“We felt compelled to call the world’s attention to the grave human rights abuses occurring in the U.S. as each of us has witnessed the horrific effects of Dobbs through our work.”
On the eve of International Women’s Day, a coalition of nearly 200 organizations and individuals made an urgent appeal to several United Nations human rights experts, explaining that the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization puts the U.S. in violation of its obligations under international law. We provided testimony for that submission. We felt compelled to call the world’s attention to the grave human rights abuses occurring in the U.S. as each of us has witnessed the horrific effects of Dobbs through our work as doctors, medical students, human rights advocates and experts on abortion.
Denying a pregnant person access to an abortion means that they will be forced to carry, deliver and potentially care for a child that they do not have the financial, social or emotional resources to raise. This forced pregnancy is a violation of the human right to bodily autonomy and causes significant harm, the most obvious of which are physical.
We have watched patients forced to carry a high-risk pregnancy with little to no chance of viability because the risk to their health was deemed insufficient to justify abortion. Frequently, the laws as to what constitutes a medical emergency are too vague for doctors to be able to act without fear of punishment.
Even where such patients survive or do not suffer grave bodily injury, they experience extreme mental anguish and long-lasting trauma associated with their pregnancy. Similar repercussions are experienced by patients denied abortion due to rape, yet the restrictions in many states continue to make it difficult to get an abortion for this reason.
The impact of Dobbs on pregnant people’s access to healthcare is not limited to reproductive care. In many cases, we have seen doctors prevented from providing timely cancer treatment to pregnant patients for fear that it would harm the fetus, especially in early pregnancy. A delay in treatment, however, can put the cancer patient’s life at risk.
We have watched patients forced to carry a high-risk pregnancy with little to no chance of viability because the risk to their health is deemed insufficient to justify abortion.
Apart from physical and mental harm, anti-abortion laws also contribute to the criminalization of pregnant people. Pregnant women who seek to obtain abortions, including by traveling to states where abortion is legal, are already being prosecuted for their actions.
This policing of pregnant people’s bodies will only get worse. Similar to doctors working in states without abortion restrictions, we have treated patients coming from states with abortion bans to get the care they cannot obtain at home. In each case, we have witnessed patients forced to decide whether the healthcare choices they make constitute actions for which they could be prosecuted. Such considerations have no place in healthcare.
The end of Roe has meant that we, as doctors, are forced to analyze the complicated and often rapidly changing laws of the states in which we work. We entered medicine to help people, not to adjust our standard of care due to legislation. Now, we must see whether we are facing criminal prosecution for helping our patients. For evidence of the disruptive consequences of this uncertain environment, look no further than the Idaho hospital that had to shut down labor and delivery care after physicians fled the state over its abortion ban.
These impacts are also not equally distributed. Certain groups are more affected than others. Minors, people who are incarcerated, hospitalized, under court supervision, BIPOC individuals, people of diverse gender identities and sexual orientations, migrants, persons with disabilities, people who are low-income or living in poverty, rural residents and undocumented individuals feel the greatest pain from the loss of their rights.
We entered medicine to help people, not to adjust our standard of care due to legislation. Now, we must see whether we are facing criminal prosecution for helping our patients.
Even before the Dobbs decision, many medical schools did not include abortion care as part of their curriculum, requiring interested students to seek it out on their own. This lack of education has only grown. With many states now restricting or banning abortion, medical residents in states with abortion restrictions are forced to leave in the middle of their residencies to receive abortion training out of state.
Students applying for residency must ask themselves: Do I go somewhere that clearly needs physician advocates for reproductive justice, or do I choose a program that will teach me the skills I need to provide for my future patients? Some medical students will likely decide not to enter practice in states with abortion restrictions, which could impact the inflow of new doctors into those states and, ultimately, make all medical care more difficult to come by in those places.
Watching pregnant patients suffer as these harms manifest has been agonizing. The devastation is playing across broad swaths of the country and with such regularity that there is a risk that this grave human rights and healthcare crisis will simply become routine and accepted—though it is anything but.
We never expected to witness this kind of regression of human rights and are embarrassed that such cruelties can occur in the United States, which holds itself as champion of human rights. We hope others, both abroad and at home, will not ignore this real human suffering and will, like us, feel compelled to speak out. It is the least we can do.
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