Kentucky voters turned out in 2022 to protect abortion rights—but the state ban has remained in place, with devastating consequences for those receiving and providing reproductive healthcare.
Members of Kentucky Physicians for Reproductive Freedom, a group representing over 280 healthcare providers, delivered an open letter late last month demanding the repeal of their state abortion ban and decrying the devastating impact the ban is having on their patients. Citing “Do No Harm,” the primary vow of healthcare providers to care for their patients, the physicians spoke out against abortion bans.
The Dobbs decision triggered Kentucky’s law that completely banned abortion in the state except in very limited circumstances, and through which healthcare providers who violate these restrictions could face civil and criminal penalties.
Although in late 2022, Kentucky voters rejected an amendment to the state constitution that would have stated that the constitution does not protect abortion rights, Kentucky’s abortion ban has remained in place with devastating consequences for those receiving and providing essential reproductive healthcare in the state.
Kentucky Physicians for Reproductive Freedom stressed the impact of these draconian measures on the training and recruitment of healthcare providers in Kentucky. In a state with the second highest maternal mortality rate in the country, the physicians underscored that Kentucky is in desperate need of physicians trained to provide reproductive healthcare.
Urooj Nasim, a second-year medical student, said many of her classmates would be forced to seek residency training outside Kentucky without comprehensive medical training in the state. Nearly 60 percent of medical students have stated that they would not pursue residency training in states with abortion restrictions, according to a national survey by the American College of Obstetricians and Gynecologists.
According to Nasim, among those who leave Kentucky for residency, very few medical students will come back as they would be “forced to choose between acting in the best interest of our patients or potentially facing prison time.”
I am now being forced to make impossible choices that put my professional ethics and my faith in direct conflict with the law.
Dr. Michelle Elisburg
Beseeching legislators to listen to physicians and leading healthcare organizations and repeal all bans on abortion, Dr. Marjorie Fitzgerald, a physician who participated in the press conference, said, “Legislators must not interfere with decisions made between doctors and patients.”
“I am now being forced to make impossible choices that put my professional ethics and my faith in direct conflict with the law,” said Dr. Michelle Elisburg, a pediatrician in Louisville, Ky. She emphasized that politicians and legislators should not be involved in personal and private health decisions, as “they should remain between the patient and their medical provider according to their individual religious beliefs and evidence-based medical standards of care.”
Restrictive healthcare laws affect everybody in this state, not simply women seeking abortions. It erodes the foundation of patient-centered care and puts pregnant Kentuckians’ lives at risk.
Dr. Karen Berg
Noting the implications of these legal measures for all in Kentucky, Dr. Karen Berg, a physician and member of the state Senate, said, “Restrictive healthcare laws affect everybody in this state, not simply women seeking abortions. It erodes the foundation of patient-centered care and puts pregnant Kentuckians’ lives at risk.”
Rep. Pam Stevenson, whose district includes the University of Louisville Medical State School, also addressed the ripple effect of the ban. “It makes it difficult for Kentucky to retain and recruit doctors. Who wants to come to a state where lawyers get to tell you how to medicine? It runs doctors away when we need them the most.”
Dr. Nancy Newman, a board-certified obstetrician, warned that these restrictive measures have created a “culture of fear” in healthcare, with healthcare providers worried about the consequences of providing necessary healthcare. “And how do you practice medicine in a culture of fear? I don’t think you can.”
The letter is pasted in full below. For a full list of signatories, view the original letter here. Sign the letter here.
As health care providers in Kentucky, we are gravely concerned for the well-being of our citizens, particularly women. We raise our collective professional voices and call on Kentucky legislators to protect the freedom of women in our state. We also call for repeal of the total ban on abortions.
Restrictive health care laws affect all Kentuckians, not just women seeking abortion. More than half of Kentucky’s 120 counties had no dedicated OB-GYN physician in 2021 and the primary care shortfall is affecting 94% of Kentucky counties. Kentucky is ranked 36 out of 50 for infant mortality and has the 6th highest rate of maternal mortality in the nation. In a national survey of nearly 500 third- and fourth-year medical students with interests across specialties, NEARLY 60% reported that they were unlikely to apply for residency training in a state with abortion restrictions. Even if residents come to the state to train, they will receive inadequate instruction in important life-saving techniques, which will further harm women in the state. The abortion bans make it more difficult to retain and recruit physicians in Kentucky and continue the downward spiral of inadequate or unavailable healthcare. Physicians are unwilling to live and work in a state that puts them and their patients at risk.
Complex and personal healthcare decisions should be made between a health care professional and the patient without the interference of legislators whose decisions are not based on science, best medical practices, or the individual patient’s best interest. Kentucky’s total ban on abortion puts patient’s lives at risk. Women with pregnancy complications, lethal fetal anomalies, tubal pregnancies, and those women who face the diagnosis of cancer during pregnancy are all required to risk their lives or leave the state for health care. Kentucky’s harsh policies display little regard for those who must endure them.
What defines and necessitates abortion is nuanced. Women may require abortion to undergo life-preserving treatments such as chemotherapy. Women may choose to have an abortion to terminate an unviable pregnancy, and to be spared the emotional anguish and physical threat of carrying a fetus that cannot survive outside the womb. A woman (including a child or an adolescent minor) may choose to have an abortion after incest or being raped and impregnated. A woman may choose to have an abortion simply to protect her future. No explanation should be required for a choice that guarantees a woman equal status in society as a man: freedom to control and preserve her individual health and wellbeing.
Some of us are currently caring for patients seeking abortions or experiencing medical emergencies that threaten their health; we understand the complexities of this decision. Many of us have been forced to put our patient’s care at risk because of restrictive state laws that limit access to reproductive health care and criminalize evidence-based standards of medical care.
Doctors are guided by evidence-based medicine and are bound by our commitment to:
DO NO HARM
We stand steadfast in our support for the sanctity and privacy of the patient-physician relationship. Withholding treatment until a preventable medical emergency occurs is antithetical to our roles as healthcare workers. We wholeheartedly believe that a woman’s mental health is essential in the discussions regarding medical necessity and emergency; suicide is a leading cause of death amongst women of child-bearing age. A government that takes away the freedom of women and pregnant persons to access critical medical care and threatens physicians with criminal penalties for upholding their oath is un- American.
As physicians of many specialties and allied health professionals, we call for the Kentucky State Legislature, as well as all elected and government officials in the state of Kentucky, to repeal all abortion bans.
Project of the Kentucky Reproductive Freedom Fund
www.kyrff.com/health-professional
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