Last Call For The Road To Gilead, Con't

The latest Kaiser Family Foundation poll of OBGYN doctors and healthcare in America, one year after the Supreme Court ended Roe v. Wade, shows that the availability, quality, and outcomes of women's healthcare in America have fallen off a cliff.

 

Sweeping restrictions and even outright abortion bans adopted by states in the year since the landmark Dobbs v. Jackson Women’s Health Organization ruling have had an overwhelmingly negative effect on maternal health care, according to a survey of OBGYNs released Wednesday that provides one of the clearest views yet of how the U.S. Supreme Court decision has affected women’s health care in the United States.

The poll by the health research nonprofit KFF reveals that the Dobbs ruling — which ended federal protection on the right to abortion — affected maternal mortality and how pregnancy-related medical emergencies are managed, precipitated a rise in requests for sterilization and has done much more than restrict abortion access. Many OBGYNs said it has also made their jobs more difficult and legally perilous than before, while leading to worse outcomes for patients.

The findings are the first nationally representative survey of OBGYNs since the Dobbs ruling, after which at least 15 states now ban abortion outright or within a few weeks of conception.

Nearly 7 in 10, or 68 percent of OBGYNs, said the effects of Dobbs have made the management of pregnancy-related medical emergencies worse, while 64 percent said the ruling has worsened pregnancy-related mortality. The poll, conducted between March 17 and May 18, collected responses from a random sample of 569 board-certified OBGYNs across the country who provide sexual and reproductive health care to patients in office-based settings.

The striking responses come as the number of Americans who die while giving birth — or in the weeks after — has been on the rise since 2018, from 658 that year to 1,205 in 2021, according to a March report from the Centers for Disease Control and Prevention. Data from 2022 has not yet been released.

The responses were even grimmer regarding the already stark racial and ethnic inequities in maternal health care: 70 percent of OBGYNs said Dobbs has widened that gap. Black women are already twice as likely to suffer serious complications during pregnancy and are three times as likely to die as women of other races.

Some of the earliest signs of the impact of Dobbs on women’s health were evident within weeks of the ruling. Patients with emergencies such as miscarriages, ectopic pregnancies and other complications were confronted with a maze of delays or denials of care as providers were mired in confusion over swiftly changing restrictions.

The Washington Post reported on several such instances last July, including on a Wisconsin woman who experienced an incomplete miscarriage and bled for more than 10 days after emergency room staff refused to remove the fetal tissue amid confusion over restrictions. At a hospital in Kansas City, Mo., administrators temporarily required “pharmacist approval” before dispensing medications used to stop postpartum hemorrhages because those drugs can also be used for abortions.

In the months since, those challenges have not abated. In the KFF poll, 40 percent of OBGYNs in states where abortion is banned said they have personally experienced “constraints on management of miscarriages,” while 37 percent reported constraints on management of pregnancy-related medical emergencies.

 

Those who need reproductive care are pissed off, and they are coming for the GOP. 

When the Supreme Court overturned the federal right to abortion, between 50 and 60 percent of Americans wanted the right to stay in place. But while abortion was legal throughout the country up to a certain point in pregnancy, Americans had the luxury of not having strong or cohesive views on the topic, or thinking much about abortion at all. Their views were messy and sometimes contradictory, and there was little evidence suggesting that the issue was a political priority for anyone except Christian conservatives. In the fall of 2021, with the Dobbs case looming on the horizon, many Americans thought that Roe wasn’t in real danger.

Now, a FiveThirtyEight analysis finds that after one of the most disruptive Supreme Court decisions in generations, many Americans — including women, young people, and Democrats — are reporting more liberal views on abortion than major pollsters have seen in years. Even conservatives, although the changes are slight, are increasingly supportive of abortion rights. There are other signs that longstanding views are shifting: For instance, Americans are more open to the idea of unrestricted third-trimester abortion than they were even a year ago. And although it’s hard to predict what will shape upcoming elections, there are indications that abortion has the potential to be a major motivator for some Americans when they go to vote in 2024.

Even before last summer, there was some evidence that Americans’ views were getting slightly more liberal on abortion, driven mainly by Democrats who were increasingly likely to say that abortion should be legal (and also more likely to prioritize the issue politically). But when asked about their opinions, most chose a middle-ground option that allowed for abortions in at least some cases, and their ambivalence about the issue was clearly visible in other questions. Legal abortion was consistently much more popular in the first trimester than later in pregnancy. Majorities of Americans were simultaneously OK with some restrictions on abortion access, while saying they wanted women to obtain legal abortion in their own communities, without pressure to change their mind.

But over the past couple years, views have shifted. FiveThirtyEight gathered every poll that asked a standard question about abortion — whether it should be legal in all cases, legal in some cases, illegal in some cases, or illegal in all cases — since September 2021, and found that the share of American adults who want abortion to be legal in at least some cases is rising, and the share of Americans who want abortion to be illegal in all cases is falling.

 

That's because abortion rights affect everyone. 

Everyone who votes and doesn't vote has a stake.

You should choose the former.