Op/Ed: In a state with high maternal mortality, Indiana lawmakers put more women at risk

With its June 30 decision, the Indiana Supreme Court put into effect a total abortion ban with few exceptions. This decision will have a negative effect on Hoosiers’ reproductive rights and health care and demonstrates a lack of understanding and respect for privacy in the patient-physician relationship.  

The abortion ban, Senate Enrolled Act 1, was initially passed last summer, but due to a legal challenge in court, was not enforced. With the Indiana Supreme Court decision, as early as Aug. 1 this law will ban all abortions except for in certain circumstances, such as pregnancies complicated by health- or life-threatening medical conditions, lethal fetal anomalies and pregnancies due to rape (but only until 12 weeks in pregnancy). This law takes away reproductive rights and will worsen health care for Hoosiers. The risk of dying during pregnancy or the postpartum period is higher in states with restricted access to abortion. A 2022 study found maternal death rates were 62% high in abortion-restricted states compared to states where abortion was more easily accessible. It is unconscionable that Hoosiers, who already experience one of the highest maternal mortality rates in the United States, are being put at even more at risk by this abortion ban. 

More:Indiana abortion ban begins as soon as Aug. 1. What you need to know.

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Fundamentally, this abortion ban removes Hoosiers’ ability to make private medical decisions with their physicians. Without that basic right, physicians can’t provide the evidence-based, compassionate care we are trained to provide. And patients can’t make private health care decisions without intrusion by politicians. Importantly, the law does not require anyone to report people who seek legal abortion care, in Indiana or out of state. However, many people do not know or understand the details of the law. Government intrusion into health care like this abortion ban creates uncertainty and destroys the trust and privacy that is so important for a physician-patient relationship.  

More:Indiana's Terminated Pregnancy Report shows how changes in access affected abortion numbers

Furthermore, the abortion ban includes significant penalties for physicians who provide abortion care that non-physicians deem “illegal.” Physicians in Indiana will now live in fear that their medical decisions about when to provide abortion care in situations of unexpected and tragic pregnancy complications will be second guessed by non-physicians. The consequences of these investigations include losing their license or even going to jail. And, even more importantly, physicians practicing in an environment of fear from non-medical oversight are discouraged from providing safe, evidence-based care to all Hoosiers because they are not permitted to make decisions solely based on their training and expertise. Laws should reinforce the patient-physician relationship to foster optimal health care. By choosing to do the opposite, the Indiana State Legislature and the Office of the Governor have voted in favor of keeping people in Indiana on the wrong side of the widening maternal health divide. Not just because of lack of access to abortion care, but because physicians won’t want to stay in or move to Indiana to practice in this environment.  

More:AG Todd Rokita wants out-of-state abortion medical records. Here's why this concerns some.

Our patients know that we may be forced to let them suffer untold physical and mental harm because we cannot provide the care they need. Without trust, creating and protecting the patient-physician relationship is incredibly difficult. Hoosiers deserve better than this. Hoosier patients deserve to be able to make their own private health care decisions with their physicians, and Hoosier physicians deserve to be able to provide the evidence-based, compassionate care their patients need. When the abortion ban goes into effect, both patients and physicians in Indiana will suffer. 

Officers of the Indiana Section of the American College of Obstetricians and Gynecologists: Drs. Caitlin Bernard, Elizabeth Ferries-Rowe, Elicia Harris, Caroline Rouse and Julie Tillman.