Dr. Shefaali Sharma was just two patients into her day when a pregnant mother of two issued a startling request inside the exam room that made the Madison, Wisconsin, obstetrician-gynecologist “want to throw up.”
“‘I need you to pick me. I need you to choose me because I have two kids at home,’” Sharma recalled the pregnant patient in her third trimester telling her last Thursday.
Several patients later, Sharma said, a first-time mother also in her third trimester asked her virtually the same thing, describing her fears that any complications during her pregnancy might result in her unborn child’s life taking priority over her own.
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The doctor said that while that question remains nauseating, it was becoming commonplace among her patients since the reversal of Roe v. Wade last month. Among the 30 patients Sharma saw last week, she said, at least half of them brought up the need to advocate for their own health in “some way, shape, or form.”
“I got goosebumps. I’m outside right now and I still have goosebumps thinking about it,” Sharma told The Daily Beast. “I never went into this field thinking or anticipating any patients ever saying anything like that.”
The need for pregnant women to advocate for their own lives has only come into sharper relief as anecdotes pile up about patients’ lives being put at risk by delayed or even denied care in situations like ectopic pregnancy and miscarriage.
Since the Dobbs vs. Jackson Women’s Health Center ruling that upended nearly five decades of judicial and medical precedent, doctors across the country have been navigating a new normal where the standard of care for patients may take a back seat to politics.
“Basically, we are stuck between taking care of our patients or possibly risk going to jail,” Dr. Kristin Lyerly, a Wisconsin-based OB-GYN who is also legislative chair for the American College of Obstetricians and Gynaecologists, told The Daily Beast. “What are we supposed to do? Some of us feel hopeless.”
But doctors canvassed by The Daily Beast—both in states like Wisconsin, where abortion rights face a century-old ban, and in states where it remains mostly legal—said healthy women are not waiting for trouble to express fear.
During a recent routine check-up, Dr. Katherine McHugh, an obstetrician-gynecologist in Indianapolis, said she was asked to prioritize the care of her longtime patient over her unborn child—despite having delivered two of her previous babies successfully.
McHugh told The Daily Beast the patient looked her in the eye and said: “I need to know who you would pick. Me or the baby. I need to know who you would pick if I were dying.”
While the question was jarring, McHugh said, it was not incredibly shocking, since almost all of her patients are “scared to be pregnant” right now.
“The idea of your life being solely for the purpose of reproduction—it is so defeating to people,” the doctor told The Daily Beast. “Every single patient I see asks me about it.”
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“I think these questions reflect the incredible fear that the government has introduced in this patient/physician relationship,” McHugh added. “The distrust. This level of distrust is new and the fear in these expecting mothers is something I have never seen before.”
While abortion is currently legal up to the 22nd week of pregnancy in Indiana, McHugh said that she and her colleagues were checking daily to see what laws have been put in place that might jeopardize the care of their patients and their practice. In the interim, McHugh noted that Indiana “is a very conservative state, but we don’t have a trigger ban, meaning that we are seeing a big influx of patients from surrounding states while simultaneously anticipating our own possible abortion ban any day now.”
Protections for the right to choose are already crumbling in the state. On Monday, the Supreme Court issued an order allowing Indiana to begin enforcing a state law requiring parental consent in order for a minor to terminate a pregnancy.
“No state feels safe,” McHugh added.
For Harry Nelson, a lawyer at a health-care law firm that advises physicians, seeing doctors nervous over providing legitimate care to pregnant patients “is surreal.” The fear of litigation, he told The Daily Beast, is forcing his firm and others similar to try to craft processes that would help lawyers and doctors work hand-in-hand to avoid life-threatening situations.
“This is a whole new world. I can’t imagine the level of additional stress these doctors are going through,” Nelson said.
In Wisconsin, providers are struggling with what services they are able to provide for pregnant people thanks to an 1849 law banning almost all abortions that went back into effect after Dobbs. Democratic officials, including Gov. Tony Evers and Attorney General Josh Kaul, are fighting the ban and have since filed a lawsuit to block its enforcement.
“There are a series of laws that were passed subsequent to Roe that provide regulation for lawful abortions in Wisconsin,” Kaul previously said while announcing the lawsuit. “Those statutes are directly inconsistent with Wisconsin’s 19th century abortion ban. It can’t be both legal and illegal to provide an abortion to protect the health of a mother.”
But while the 173-year-old law does allow doctors to end a pregnancy if the patient’s life is in danger, as in other states, the wording is so vague that it has prompted health-care providers to consult with lawyers to make decisions about normally routine procedures.
Among the most chilling examples of how Dobbs has put women’s lives at risk was recently reported by The Washington Post, which described a woman suffering from an incomplete miscarriage who was forced to bleed for more than 10 days after emergency staff chose not to to remove fetal tissue. Lyerly noted that she and several of her colleagues were frustrated by the reality that some of their patients may have “dismal outcomes” because doctors are forced to wait to hear for the legal repercussions of their patient-care plans.
“We are kind of paralyzed in how we care for some of our patients. We know what to do, we know how to give them the best treatment plan, but we just don’t know if we are legally allowed to do so,” she added.
Dr. Laura Berghahn, another obstetrician-gynecologist in Wisconsin who works with Sharma, painted a picture of seemingly endless scenarios that doctors and attorneys had to game-plan.
“For example, a patient comes in at 18 weeks with bleeding from a placenta previa or ruptured membranes,” Berghahn said. “These may be situations in which a pregnant person is stable but at risk for serious life-threatening hemorrhage or infection. I have had patients who are not willing to risk their lives.”
She too, now has healthy, pregnant patients asking whether she would take care of them and put their health first if there were a serious complication. It was an inquiry, she said, that made her cry the first time she was asked—and has since led her to question how she would have responded two decades ago, when she began to practice medicine.
“If I were a young OB GYN, I would not practice in Wisconsin,” she said.
For her part, Sharma remained in shock that she was now forced to reassure pregnant patients that she would not turn on them in their hour of need.
“There are periods of time where I technically have two patients, but the mom is my patient at the end of the day,” she added. “I hate that I have to even remind them of that.”
