The following article was originally published in the Ohio Capital Journal and published on News5Cleveland.com under a content-sharing agreement.
A chorus of medical students and other future health professionals is trying to get the word out that re-enactment of harsh abortion restrictions will erode their numbers in Ohio, which already suffer from one of greatest numbers of care deserts in the country.
More than 500 students of the health professions attending Ohio universities signed on to a letter provided to the Capital Journal on Thursday. It urges voters across the state to vote yes on Issue 1 to keep harsh abortion restrictions from again having the force of law.
“Abortion bans endanger patients,” it says. “Many of us have taken, or will take, the Hippocratic Oath to do no harm to our patients. The patient-provider relationship is sacred and built on trust. Should an abortion ban go into effect, we will be unable to live up to the very promise that is the basis for our work as health professionals.”
Early voting on Issue 1 has already begun. Election Day is Nov. 7.
The measure would build reproductive rights into the Ohio Constitution. That includes allowing elective abortion up to the point of fetal viability — generally after the second trimester of pregnancy — and it would protect abortions thereafter when they’re “necessary to protect the pregnant patient’s life or health.”
When the U.S. Supreme Court on June 24, 2022 overturned abortion protections under Roe v Wade, Ohio Attorney General Dave Yost rushed to immediately begin enforcing Senate Bill 23. Passed in 2019, that law outlawed the vast majority of abortions after about six weeks of pregnancy, including in cases of rape and incest. That cutoff is so early that many women don’t yet know they’re pregnant.
The law provided some protections for women’s health. But doctors said the protections were vague and inadequate — and that theyfelt hamstrung by fears that prosecutors could charge them criminally or that ideologically motivated colleagues might report them to the State Medical Board in an attempt to revoke their licenses.
Enforcement of S.B. 23 was temporarily stayed by the courts after about three months of enforcement. But while it was in effect, horror stories abounded.
A 10-year-old Columbus rape victim had to go to Indianapolis for an abortion. And in sworn affidavits, workers in abortion clinics told of other children and teens who also had to leave Ohio if they didn’t want to have their rapists’ babies.
They also told of cancer patients and women whose fetuses had fatal abnormalities who couldn’t get Ohio abortions. And they told of women who said they’d kill themselves when they learned they couldn’t have abortions they expected to get.
“Ohio has already passed one of the most restrictive abortion bans in the country with no exceptions for rape or incest, even preventing doctors from giving care until the patient is on the brink of death,” the student letter said. “While the law is currently on hold, during the three months it was active in 2022, patients were forced to leave Ohio to get the care they needed and others were forced to endure traumatic health conditions. This was incredibly dangerous for patients, putting them at unnecessary risk of death or developing life-long complications.”
For many health students — particularly those who want to work in reproductive health — serving a residency or practicing in a state with strict abortion limitations is a deal-killer.
A class of about 20 third-year students at the Case Western Reserve School of Medicine was asked on Tuesday whether the failure of Issue 1 would make them consider leaving the state for their residency. The great majority said yes.
Their reasons ranged from not being able to get the abortion training necessary to be an obstetrician, to fears of being unable to care properly for their patients, to fears of being at the mercy of an ideologically zealous legislature.
“I don’t think politics should dictate medical training,” one said.
Another student pointed out that lawmakers supporting Ohio’s abortion restrictions ignore that forcing women to carry pregnancies to term makes them far more likely to die than if they have an abortion.
“Pregnancy is not health-neutral,” she said. “That’s something we’ve all learned in medical school. Labor and delivery — not only is it incredibly painful — but very horrible outcomes can happen. Women can die.”
A medical resident who also attended the class cited another reason to stay away from states with strict abortion laws. If she were to become pregnant, she’d be hard-pressed to find the time to travel out of state for an abortion.
“As residents, we have very little control over our time or where we can be at a given time,” she said. “So from not even a political point of view, if we want to move ahead in our careers, we might want to leave the state” if Issue 1 fails.
The students aren’t alone. A survey of 494 medical students conducted earlier this year found that abortion restrictions were likely or very likely to influence 77% of students’ decisions about where they want to do their residency. And since admissions to residencies are competitive, that’s likely to influence which states will have their pick of the best young doctors.
Ohio can ill afford the loss of those and other health students. The state already has the 12th-highest number of “health professional shortage areas” — or care deserts — according to the U.S. Health Resources & Services Administration.
Ellena Privitera is a third-year student at Ohio State Medical School who helped organize the effort to get aspiring health professionals to sign the letter urging a yes vote on Issue 1. In an interview Thursday, she said she and her peers have a duty to speak up on an issue on which they have expertise and which affects the future of healthcare in Ohio.
“At this point, we’re at a juncture,” she said. “If we do not pass Issue 1, then Ohio’s extreme abortion ban — without exceptions for rape or incest — is going to go into effect. As students, we recognize that silence is not a statement.”
