By Dr. Theresa Rohr-Kirchgraber and Dr. Lara Hart
Originally published on KevinMD.
Last month marked the fourth anniversary of Dobbs v. Jackson Women’s Health Organization, the Supreme Court decision that fundamentally changed reproductive health care in the United States, returning many parts of the country to a reality that most practicing physicians and many patients had never experienced. Since then, access to reproductive health care and even routine pregnancy care, like miscarriage management, is based not on medical evidence or clinical judgment but on where you live. It is a troubling reality when health care becomes subject to politics rather than medical expertise.
In the aftermath of Dobbs, the American Medical Women’s Association (AMWA) joined with Doctors for America and other health care and advocacy organizations to establish the Reproductive Health Coalition (RHC). Today, the coalition includes more than 200 groups, representing over 150 million members, including national and state medical societies, health care organizations, legal experts, and advocacy groups.
Over the past four years, the coalition has worked to raise awareness of the far-reaching effects of changes in reproductive health care access, educate health care professionals and the public, support evidence-based policy, amplify the voices of frontline clinicians, and foster respectful, informed conversations about reproductive health care. Through training, educational initiatives, advocacy, public awareness campaigns, and cross-organizational collaboration, the coalition has sought to ensure that discussions about reproductive health care remain grounded in science, clinical expertise, and the lived experiences of patients and those who care for them. This year, the coalition launched a Dobbs Day of Reflection centered on stories: stories of patients, families, practitioners, medical students, and communities whose lives have been changed over the past four years since the ruling.
Stories matter because they remind us that human lives rarely fit neatly into legal frameworks. Medicine and law serve different purposes. The law seeks action after something has happened; medicine seeks to prevent suffering before it begins. While phrases like “when the woman’s life is in danger” appear straightforward in legislation, they rarely translate into clear clinical guidance. Clinical care relies on timely decision-making and the ability to intervene before a patient reaches the brink of catastrophe. The stories of harm from the Dobbs decision speak to that fact all too well: Emergency care denied, leading to life-threatening complications. Delayed miscarriage care, resulting in infection, hemorrhage, or loss of future fertility. Women forced to travel hundreds of miles while facing devastating pregnancy complications.
And what is it like for the practitioners? How can they practice evidence-based medicine while navigating uncertain legal landscapes and the possibility of criminal penalties? Medical students have altered career plans because they can no longer receive comprehensive training in states where they had hoped to build a future. Physicians have left lifelong practices to work in other states. Workforce shortages have left everyone scrambling.
These are only the stories we know.
How many others remain untold because patients fear stigma, legal consequences, or public scrutiny? How many clinicians remain silent because of professional or institutional concerns? How many families have quietly carried these experiences without ever sharing them?
The Day of Reflection reminded us that we have a responsibility to remember and document these stories. Behind every headline or legal case is a patient. And for those patients and their families, access to abortion is not about abstract political debates. It is about access to vital, lifesaving health care.
Theresa Rohr-Kirchgraber, MD, is a professor of clinical medicine education at the University of Georgia School of Medicine and the AU/UGA Medical Partnership, and an adjunct professor of medicine. She is a past president of the American Medical Women’s Association (AMWA).
Lara R. Hart, MD, is an obstetrician-gynecologist with Women’s Healthcare Associates in Athens and an assistant professor at the University of Georgia School of Medicine, where she serves as campus lead for women’s health and OB/GYN clerkship director.