Improving Access and Equity in a Post-Dobbs World

One year after the Supreme Court's Dobbs v. Jackson Women's Health Organization decision stripped federal right to abortion from millions of people, researchers, scholars, advocates, and providers are still evaluating unfolding ramifications reversal 50 years national legal protections. Issues is committed using evidence-based research inform advocate for policies programs that foster women's health well-being across lifespan, seismic events such as require multisector responses. To end, we asked six teams thought leaders in field offer their informed perspectives on current downstream implications this landmark recommendations our collective investment. Improving access requires understanding who has it needs it. In first commentary, Weitz O’Donnell, 2023Weitz T. O’Donnell J. The challenges measurement use post-Dobbs.Women’s Issues. 2023; (Epub ahead print)https://doi.org/10.1016/j.whi.2023.05.002Abstract Full Text PDF PubMed Scopus (0) Google Scholar explain U.S. abortions was inadequate before will now become far more challenging care criminalized many states. Traditional measures have not sufficiently accounted barriers besides geographic distance often confront those seeking abortions, nor they kept up with shift receiving medications by mail. O'Donnell call apparatus stop leaving funding work private philanthropists instead lead efforts strategize strengthen abilities provide accurate reliable data. Research made clear changes provision United States disproportionally impact populations already experience systemic inequities because structural racism. Treder et al., 2023Treder K. White K.O. Amutah-Onukagha N. Abortion bans exacerbate severe racial maternal mortality.Women’s print)https://doi.org/10.1016/j.whi.2023.04.007Abstract warn intersection reproductive injustice mortality crisis an inequitable increase morbidity mortality. They write Black, Latinx, American Indian communities, post-Dobbs slashing “is a contemporary manifestation oppression these communities experienced centuries at hands system designed center them or needs.” mitigate harms restrictions cause, authors support funds, enhanced protections, high-quality obstetric tailored color, expanding through medication telemedicine. Jain 2023Jain D. Davies M. Perritt Blasdell via telehealth.Women’s print)https://doi.org/10.1016/j.whi.2023.04.008Abstract focus telehealth outline what can currently do ensure well needed sustain all persons States. discuss survey findings regarding face offering recommend ways institutions reduce barriers, establishing protected clinical time care, freeing responsibilities related stocking drug mifepristone, carrying appropriate liability insurance. also governmental intervention state levels passage bold legislation like Protection Act protect clinicians patients care. training medical one piece overall be impacted decision, noted forward-thinking commentary Lambert 2023Lambert S. Horvath S.K. Casas R.S. Impact education care.Women’s print)https://doi.org/10.1016/j.whi.2023.03.011Abstract Scholar. ban severely limit vital experiences students residents, just obstetrics gynecology. lack exposure restrictive states undoubtedly harm patient population health, warn, trainees see abortion-banning less desirable residency destinations hurdles learning skills necessary treating miscarriages (which same performing abortions). al. partnerships between states, expansion primary emergency medicine, growth fellowship gynecology, improvements education. Another implication higher accessing contraception. Salganicoff Ranji, 2023Salganicoff A. Ranji U. A contraception wake Dobbs.Women’s print)https://doi.org/10.1016/j.whi.2023.04.002Abstract write, “The new present want prevent pregnancy compounded ongoing gaps contraceptive financing, limited options points, mis- disinformation about sexual health.” meeting challenge multiprong approach includes increasing focusing equity, improving (e.g., pharmacist-dispensed over-the-counter oral contraceptives), providing information all. Last, importantly, Hassan 2023Hassan Hirz A.L. Yates L. Hing A.K. Rebuilding future disability justice.Women’s print)https://doi.org/10.1016/j.whi.2023.04.006Abstract urge take moment history opportunity better, especially four living disability, too sidelined. write:Reproductive bodily autonomy cannot orbit solely around line upstream public approaches address root causes, medically judgment-free counseling must begin early lifecourse, discovery unwanted pregnancy. Having educators recognize people disabilities whole individuals lives, goals, futures significant impactful change championed several ways. Although there no simple easy solutions, investments disabled scholars redistribution power achieve core both justice. Together, commentaries remind us pre-Dobbs world one, responses disastrous aim than return status quo. pieces viewpoints, recommendations, only but progress toward As journal, remain showcasing centering today tomorrow. We thank authors, editorial board, readers working goal ensuring leads better outcomes