Three years ago, in Dobbs v. Jackson Women’s Health Organization, the Supreme Court’s conservative majority enabled states to severely restrict abortion or ban it outright. Since then, 17 states have enacted such limits; infant and maternal mortality have risen in many of them. But the impact of overturning Roe v. Wade extends far beyond medical catastrophes. It also appears in the quieter struggles—a myriad of small, compounding barriers that stand between individuals and their access to health care. Here are some of the stories of people who have stepped up to do what they can to provide care, and some of the women who found themselves trapped in a system increasingly difficult to navigate.
After finishing medical school, an OB-GYN residency, and a family planning fellowship in 2014, I was basically a cog in the wheel of hospital care in New Mexico. Helping people is much more difficult because you can’t just do what you were taught in medical training. If the hospital administration doesn’t want you to perform abortion care because they don’t want protesters outside, then you are not permitted to provide abortion care.
I was in that system for about six years. Then I was approached by Robin Marty, an abortion-rights advocate and communications expert working at a nonprofit called the Yellowhammer Fund that had purchased a clinic in Alabama. They were looking for a new medical director and they wanted someone who was a feminist and who was progressive. Robin Marty threw out my name as an option. I said, “Absolutely. Yes.”
I was pretty much consumed with abortion care: counseling folks, doing dilation and curettage procedures in the mornings and then medication abortions in the afternoons. We had a 48-hour waiting period as well during those times. So, while the state wanted people not to be far along in their pregnancy when they had an abortion, they also wanted people to wait 48 hours just in case they weren’t sure about their decision. That’s all awash now because no one’s allowed to make that decision for themselves—the state has done it for them.
When folks can get the health care that they need in a state like Alabama—in an environment that is structurally racist and misogynist—it’s a relief. The same way you might feel after a car accident, when you wake up in the hospital and the EMTs and surgeons are saving your life. To stick with the same analogy, now the state says, “Well, sorry you were in a car accident. I hope you can put yourself together because it’s illegal for healthcare providers to help you.”
Around every corner, my job became more and more illegal. When the Dobbs decision was announced, Robin Marty texted the staff, “Stop.” We followed her directions so we wouldn’t get shut down and wouldn’t get arrested. We had just lost the ability to help people. We closed for a week to mourn and to regroup and be able to pick ourselves back up and say, “Abortion care is not the only care people need, so let’s keep helping people.” And that’s how we proceeded.
We expanded our reputation and said, “Hey, we don’t do abortions, but we do all these other things now.”
In Alabama, Medicaid will not insure a pregnant person without a doctor’s letter verifying the pregnancy, and doctors’ offices won’t see patients unless they have insurance. If there’s a catch-22 about how to ensure that people do not get prenatal care, Alabama has really figured it out. So, after Dobbs, we prioritized providing what’s called “pregnancy verification” so people could get on Medicaid and have health care early in their pregnancies, when ectopic pregnancies and miscarriages are common.
While I was busy at West Alabama Women’s Center, now known as WAWC Healthcare, I came across an email requesting a traveling abortion provider. “Why couldn’t I be that person?” I thought. I wanted to help people, but I didn’t want to go to prison, which could have happened in Alabama.
I had to obtain a Colorado medical license, which takes months. Thankfully, I did and was able to travel there, where a large portion of the patients were also from out-of-state.
I then went to Colorado once a month, and provided abortion care to patients there, while also maintaining my non-abortion patients in Alabama.
Some folks drive 12 hours, arrive, and find out the bleeding they had last week was a miscarriage, and they aren’t even pregnant anymore. They are scared about their situations, but they are also scared to obtain care where they live. They don’t even want to go get a pregnancy test at their doctor’s office if they are in a state that would arrest them for miscarriage.
The Dobbs decision itself didn’t surprise us; the people in the reproductive justice movement have been telling politicians and voters that it’s been coming down the pike for years. Those people told us we were crazy, that the Supreme Court wouldn’t overturn Roe, because people would die if they did. So, I hate to say I told you so, but we actually, really, literally did tell folks. And now people are dying.
—Dr. Leah Torres, MD MS
