I am an OB-GYN resident physician who grew up in the South and trained at Emory University for medical school. I always had a plan of coming back to serve the women of my community. But in light of the U.S. Supreme Court’s recent decision to overturn Roe v. Wade, many trainees in medicine, nursing and other health care fields are figuring out what it would mean to practice in a state that could restrict all access to abortion this summer, severely undercutting the type of counseling and care we can provide.
The impact of the Supreme Court’s decision of Dobbs v. Jackson Women’s Health Organization will have monumental impacts to Georgian women, partly by ensuring that there are fewer providers to take care of all their reproductive health needs.
The court’s decision on Friday reverses over 50 years of protecting the constitutional right to abortion by allowing states to enact abortion bans before viability. Georgia has legislation that is supported by Gov. Brian Kemp to ban abortion after a fetal heartbeat is detected, typically around six weeks gestation and before many patients know they are pregnant.
Georgia is a state with already tragically limited resources for women, ranking the 2nd-worst in maternal mortality, 7th-highest in preterm birth, and in the top quartile of teen pregnancy rates across the country. Restricting access to reproductive health services even further will prevent newly graduated trainees from establishing their careers and returning home to help combat these dire statistics.
Consider a patient who is getting regular prenatal care from her midwife and breaks her water early when she is 5 months pregnant. With the expected ban in place, she would not be able to receive a safe procedure that could prevent devastating and life-threatening outcomes for her and her family. Another patient under this midwife’s care may not know she is pregnant because she is breastfeeding her young infant and does not get regular periods. By the time she recognizes she is pregnant, she would not have all options available to her to be able to make the decision that is right for her family.
As an OB-GYN, I have been trained in providing comprehensive women’s health care, from counseling teens about contraception, to helping patients navigate pregnancy complications, to treating patients through menopause. I am apprehensive of setting up a practice in this state when receiving safe care in all their reproductive health choices is not guaranteed. Many women’s health providers will find alternative places to work, and patients seeking their routine breast or cervical cancer screening, birth control refills, or preconception counseling will not be able to see their doctors in their own communities.
And this spans beyond women’s health – many physicians across multiple specialties oppose abortion restrictions, not only because they limit patients from receiving appropriate and timely care, but also because they interfere with and undermine the privacy of health care choices. Will an oncologist feel comfortable prescribing toxic chemotherapies to their young female patients knowing that their patients will not have an alternative if they have an unintended pregnancy? Will a cardiologist treating patients from infancy to adulthood with congenital heart abnormalities tolerate the fact that for some, there is more chance than not that continuing a pregnancy could kill their patient?
Some may argue that Georgia has other stopgaps in place to attract health care providers, such as loan forgiveness incentives. Regardless of the politics of abortion, providers want to provide safe and accessible care throughout a patient’s reproductive years, and policies that specifically target and criminally penalize providers like Georgia’s ban create a culture that is unappealing for highly trained individuals to practice here.
The Court’s decision will have an unmeasurable, devastating impact on patients across the country in how and if they receive the reproductive health care they need, particularly in the South. The hostile environment to be a women’s health provider in Georgia perpetrated by the impending ban will further widen care gaps across the state by deepening the provider shortage, and Georgian women and their families will be the victims.
Preetha Nandi, M.D., M.P.H. is a fourth-year OB-GYN resident physician at Tufts Medical Center in Boston. She grew up in North Carolina and received her medical and public health graduate degrees at Emory University. She hopes to return to the Southeast to provide comprehensive women’s health care.
