Likely abortion restrictions mean we’re not returning to Iowa

I am an Iowa native and an OB/GYN. As a physician, I help usher women safely through the joys and sorrows of childbearing, including abortion care. Since the June Supreme Court decision, state legislators are free to dictate the medical care I and my colleagues across the nation provide, however misinformed or politically motivated they may be. And for this reason, as much as I’d like to, I will not be relocating to my beloved home state any time soon.

Women in conservative states are already feeling the impact, even when seeking care for miscarriage and ectopic pregnancy. At this time no state explicitly restricts care for these conditions. However, their treatment often includes the exact same procedures and medications used to provide elective abortion. There are already many reports of pharmacies withholding medications for the treatment of miscarriage. In Texas any layperson may sue if they even suspect an illegal abortion. Physicians in some states may face extensive legal fees, loss of their medical license and even prison time.

Conservative lawmakers across the country have proposed and passed bills with problematic and incorrect medical statements. For example, politicians are touting abortion bans from “the moment of fertilization.” This phrasing puts the legality of IVF, certain contraceptives and morning after pills in jeopardy. Many also profess their disdain for “late term” or “partial birth” abortions. Both terms are purely political and have no place or meaning in actual abortion care. A 2020 Ohio bill even proposed physicians should have to “reimplant” ectopic pregnancies — a scientific impossibility that left every OB/GYN I know either laughing or shaking their head in horror.

Then there are exceptions for “the life and health of the mother.” In all my years of medical training and practice, I’ve never been taught about the mythical line that, when crossed, means there is an official threat to a patient’s life. How much bleeding is enough? How high the fever? How many seizures? What if they attempted suicide? What about delayed cancer treatment? I’m still early in my career, but I’ve encountered every one of these tragic scenarios and many more. A woman is 14 times more likely to die during childbirth than during an abortion. For many that number is much higher. How “dying” does she need to be? Who decides? Surely it shouldn’t be the politician hoping to score points by casually spouting medical nonsense, ignorant of the devastating real world consequences. He doesn’t have to look into the eyes of the woman who narrowly survived her last delivery, the woman whose baby won’t ever leave the NICU, the woman whose children already go to bed hungry, the woman whose partner beats her senseless and tell her she doesn’t get a choice. That’s my job, apparently.

The science of medicine is far from exact. That’s especially true for the dynamic, wondrous, but sometimes perilous process of pregnancy and childbirth. Decisions surrounding pregnancy, complications and pregnancy loss are complicated and deeply personal. I sincerely hope the people of Iowa and nationwide recognize this and vote accordingly.

Dr. Emily Garrett lives in Washington state.