Upon finding out I am an OB/GYN, many people comment about how fun my job must be and how it must be so happy all the time.
“I love babies, how fun to meet so many babies all the time!” they say, smiling and looking for my enthusiastic confirmation. They are imagining happy couples, supportive families, healthy babies and a fully equipped nursery waiting at home.
I always agree and fix my face into a convincing smile. But so often, my days and nights are filled with pregnant people who are struggling, who rightfully fear that they will not survive this pregnancy, who don’t know how they will pay for or care for another child.
Positive pregnancy tests can be devastating and potentially life threatening. People across socioeconomic, racial, ethnic and age groups need abortion care, and it is my honor to be present and helpful.
Not everyone wants to be pregnant or to parent. Not everyone can survive pregnancy. Not all pregnancies can result in a healthy, living child.
For all these reasons, abortion will always be a necessary and essential component of comprehensive health care. No one should be forced to become or remain pregnant.
Faith is a commonly cited reason to disagree with abortion care. This makes sense, as religion deals with the topics around life and death, governs interpersonal relationships and creates the ethical framework and societal values in a tangible way.
It is natural that people will turn to their cultural belief framework for guidance while making an important decision about their lives, like pregnancy, personal health and family size and composition.
The American theologian Stanley Hauerwas addressed religious reflection and abortion by saying, “… no amount of ethical reflection will ever change the basic fact that tragedy is a reality of our lives. A point is reached where we must have the wisdom to cease ethical reflection and affirm that certain issues indicate a reality more profound than the ethical.”
While there are certainly people who choose abortion that struggle with an ethical conflict about their choice, the vast majority of people are confident in their decision, feel that they have made a moral decision, and know that it was the best decision for their lives.
It is precisely my faith in people to make the best decision for them at that moment and for their own family that draws me to provide abortion care.
All patients deserve compassionate care, comprehensive counseling and the ability to control what happens to their bodies regardless of any medical decision they make and regardless of who their doctors are or what their doctors believe.
My deepest and most truly held belief in medicine is in a person’s right to make their own health care decisions. It is the foundation of the care I provide.
Nearly 60% of pregnant people who choose abortion are already parents, according to data provided by the Guttmaker Institute. These people have conceived, gestated and birthed children already, and most are parenting.
They know the full implication of this positive pregnancy test and feel the weight of responsibility. I trust that this person will make the most responsible and moral choice for themselves and their family.
My role in this moment is to provide education and evidence-based guidance, keep them safe during a simple outpatient procedure and provide as much support as I can throughout the process.
In the last decade, hundreds of state-based bills have been considered and passed to restrict access to abortion, forcing pregnant people who need abortion care to travel to states with more compassionate and evidence-based legal codes.
This burden is one that falls disproportionately on people of color, minority groups or otherwise marginalized people.
Wealthy people can afford to take multiple days off of work, pay for lodging during legally required waiting periods, provide childcare for their other children and pay for the procedure.
For those without these privileges, abortion may not even be an option.
Decades of data show that places with stricter abortion restrictions result in worse outcomes for both pregnant people and their children.
While the rest of the world found ways to decrease maternal mortality, the maternal mortality rate in the United States is the highest of any industrialized country.
How can we force people to undergo pregnancy when this is our current state of health care? How is it ethical to deny pregnant people the right to decide not to risk their lives, health and safety when we cannot offer any evidence to mitigate the risk?
To be honest, it is difficult to practice obstetrics in our country. Pregnant people are not prioritized in any meaningful way.
Health care is expensive at the best of times and typically linked to full-time employment, something that is not always possible while parenting. Importantly, health care can be dangerous, especially for people of color who experience racism and suffer worse medical outcomes by all measures.
Workplaces are not friendly to pregnant or breastfeeding people, and jobs are jeopardized by the threat of decreasing productivity. Postpartum leave is not a protected time for new parents to raise and adjust to their family, not to mention ensuring the health of the postpartum person.
It is hard to see my patients struggle without any way of helping them through the social challenges that our society has created.
Medical school made me into a medical doctor. Residency training made me into an OB/GYN. But I became a physician when I learned to provide compassionate, comprehensive reproductive health care, including abortion.
Sir William Osler, a founding father of modern medicine and ethical standards, said in 1907, “To serve the art of medicine as it should be served, one must love his fellow man.”
My love for my fellow human being manifests in respect for individual circumstance, in protecting bodily autonomy and in defending the right to choose one’s own path. And sometimes that love is shown by providing compassionate and safe abortion care.
Editor’s note: This article is being published during National Women’s Health Week (May 9-15). An April 23 podcast interview with China Dickerson and Dr. Jen Villavicencio on Good Faith Weekly discussed policy and health practices surrounding reproductive rights.
Assistant professor of Clinical Obstetrics and Gynecology at Indiana University School of Medicine. When not clinically active, Dr. McHugh teaches physician advocacy, trauma informed care of patients, and advancing health equity in the pursuit of a more just society.
