Three weeks before the Supreme Court overturned Roe v. Wade, Dr. Caitlin Bernard, an Indianapolis obstetrician-gynecologist, put on her white lab coat, put her daughter in a baby carrier, and joined a few colleagues who marched to the state Capitol, hoping to deliver a letter to Governor Eric Holcomb.
Signed by hundreds of health professionals, the letter pleaded with Mr. Holcomb, a Republican, not to convene a special legislative session to further restrict abortions. It contained a targeted political message: “Abortion bans are not popular in our state.”
dr. Bernard, who shot into the national spotlight last month for granting an abortion to a 10-year-old rape victim, provides babies and provides birth control, Pap smears and other routine obstetrics and gynecological care. She is also one of a small number of physicians in her state with specific training in complex reproductive care, including second-trimester abortions.
But some of her riskiest work takes place outside of her hospital, publicly advocating access to abortion.
Her candor has won an award. dr. Bernard, 37, has been criticized in right-wing media, harassed and is the subject of an investigation by the Indiana Attorney General. She finds herself at the center of a post-Roe conflict that the medical community has feared — one in which doctors themselves are at the center of political and legal attacks.
“Doctors who give abortions have been harassed, they have been murdered,” said Dr. Bernard Tuesday in an interview with The New York Times. “And I think that’s why they’ve had to shut up for too long to protect their families, and it’s created the idea that we’re doing something wrong or something illegal. And we are not. And I feel compelled to say that.”
Threats against abortion providers are not new. But Roe’s overthrow has created a terrifying new legal landscape for doctors.
In Indiana, Todd Rokita, the attorney general, investigates whether Dr. Bernard, an assistant professor of clinical obstetrics and gynecology at Indiana University School of Medicine, reported the Ohio girl’s abortion to Indiana state officials as required. Records show she did.
Read more about abortion issues in America
In a statement to The Times on Tuesday, the attorney general said he would “hold this duty to the end,” accusing Dr. Bernard of using “the personal trauma of a 10-year-old rape victim” to “use her ideological stance.”
dr. Bernard, in turn, says that Mr Rokita is just another politician who engages in “state harassment for their own political ends”. She has filed a tort claim against him, the first step to a possible defamation lawsuit.
Medical professionals working in reproductive health are closely monitoring events in Indiana, said Dr. Kristin Lyerly, a Wisconsin obstetrician-gynecologist who coordinates reproductive health advocacy in the upper Midwest for the American College of Obstetricians and Gynecologists. . Before Roe was destroyed, she said, she performed abortions at one of four clinics in Wisconsin. Abortion is now prohibited there under an 1849 law that makes it a criminal offence.
“Those of us who provide abortion care have been trying to do it discreetly and carefully for many years, knowing this is necessary healthcare for our patients,” said Dr. Lyerly. “Now we feel like we really need to tell the story and be very honest about what we’re seeing and experiencing and what our patients are dealing with as we go along that very fine line to protect patient privacy.”
Abortions are only a small part of Dr. Bernard. She handles complex abortion cases – those where the mother’s life is in danger – at the university medical center. She gives abortions — both surgical and drug — several days a month at Planned Parenthood clinics in Indiana and Kentucky.
The work has long involved stressful elements that go well beyond providing sensitive medical care: In 2020, she said, the FBI informed Planned Parenthood that it was investigating a kidnapping threat against her daughter.
Her patients describe her as kind and caring; Rebecca Evans, an obstetrician who sought care from Dr. Bernard after she had a miscarriage, Dr. Bernard a “full scope” clinician, who “does all these different things, and she’s really passionate about it.”
dr. Bernard’s advocacy, she says, is to further her goal of providing patients with the best medical care possible. By limiting abortion options and requiring her to make certain statements — such as informing patients that fetuses feel pain during an abortion when the science on the subject is still unclear — the state is forcing her to practice medicine in a way that is unsafe and not medical. right, she says.
She is the plaintiff in a 2019 lawsuit filed by the American Civil Liberties Union, which unsuccessfully attempted to overturn Indiana’s ban on nearly all second-trimester abortions. She regularly testifies in the state legislature. After Roe was overthrown, she staged a protest. (She also has a tattoo on her left foot, with a wire hanger — a symbol of dangerous abortions at home before the procedure was legal — above the words “Trust women.”)
