Tisch College and Tufts University School of Medicine hosted a Solomont Speaker Series event titled “The Aftermath of Dobbs – Abortion in America” on October 26. The panel considered the implications of the landmark June Supreme Court decision in Dobbs v. Jackson Women’s Health Organization in the cross-cutting areas of health policy and legislation.
The panel was moderated by Dr. Laura Baecher-Lind, Dean of Educational Affairs and Professor of Obstetrics and Gynecology at TUSM. The three speakers, Dr. Danielle Roncari, Dr. Nina Ashford and Amanda Hainsworth, examined how the Dobbs decision impacted their respective fields from a social, legal and clinical perspective, as well as the work they have done to expand access to abortion and reproductive rights for patients and providers.
“This conversation is going to be difficult and challenging to have, but important to have,” Baecher-Lind said. “This program tonight will focus on helping us make sense of this decision from different perspectives, process its effects together as a community, and ask questions about what Dobbs means for patients, providers, the future of health policy and the future of our rights.
On June 24, 2022, the Supreme Court ruled that abortion is no longer a constitutional right, reversing the 49-year precedent set by Roe v. Wade and leaving the fate of abortion access to individual states. As a result of the ruling, 13 states have enacted or attempted to enact trigger bans, and a total of 26 states have prohibited or are expected to enact major limitations on the procedure.
Here in Massachusetts, access to abortion is protected by state law, with the ROE Act of 2020 extending this right to people as young as 16 years old. Regardless, Roncari, an associate professor of obstetrics and gynecology at TUSM and director of family planning at the Ryan Residency Training Program, approached the local impacts of Dobbs from a clinical perspective.
“We see more and more patients coming [to Massachusetts] from out of state, something we’ve never seen before,” Roncari said.
Roncari also referenced the potential challenges that could arise once a patient returns home after receiving treatment in another state.
“We want everyone to get the best possible care and be complication-free…but all of the same complications that can happen if you live in Massachusetts can also happen if you have to go home to Texas,” Roncari said. . “It’s been very difficult trying to figure out the best way to care for someone and what to do when that patient then goes home.”
In the United States, more than half of all abortions are medical abortions, meaning the procedure is performed with prescriptions for mifepristone or misoprostol, according to data from the Guttmacher Institute. Roncari explained how this option differentiates a post-Dobbs era from a post-Roe era in its ability to increase access to abortion with proper oversight.
“It’s an incredibly safe drug,” Roncari explained. “He has a really important role.”
Dobbs has caused repercussions beyond the medical realm, reaching into broader concerns in the areas of reproductive justice, social disparities and the issue of unlisted rights. Ashford, an assistant professor in TUSM’s Department of Public Health and Community Medicine and policy manager for the Tufts Center for Black Maternal Health and Reproductive Justice, discussed the social ramifications that occur when abortion access is denied.
“Not only are we forcing women to give birth, but we’re forcing women to give birth in a country where we still haven’t decided and determined that access to health care is a human right,” Ashford said. “Disparities in maternal health care are a microcosm of what is happening in general in this country.”
Due to the disproportionate number of black and brown women who do not have access to health care and live in states where trigger bans are in place, the Dobbs decision will exacerbate pre-existing health care disparities and maternal mortality rate for minority women, according to Ashford. There could be a 33% increase in pregnancy-related deaths among black women after Roe, according to a 2021 study published in the academic journal Duke’s Demography.
In an interview with the Daily, Ashford explained that “black women [are] disproportionately affected simply because of where they live and reside.
Ashford added that the effects of Dobbs will be felt beyond the current generation.
“Access to abortion is really important in terms of economic progress … and on the social determinants of health,” she said. “We know that black women are disproportionately affected by postpartum depression and postpartum anxiety… the whole healthcare system is not [set up] to support these women.
Hainsworth, chief counsel for the civil rights division of the Massachusetts attorney general’s office, discussed some of the initiatives her office has taken since the Dobbs case. decision. One was the creation of the Shield Act in 2022, which protects providers, patients, and people who help others access abortion from legal consequences out of state. This ensures that doctors who perform abortions on patients from abortion-banning states are not punished by those states.
One of Hainsworth’s concerns about the Dobbs decision lies in its implications for unenumerated rights that could be compromised by the legal precedent set by the Supreme Court. These rights include same-sex marriage, interracial marriage and access to contraception.
“You can’t just remove Roe from the middle of a long line of cases without there being implications or potential implications for other rights,” Hainsworth said.
Panelists discussed what could be done in Massachusetts and by higher education institutions to navigate the post–Roe period.
“[It’s important to continue] offer services, [continue] to organize events like this to highlight issues and reinforce commitment to protecting reproductive access for the students and patients we serve,” Ashford said.