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After Roe v Wade: US doctors are harassed, confused, and fearful, and maternal morbidity is increasing

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On 24 June the US Supreme Court overturned Roe v Wade, the 1973 decision that legalised abortion and left the regulation of abortion to the states.4 At present, about half of the 50 states ban or severely limit abortions, but the picture is changing daily as century old bans go into place in some states, bans are challenged in courts, and state legislatures debate changes to their laws.

The American College of Obstetricians and Gynecologists (ACOG) said, “Each piece of legislation is different, using different language and rationales. State legislators are taking it upon themselves to define complex medical concepts without reference to medical evidence. Some of the penalties for violating these vague, unscientific laws include criminal sentences.”

Doctors report being confused and fearful about how they can continue to practise in states where abortion laws are changing day by day and sometimes hour by hour.

Katie McHugh, an obstetrician and gynaecologist in Indianapolis, where abortion until 20 weeks is legal for the moment, told The BMJ about a patient who arrived from another state (around 200 miles away) with a miscarriage.

“A fetal heartbeat could still be detected. The local hospital sent her home and told her to come back if she became very sick.” Instead she travelled two and a half hours by car to McHugh.

“I don’t blame the physicians in [the other state]. I don’t know if abortion is legal now a trigger law is in effect. They could face lawsuits. As a physician, it’s unacceptable to have to watch the news to know what’s legal and how to practise,” said McHugh.

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Source: BMJ, 1 August 2022

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