Lawmakers Square Off on Impacts of Dobbs Decision

Patients and ob/gyns described the impacts the Supreme Court‘s Dobbs decision and ensuing abortion bans have had on access to care during a hearing of the Senate Health, Education, Labor, and Pensions (HELP) Committee on Tuesday.

Democrats charged that politicians have taken important and personal healthcare decisions away from patients and their doctors. Republicans, on the other hand, accused Democrats of “fear-mongering” and playing politics.

“No one should be dragged through a pregnancy against their will. Right now in America, more than a third of women of reproductive age live in states where they essentially do not have the choice to end a pregnancy if they need to,” said Sen. Patty Murray (D-Wash.). “Instead, Republicans have made the choice for them with extreme abortion bans and cruel restrictions on access to care.” (Murray was invited to lead the hearing by committee chair Sen. Bernie Sanders (I-Vt.), who felt it was more appropriate for a woman to chair the hearing.)

Murray ticked off stories of people impacted by the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, from patients who were denied care for miscarriages or were prevented from receiving care until they “lost over half their blood,” to children “forced into motherhood” after being raped. “One teenager delivered a baby while clutching a teddy bear,” Murray said.

Ranking member Sen. Bill Cassidy, MD (R-La.), bristled at the stories and claimed Democrats were engaging in “partisan politics” in a committee hearing. The main reason the abortion issue is getting so much attention is because it’s an election year and President Biden wants to keep the issue in focus, he said.

“Demagoguing and fear-mongering on access to treatment for miscarriages and ectopic pregnancies [and] casting a decision to abort or not to abort as an easy one does a tremendous disservice,” to Americans, said Cassidy.

He also disputed the stories of people with wanted pregnancies being denied care. “There is no law in any state preventing a doctor from treating a patient going through a miscarriage or an ectopic pregnancy, or from preventing the saving of the life of a mother. That is called healthcare. That is not an abortion,” he argued.

Impacts of Abortion Restrictions

In the fall of 2021, roughly a year before the Dobbs decision, Madysyn Anderson, then a senior at the University of Houston, was feeling nauseous and having trouble sleeping. She had just gotten out of a 2-year relationship. She took five pregnancy tests, all of which confirmed her fear: she was pregnant. She got an appointment at the local Planned Parenthood for later that week.

At the Senate hearing, Anderson described how she thought she was only a few weeks pregnant. But at her appointment she discovered she was 11 weeks along and therefore could not get an abortion in Texas, as the state’s 6-week abortion ban had just taken effect.

After calling 20 different clinics, she got an appointment in Mississippi at the Jackson Women’s Health Organization, the defendant in the Dobbs case. After two visits (because Mississippi requires a 24-hour waiting period) and spending more than $2,800 on flights and gas, she was able to get an abortion.

Anderson said if she were in need of an abortion last month or even last year, the clinicians who provided her care could no longer provide it due to the abortion ban that took effect in Mississippi following the Dobbs decision.

Nisha Verma, MD, MPH, a fellow with the Physicians for Reproductive Health and an abortion provider in Georgia, said she met with a patient, a junior in high school, who came to see her seeking an abortion soon after missing her period and realizing she was pregnant. Because of Georgia’s 6-week abortion ban, Verma was unable to provide her with an abortion. The student was also unable to find the resources and support to get an abortion out of state, Verma said. “I know it was Georgia’s laws that prevented me from providing her with the medical care she needed and deserved, but I still feel like as her doctor, I failed her.”

Clinicians also testified that the Dobbs decision has exacerbated physician shortages, as many ob/gyns don’t feel safe practicing in states where lawmakers place restrictions on the care they provide.

Pointing Fingers

Members from both sides of the aisle tried to cast the other party’s views as extreme.

During her turn at the dais, Murray asked Christina Francis, MD, of Fort Wayne, Indiana, the CEO of the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG), a series of pointed questions regarding the limits of her anti-abortion views.

“Do you believe that women should have access to Plan B? Yes or no?” Murray asked.

“I believe that women deserve to have accurate information about their healthcare,” Francis said. Murray asked the question at least two more times, but Francis did not give a direct answer.

“Do you believe that women should have access to a medication abortion? Just yes or no,” Murray asked. Francis said that “chemical abortions are high-risk, dangerous drugs.”

“Do you believe women should have access to IUDs [intrauterine devices]? Yes or no?” Murray continued.

“I believe that, again, women should receive comprehensive healthcare under the direction of their physician,” Francis said. After repeating the question a second time, in an effort to obtain an on-the-record “yes” or “no,” Murray then asked Francis whether she thought IUDs and contraceptives were abortifacients; “If you look at the package inserts for … the copper IUD, it actually clearly states that they do prevent implantation. I would classify that as an abortifacient.”

Murray argued that it is “well-documented” that AAPLOG has been “working behind the scenes with Republican lawmakers to redefine certain kinds of contraceptives as abortions. So you can ultimately ban those types of contraception…. It’s really important for people to understand the Republican minority has specifically invited you to this hearing today despite those dangerous positions.”

Murray also pointed out that a bill “to enshrine fetal personhood nationwide” had received support from more than half of the House Republican conference.

Earlier in the hearing, Cassidy, claimed that nine states and Washington, D.C., “allow for abortion up to parturition.”

“The child can be ready to go through the birth canal, and abortion is legalized,” Cassidy said.

Verma later disputed Cassidy’s claim regarding how late an abortion could be offered. “The situation of doing an abortion at the moment of birth doesn’t happen,” Verma said, adding that 90% of abortions occur in the first trimester and around 1% occur after 20 weeks “when in most cases something has gone terribly wrong with a patient or the pregnancy,” Verma added.

Cassidy also asked Francis about the necessity for late-term abortions. “At the point where a child can survive outside of his or her mother, there would never be a reason you would need to intentionally end that child’s life,” Francis said.

He also argued that while Sens. Tim Kaine (D-Va.), Lisa Murkowski (R-Alaska), Kyrsten Sinema (I-Ariz.), and Susan Collins (R-Maine) introduced a bill to “codify Roe,” the policy is “too conservative for the fringes.”

“The truth is, the Democratic policies go beyond Roe,” Cassidy said. “Their marquee legislation would legalize late-term abortion … in every state.”

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