It is an honor to begin my term as President of the Board of the Columbus Medical Association. For those of you who I have not met, I am a family physician. I trained on the east coast and practiced full spectrum family medicine until I moved to Ohio 9 years ago. Since then, I have almost exclusively provided abortion care throughout the state.
Last month, the skills that I have honed over the last 12 years, became illegal. The Supreme Court ruled in Dobbs v Jackson that a person no longer has the right to make private healthcare decisions about a pregnancy. The court’s decision threatens the most basic tenets of healthcare – the patient-physician relationship and practicing evidence-based medicine without the threat of harassment, retribution, or punishment. Every major medical association has condemned this decision. Within hours, a federal court allowed Ohio’s ban on abortions after the detection of cardiac activity to go into effect. I am no longer allowed to practice the medicine that I trained in, and that I have risked my life to provide. I am obsolete.
It is strange to step into my new role at President of this organization, which has given me so much support and opportunity, at this moment. I am scared. I am scared for my colleagues who are now out of work and the families that depend on them. I am scared for the people I love who may need abortion care. I am scared for the patients who I will never see. I am also optimistic that this community of physicians exists and stands together against the criminalization of evidence-based medicine.
Many people are wondering what they can do to help and what they need to know. Here is my understanding of our current situation in Ohio:
1. For now, abortion is legal in Ohio before cardiac activity is detected but we still have strict laws that require 24 hour waiting periods, parental consent, mandatory ultrasounds, and special facility requirements.
2. It is still legal to provide care for ectopic pregnancies, even if there is cardiac activity. It is also still legal to perform an abortion for a patient who presents with a medical emergency related, but not limited, to cardiac disease, premature rupture of membranes, infection, acute fatty liver of pregnancy, inevitable abortion, eclampsia, preeclampsia, respiratory failure, hemorrhage, multiple sclerosis, or diabetes.
3. Patients may choose to order medication abortion pills online and manage their abortions at home without the direct supervision of a clinician. We have a rich literature that tells us this practice is safe and effective. If a patient chooses to manage their abortion at home and discloses that to you, there is no limitation on you caring for them just as you would any other patient who has had an early pregnancy loss.
Finally, if I can ever be of help to any of our members, regardless of the issue, please do not hesitate to reach out. We will navigate this new landscape and the ever changing practice of medicine together.