On Wednesday, Gov. Kay Ivey signed a bill into law that would ban nearly all abortion care in my home state of Alabama. Not surprisingly, a media frenzy ensued. #Alabamaabortionban trended on Twitter, an airplane circled the state capitol proclaiming “Abortion is OK” and reporters called me nonstop for comment.
Dr. Yashica Robinson is the medical director at Alabama Women’s Center for Reproductive Alternatives and a board member of Physicians for Reproductive Health. The views expressed in this commentary are her own.
But the new law, which does not take effect for six months and faces inevitable court challenges, will not change my daily routine as an OB-GYN. Just as I have for the last 15 years of my medical career, I will continue to deliver babies, give prenatal care — and provide abortions.
As a mother and a physician, this abortion ban is deeply personal. I carry both these identities with me as I care for women and honor their decisions to become parents or to terminate their pregnancies.
I understand the struggle to make that choice. I became pregnant when I was in high school. Because of my fear and lack of resources, I didn’t confide in my mother or grandmother until it was too late to have an abortion. I love my children with all my heart, but I know that everyone should be able to make this decision for themselves.
Of course, seeing the bill become a reality has taken its toll. I am angry at the politicians who do not see women as responsible decision makers and therefore believe the care I provide should be outlawed. I am enraged that the state of Alabama would force me to choose between what is ethical and medically appropriate care and breaking the law.
I am appalled that I could get a more severe penalty (up to 99 years in prison) for providing safe abortion care than someone who commits second-degree rape. And I hate that I am being placed in the position of reassuring my patients that abortion is still legal today — and for the foreseeable future — despite the actions of politicians in Birmingham.
I am frightened for Alabamians because, should this law ever go into effect, doctors like me will leave Alabama rather than stay and practice substandard medicine. And I am afraid for patients, particularly when I reflect on treatment I recently provided for one woman. She was 22 weeks pregnant and had a condition called preeclampsia, which is when high blood pressure puts the health of the mother and baby at risk and can result in death. The only option in that situation was to immediately deliver.
The patient understood the high stakes and instead decided to end her pregnancy. But it took time (which we did not have) to convince the hospital and other physicians that this was the correct course of action because of the already hostile climate for abortion.
I fear what could happen to women in this situation if the law and its criminal penalties go into effect. Physicians will hesitate in how to care for complex health situations — and Alabama is already a state with an unconscionably high maternal mortality rate. According to the Alabama Department of Public Health, in 2017, there were 31 pregnancy-related deaths out of 100,000 live births for white women. That number more than doubled for black women. When compared to the CDC’s national average figures of 12.4 deaths per 100,000 for white women and 40 deaths per 100,000 for black women, these numbers are particularly stark.
But I remain hopeful for my state and my patients. The law will almost certainly be stopped in court. The outpouring of attention and activism is invigorating. Donations of all sizes are being made to clinics and abortion funds like ARC Southeast, the Yellowhammmer Fund, URGE and the Alabama Women’s Center (where I work). I’m also encouraged that other states, from New York to Vermont, are taking steps to protect abortion access. And until I am told otherwise, I will continue to provide the best reproductive healthcare I can.
Bottom line: Alabamans deserve better. We all do. So, I cling to a vision of a world in which people are not afraid to talk about their abortions, in which insurance covers the full cost of abortions and in which all women have access to high-quality maternity care and contraception.
I urge the politicians in Alabama, and those around the country, please stop trying to make it harder for people to access health care. Instead, help me turn this vision into a reality.