional privacy protections.”4

After the Supreme Court’s ruling, at least eight states immediately banned abortions as “trigger” laws went into effect. Some 26 of the nation’s 50 states are expected to either ban abortion or severely limit it. Some have no bans for rape or incest.5

Each state’s decisions will rest on the state’s constitution and laws. In Texas, Louisiana, and Kentucky the legality of abortion bounced back and forth from day to day and hour to hour as old abortion laws went into effect, were challenged, and sometimes went into effect again over the 4 July Independence Day weekend. Texas, for example, had a 1925 ban on abortion that exposed abortion providers to lawsuits and fines. It was blocked in the courts but then reinstated.6 Kentucky enforced two abortion bans, but these were blocked in a lawsuit filed by the American Civil Liberties Union and Planned Parenthood and then reinstated.7

The battle over abortion is playing out in state courts without much input from doctors, who are sometimes left in limbo over what is permitted and what is illegal. Among their concerns are treatments for ectopic pregnancy and for miscarriage.

The Indianapolis Star reported the case of a pregnant 10 year old girl who had to travel from nearby Ohio for a legal abortion after child abuse. Ohio had outlawed abortion after six weeks of pregnancy, and the girl was six weeks and three days pregnant. Indiana’s own legislature will meet later this month to consider stricter laws on abortion.8

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