Abortion Bans Mean Fewer Doctors to Deliver Babies and Worse Healthcare All Around

The dark irony of "pro-life" laws.

Photo by Alexander Grey on Unsplash

Several predictable but depressing outcomes of abortion bans: Doctors, and especially those who specialize in reproductive health care, are fleeing red states, leaving pregnant women with fewer and fewer options; medical students and residents are choosing to complete their educations in more liberal states, because they cannot get complete training in conservative ones; and red states, which already tend to have poorer health outcomes for mothers, babies, and their citizens generally, have worsened their abysmal health systems in the name of being “pro-life.”

It would be ironic, if the pro-life movement actually cared about human life more than it cared about making women suffer.

Bonner General Health in Sandpoint, Idaho is only the latest US hospital to shutter its labor, delivery, and obstetric care services after the state’s abortion ban made it increasingly impossible for doctors and nurses to do their jobs.

“Highly respected, talented physicians are leaving,” the official press release reads. “Recruiting replacements will be extraordinarily difficult.”

I can’t blame health workers who leave states like Idaho — providing basic obstetric care puts their lives, their livelihood, and their physical freedom at risk. Doctors in anti-abortion states face criminal prosecution if they end the pregnancy of a patient in need, even to save a pregnant woman’s life. They have to hope that a jury sides with them that the measure they took were strictly necessary, but that’s quite a risky bet — and one that comes with the potential of arrest, jail time, astronomical lawyer’s fees, loss of their license, loss of their job, and widespread public humiliation.

The other option is to provide patients with sub-standard care, something doctors all over “pro-life” American are currently doing: Faced with pregnant women in acute medical distress, doctors are not treating those women immediately, or are not offering the full range of treatments that would be on offer in pro-choice America. Doctors are waiting until women’s bodies are wracked with infection, until they have to lose their ovaries or uteruses. Doctors are telling women with much-wanted but doomed pregnancies, sorry, you have to carry to term, to be congratulated on a baby that will never be, to endure the pain and risk of childbirth, because of “pro-life” politics. Doctors are turning away children pregnant from rape, girls scared of what will happen to their futures, mothers trying their best to support the kids they have or leave abusive relationships or break the hold of addiction. It will only be a matter of time before women die because of these cruelties and delays, if it hasn’t happened already.

No doctor wants to look at a woman dying in front of her eyes and wait for the go-ahead from a lawyer. No doctor wants to make the impossible choice between preserving a woman’s future fertility at the cost of a lengthy prison sentence, or choosing to guarantee her own freedom but letting a patient suffer unnecessarily — breaking her own professional oath in the process.

There are no good answers here. Should doctors and nurses stay in the conservative states that treat them as enemies and potential murderers, because they are still needed for the many people who can’t leave? In the aggregate, of course, and I hope many of them stay. But I also understand why individuals choose differently — why they want to practice somewhere they can provide care, where they don’t have to say “I can’t help you” when they in fact have all the tools and training to help, where they don’t have to worry about their own children growing up without a parent because Mom or Dad went to jail for helping a woman in need. We have obligations to strangers, but we also have obligations to our families and ourselves. Here, no doctor should have to choose; but Republican politicians are forcing their hands.

This is made all the more complicated by the fact that anti-abortion states are already pretty rough places for women and children. Generally, anti-abortion states have higher rates of maternal and infant mortality, as well as more children living in poverty and lower life expectancies. When these states hemorrhage health workers, these outcomes grow worse.

But of course health workers aren’t just randomly leaving. Every single state that has refused to expand Medicaid so that more moms and babies can get health care is a a “pro-life” state. Every single Republican-dominated legislature passing anti-abortion laws has at least a few Republican members who understand full well that criminalizing abortion is going to mean worse health outcomes for women, and will also mean fewer doctors and nurses willing to work in labor, delivery, and obstetrics. They do it anyway.

Part of being a human being in the world is realizing that your assumptions about how your goals are best achieved may sometimes be wrong. If the actual goal is a “pro-life” nation — one in which life is affirmed, and in which babies in particular are protected — then the pro-life movement needs to realize that its reliance on criminalizing abortion and threatening doctors with jail time is not actually a particularly good way to get there. It’s a morally satisfying way because it’s punitive and simplistic, and because it fits into a set of preconceived notions about evil doctors killing babies for fun or money, but it doesn’t actually achieve the goal of healthier babies and mothers.

But then, of course, we are assuming healthier babies and mothers is the goal.

If the goal is a sick, fearful, and increasingly unequal populace, then abortion criminalization laws are highly effective. If the goal is tying pregnancy to fear and shame, and forcing women to risk their lives if they have a baby (or if they don’t want to have one), then abortion criminalization laws are highly effective. If the goal is a society that sees women as expendable and primarily as receptacles for someone else — for men’s desires, for the carrying and birthing of children — rather than as people vested with inherent dignity and the right futures of their own making, well, you really can’t do better than abortion criminalization laws.

And that, I suppose, really is the whole of it.

xx Jill