Born into a world where Roe has always been the law of the land, Indiana University medical students Sydney DiGregory and Lucy Brown find themselves at a crossroads.
The two fourth-year students plan to enter midwifery and will soon be choosing where to spend four years of their lives in training.
Last week, the Supreme Court made that decision, with a ruling likely to split the country into states where abortion is legal and states where it is banned. So when students like DiGregory and Brown apply for residency, states with abortion rights will take center stage.
So Wednesday night, the two young women addressed a gathering of hundreds of health care providers and other abortion rights advocates who gathered on the lawn in front of Eskenazi Health to protest the recent Supreme Court ruling. Speaker after speaker painted a picture of what the decision could mean for many in the medical world, from those who have practiced for years to future health care providers.
“We will have to make essential compromises about our future,” DiGregory said. “It threatens all of our rights to decide how and where we fulfill our professional obligation. It seems that the trajectory of our lives is in the hands of state legislators.”
‘Abortion is health care’, the crowd sings
The Indiana General Assembly will hold a special session on July 25 — lawmakers pushed it back two weeks on Wednesday from its original July 6 start date — in which lawmakers will discuss inflation easing and abortion restrictions. Lawmakers have declined to provide details of the measures they will consider, but have made it clear that they want Indiana to restrict, if not completely, ban abortions.
The protesters, many dressed in blue scrubs and white coats, were carrying placards, megaphones and a few babies in their arms. Many in the crowd, like DiGregory and Brown, were still in medical school; others had been in healthcare for decades.
All came to support the concept that “abortion is health care,” the dominant chant as the crowd swung around the greenery in a circle stretching almost from end to end. Less than a dozen counter-protesters stood in silence with their own placards.
Speaker after speaker explained how restricting abortion would have what they described as devastating effects on both caregivers and the patients they care for.
Limiting abortions will impact more than just the patients, said Dr. Carrie Rouse, a maternal fetal medicine specialist at IU Health, who defined her job as meaning getting to see patients on the worst day of their lives.
The medical risk of losing access to abortion
If abortion policy changes, patients will die from pregnancy-related complications after being denied access to an abortion, she said. Others may develop uterine infections leading to sepsis and require intensive care or blindness if they experience severe hypertension as a pregnancy complication.
“Access to abortion services is part of comprehensive health care,” she said, sending a message to state lawmakers: “Stay out of my clinic, stay out of my exam rooms.”
More:“It’s your problem, not mine.” Hoosiers tell why they had abortions after Roe rolled back.
Indiana already has the third highest maternal death rate in the country; restricting access to abortion is likely to lead to a dramatic increase, said Dr. Brett Barnes, an anesthesiologist who often treats patients undergoing reproductive health procedures.
Studies suggest that 80% of maternal deaths are preventable, Barnes said. As more states overthrow Roe, more pregnant people will be at risk.
“Women will die without access to care,” he said. “A woman’s health, not politics, should guide important medical decisions during pregnancy.”
As a sophomore internist treating numerous COVID-19 patients, Dr. Molly Lee often faced relatives of patients who begged her, ‘Isn’t there something else you can do?’
With COVID-19, doctors are already doing everything they can, Lee said. But in the future, she said, she could have similar conversations with the relatives of pregnant patients whose lives could be saved through what could become an illegal procedure.
“How do we explain to those same families who ask us to do everything that there is more we can do,” she said. “But the procedure is prohibited.”
Making her suffer is not an option
Second-generation labor and delivery nurse Corrina Morris shared the heartbreaking work of caring for patients who have made the difficult decision to terminate their pregnancy due to fetal complications.
Some, she said, have already chosen a name. Some are saving to buy an expensive car seat, money now used to bury the fetus. Some may have developed a life-threatening illness and the medication they have to take to save their own life will irreversibly harm their fetus.
“Loving parents do what’s best for their children,” she said. “My patients have already gone through so much to obtain this safe, legal and compassionate procedure. They should not also bear the burden of convincing their legislators that their grief is justified and that their choice is kind.”
Nurse Danielle Spry has been both a patient and caregiver. Spry, who has been a nurse for the past 12 years, was delighted to learn in 2019 that she was pregnant with her second child, Charlotte. She and her husband sold their house and started building a new one.
Then, during her 20-week appointment, the ultrasound revealed that Charlotte had a large hole in her diaphragm, compressing her abdominal organs. Her heart was deformed and her lungs wouldn’t develop. If Spry carried the pregnancy to full term, Charlotte would suffocate as soon as she left the womb. As the clock ticked, Spry and her husband had only six days to decide what to do.
“My husband and I knew that as much as we loved her and as much as we wanted to bring her home, letting her suffer was not an option,” Spry said.
At 21 weeks and six days, the last Spry was able to do so under Indiana law, she underwent a dilation and evacuation procedure. Now she works in labor and delivery.
‘I have to keep doing this’
However, states like Indiana could end up losing some of those seeking careers for those who have become pregnant, said Dr. Nicole Scott, chief of the obstetrics-gynecology residency program for Indiana University School of Medicine.
About half of all OB/GYN residents, or about 3,000 people, will now train in states that don’t allow abortion, she said. Programs like the one in Indiana will now have to send residents 100 miles away to an abortion-friendly state for training.
More:Indiana poised to restrict abortion access after Supreme Court ruling Roe v. Wade . has destroyed
Fewer people may choose to enter OB/GYN as a specialty and fewer people may choose Indiana as a place to do their residency, she said.
“As an educational and research institution, we will not attract the best of the best students and interns in a state that takes away the rights of more than half of the population,” she said.
Those already into labor and delivery say the discussion about Roe has at least confirmed their commitment to being the bedside of pregnant people.
Anna Bailey, a labor and delivery nurse who attended Wednesday’s meeting with two colleagues, said she had expected the ruling to come someday, but not so soon.
“It confirmed the fact that I have to keep doing this,” she said.
But her friend added that all the controversy surrounding abortion and the possible policies state lawmakers could impose can sometimes raise doubts.
“It scares you about the consequences that can come from doing your job,” says Breanna Schultz, a midwife and childbirth nurse for two and a half years.
Contact IndyStar reporter Shari Rudavsky at email@example.com. Follow her on Facebook and more Twitter: @srudavsky.