Women’s Care Looks Different In A Post-Roe World

The June 2022 overturning of Roe v. Wade has plunged physicians—particularly those in women’s health—into a complex legal and ethical landscape.

Illustration by Katrin Rodegast

On June 24, 2022, the U.S. Supreme Court overturned Roe v. Wade, triggering an Ohio ban that effectively eliminated the right to abortion after a fetus has a heartbeat.

Since then, judges and physicians have fought restrictive bans, which Thomas Burwinkel, M.D., an OB-GYN and reproductive endocrinologist at Cincinnati’s Institute for Reproductive Health, calls “an attack on women’s reproductive rights.”

As of publication, a court granted a preliminary injunction against the ban, allowing abortions up to 22 weeks while litigation continues. But in the weeks that followed the overturning of Roe, Burwinkel says the impact on his colleagues and patients has been significant.

Women are already seeking care out of state.
Roe’s overturn means tri-state women are traveling across state lines for procedures, further exacerbating the socioeconomic divide in women’s healthcare access.

“It’s created a lot of angst amongst patients,” Burwinkel says, describing colleagues across the state who have had “very difficult” conversations with patients past the 22-week cutoff.

Physicians are navigating ethical and legal dilemmas.
Burwinkel says OB-GYNs and emergency room physicians are navigating a complex legal landscape. “It’s even more difficult because you don’t know what’s happening from one day to the next,” he says, pointing to states like Texas, where doctors can face criminal charges for performing abortions.

Families are hesitating to pursue fertility treatments.
If Ohio House Bill 598 were to become law, doctors like Burwinkel wouldn’t be able to perform “selective reductions” on mothers carrying too many embryos as a result of fertility treatments.

And fertility treatment centers could face new concerns about handling embryos. “What happens if somebody drops a culture dish with embryos?” Burwinkel asks. “What if fertilization doesn’t happen? Are they going to blame us?”

New doctors could opt out of Ohio.
“There are many residents in training that do not want to practice in Ohio with this climate,” Burwinkel says. “They don’t want to practice in a state where this has happened.”

Thomas Burwinkel, M.D., OB-GYN/Reproductive Endocrinologist, Cincinnati Institute for Reproductive Health

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