Indiana currently allows abortions up to 22 weeks. This week, as the Indiana legislature considered an almost complete ban on abortion during the legislative session it was fighting against, Dr. Bernard is not there.
Opponents of abortion leave hateful messages on her cellphone, she says. She continues to see patients but has hired a security detail and her colleagues have started a GoFundMe account to help her pile up legal bills. A personal appearance in a tense environment at the legislature can further fuel the situation.
“The politicization of me and of the work I do has certainly made it difficult for me to continue the advocacy work I’ve done in the past,” she admitted.
Not long after Roe was destroyed, the Indianapolis Star learned from her 10-year-old patient, who had traveled from Ohio, where abortion is banned after six weeks, even in cases of rape or incest. Dr. Bernard’s allies say it’s no coincidence that the 10-year-old child was referred to her; there are very few doctors, they say, who can handle such a sensitive case.
Earlier this month, President Biden mentioned the matter when he signed an executive order intended to guarantee access to abortion medications. Suddenly all eyes were on Dr. Bernard directed.
dr. Bernard declined to discuss any aspect of the case on Tuesday, citing the girl’s privacy. In addition to worrying about prosecution, she may face consequences at work. Until Tuesday, her employer, Indiana University School of Medicine, a state-funded institution, and Indiana University Health, a nonprofit health care system, had kept quiet about her, except she hadn’t violated patient privacy laws.
In a statement to The Times, Indiana University president Pam Whitten and dean of the medical school, Dr. Jay Hess, that Dr. Bernard remains “a faculty member in good standing”. IU Health called her a “esteemed and respected physician” and a “true advocate for the health and well-being of her patients.”
In a way, Dr. Bernard’s life has prepared her for this moment. She inherited her activist streak from her parents, who came of age in the socially liberal 1960s, and lived on a community farm in upstate New York when their children were small.
When she was five, she told her family she was going to be a doctor, said her sister, Rebeccah Johnson. When she was 15, she and her sister walked past a phalanx of protesters at a Planned Parenthood clinic to get birth control. She later witnessed the complications women can experience with pregnancy when she and her father, a carpenter, went to Guatemala to help run health clinics.
Perhaps that’s why, she said, she was always drawn to obstetrics and gynecology. Early in her career, Dr. Bernard joined a program called AMPATH, run by Indiana University, that brings American doctors to Kenya, where abortion is largely banned.
Nearly a third of the patients she saw had complications from unsafe abortions at home. “We often saw women who had been raped, abused and now pregnant,” said Dr. Astrid Christoffersen-Deb, her supervisor.
After completing medical school and a residency at Upstate Medical University in Syracuse, NY, Dr. Bernard trained at Washington University in St. Louis, where she was accredited in “complex family planning,” a specialty that qualifies her to treat complicated cases, including second-trimester abortions.
“People who need an abortion in the second trimester are often faced with the absolute worst situations imaginable – they have a highly wanted pregnancy and their baby will not survive or will have an incredibly difficult life and they are trying to spare their child from that result,” she said, adding, “Politicians, people who are uncomfortable with abortion care, have usually never been in those situations.”
In 2017, Dr. Bernard St. Louis to Indiana, where she has become the “go-to” doctor for championing reproductive rights, said Dr. Tracey A. Wilkinson, a pediatrician who, along with Dr. Bernard, is involved with Indiana’s chapter of the Reproductive Health Advocacy Project. dr. Wilkinson spent all day Monday at the Indiana Capitol, saying she regretted Dr. Bernard felt acutely.
“We’re not going to know that we’re going to change the way the voting takes place,” said Dr. Wilkinson. “We are going to mention that someone stood up and said this was wrong. We go so that our patients hear that someone is standing up for them.”
On Tuesday, Indiana’s abortion ban came out of a Senate committee and drew critics from across the political spectrum. Abortion rights advocates called the measure an attack on women, while several anti-abortion activists criticized exceptions that would allow abortion in cases of rape and incest; one suggested that Dr. Bernard should have given birth.
If the bill is passed, Dr. Bernard, she will likely refer Indiana women to out-of-state abortion providers. While she knows this could cause even more trouble for her, she’s not about to be quiet.
“One of the most important things about the issue of abortion in the US is that people don’t want to talk about it,” she said. “They are afraid of the stigma, providers are afraid of the stigma that they will be harassed, attacked, because they have been. So one of the most important things is to just be honest about it.”
Mitch Smith contributed to this story.