Leaders of the American College of Obstetricians and Gynecologists (ACOG), one of the country's top medical organizations, believe the United States' maternal health crisis will likely worsen in the wake of Friday's Supreme Court ruling to overturn Roe v. Wade, the landmark case that established the constitutional right to abortion.
“Today is a very dark day in healthcare. It is a very dark day, indeed, for the tens of millions of patients who have suddenly and unfairly lost access to safe, legal and evidence based abortion care,” Dr. Iffath Hoskins, ACOG president, said in a press briefing. “It is a dark day for the thousands of clinicians who now, instead of focusing on providing health care to their patients, have to live with the threats of legal, civil and even professional penalties while providing health care to patients when they need it.”
ACOG has 62,000 members who provide OB-GYN care throughout the United States.
Roe v. Wade and the maternal health crisis
The Supreme Court’s decision will likely cause more people to die during and after pregnancy, according to ACOG. The U.S. already has one of the worst maternal mortality rates among developed nations. In 2020, there were almost 24 deaths per 100,000 births in the U.S., up from 20 in 2019.
“Maternal mortality is the most serious outcome when a woman is carrying a pregnancy,” said Hoskins, a maternal-fetal-medicine specialist who treats high-risk patients. “Maternal mortality, unfortunately, (is) going to be more common because of this law. We have got to think of the mothers.”
Hoskins said that this ruling will mean that doctors in many states won’t be able to offer solutions to people who develop dangerous conditions while pregnant.
“Mothers are having babies, and (this) should not be a cause for them to die,” Hoskins said. “Women will be forced to be carrying pregnancies forward into ... the later part of pregnancy, where there is an inherent possible increase in them developing complications.”
“I think of the patients who will present (with) critical conditions because now they’re carrying a forced pregnancy, and they did not receive adequate prenatal care, which we all know is an essential component of good health care,” Hoskins continued. “I also think of the patients who need to end their pregnancies in order to save their own lives.”
The experts also expect the ruling will increase already severe health care disparities. Black women, for example, are three times more likely to die from a pregnancy-related cause than white women, according to the Centers for Disease Control and Prevention.
“There are people who are victims of violence, who are not connected to the health care system, young people, communities of color. They are ... people who are already disenfranchised. Without question, they will be negatively impacted." Dr. Maureen Phipps, ACOG’s chief executive officer, said. "Current data supports an association between restricted access to safe and legal abortion and higher rates of maternal mobility and mortality.”
The future of reproductive care
The ruling might also slow medical discovery and innovation, ACOG spokespeople said.
“In health care, we constantly strive to learn, to grow, to develop new information and apply it all to improve our patients lives. Today’s decision is an obvious step backward in the provision of such care,” Haskins stated. “It is unfathomable. It is unfair. It is wrong. What comes next, I wonder? What other medical care will be stripped from our patients?"
Another worry that the organization articulated is that the decision will negatively impact the patient-doctor relationship.
“The Supreme Court has forced us, the clinicians, to betray the sacred covenant that we made to our patients,” Haskins said. “This is unethical. It is dangerous.”
The American Medical Association (AMA), the nation's leading physician's group, also issued a statement rebuking the ruling. It reads, in part:
“The American Medical Association is deeply disturbed by the U.S. Supreme Court’s decision to overturn nearly a half century of precedent protecting patients’ right to critical reproductive health care — representing 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."
"In alignment with our long-held position that the early termination of a pregnancy is a medical matter between the patient and physician, subject only to the physician’s clinical judgment, the patient’s informed consent, and access to appropriate facilities, the AMA condemns the high court’s interpretation in this case. We will always have physicians’ backs and defend the practice of medicine, we will fight to protect the patient-physician relationship, and we will oppose any law or regulation that compromises or criminalizes patient access to safe, evidence-based medical care, including abortion. As the health of millions of patients hangs in the balance, this is a fight we will not give up.”