For over eight months, SB 8 has banned nearly all abortion care in Texas. By designing a bounty reward system that encourages vigilantism by private citizens, Texas SB 8 has also delayed care for pregnant people in the state and engendered widespread fear around the provision of an essential health-care service.
In our clinical rotations, we have witnessed the catastrophic consequences of this purposefully confusing and fear-mongering law. The law hinders the delivery of essential reproductive health care and endangers all pregnancies. We’ve observed some physicians delay treatment to consult with lawyers before managing ectopic pregnancy, a common but grave complication in which abortion is recommended to save the patient’s life. We have seen patients with other pregnancy complications transfer from hospitals too fearful of misinterpreting SB 8’s “maternal life-saving” exception, lest they risk lawsuits up to $10,000 plus legal fees. And for conditions in which abortion can reduce the risk of sepsis and even death—SB 8 forces doctors to forgo the oath to “do no harm” and place liability above a patient’s very life.
SB 8 disrupts the sacred shared decision-making process between patient and health-care provider. Incomplete health care for pregnant individuals results in avoidable physical, emotional, and financial costs, like higher rates of postpartum hemorrhage and an increased likelihood of experiencing intimate partner violence. These unacceptable outcomes are particularly egregious in a state like Texas, where the ongoing maternal mortality and morbidity crisis ultimately disproportionately impacts people of color.
In addition to forcing doctors to violate the tenet of acting in the patient’s best interest, SB 8 has restricted essential educational opportunities for medical students, further complicating our ethical responsibilities and impacting future healthcare delivery in the state. In our leadership roles within Medical Students for Choice, we have spoken to chapter leaders across Texas about the status of abortion education at their medical schools; many schools still do not offer formal abortion education, despite the official recommendation by the American College of Obstetricians and Gynecologists (ACOG) to include abortion training in all medical curricula. Some schools even limit the teaching of abortion to a single bullet point on a PowerPoint slide, listing it as a “pregnancy complication.”
Roe has collapsed in Texas, and that’s just the beginning.
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Additionally, the amount of support offered to medical students who advocate for the expansion of abortion education varies immensely. While some students have found faculty and administrative allies, others have encountered significant institutional pushback. Some Texas medical school professors were already understandably afraid to talk about abortion before SB 8’s passing, and they are even more apprehensive now, leaving aspiring providers without valuable mentorship.
Regardless of an institution’s willingness to support abortion education, Texas SB 8 limits abortion care exposure for medical students who depend on experiential learning.
According to ACOG, the barriers to education and training are multifactorial and include legal obstacles to timely abortion access and provision. As medical students preparing ourselves for careers centered on advocating for the health and well-being of our communities, we are deeply concerned about the consequences of legislation like SB 8. Regardless of a medical student’s future specialization, it is important for all med school graduates to be competent in the full spectrum of pregnancy options counseling. Moreover, given that medical students are future representatives of the medical community, our education must include the science of abortion care so that we can adequately combat the persistent spread of misinformation around abortion.
As medical students training in Texas, many of us kept a careful watch on the 50 anti-abortion bills that were introduced during the 87th legislative session, SB 8 being just one among them. We leveraged our voices as representatives of a rising generation of health professionals and advocated against anti-abortion legislation in the ways we knew how—we submitted public comments, called our representatives, and engaged our social and professional networks with calls to action. Still, our elected officials made anti-abortion legislation a priority over immediately pressing issues like the persistently vulnerable power grid and an appallingly mismanaged pandemic.
We now urge our peers, colleagues, communities, and elected officials to speak out against anti-abortion policies that have devastating consequences for our communities. The World Health Organization’s official guidelines recommend the removal of policy barriers to abortion access, and institutions with a vested interest in the health of their communities must do the same. We call upon the medical community to support abortion providers and advocates and assert a louder voice in the conversation around abortion care. A solutions-oriented approach to this preventable public health disaster in Texas can only be one that fiercely and unapologetically protects the human right to abortion.