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OB-GYN struggles to navigate care under Texas abortion law


Tomorrow the Supreme Court begins oral arguments in what could be one of the most consequential abortion rights cases in decades, United States v. Texas. That's a federal challenge to that state's restrictive abortion law, known as Senate Bill 8, that went into effect in early September. That bill bans abortion after six weeks and, as you've probably heard, also sets up a bounty program for individuals to get paid for reporting people who violate it. It's been in effect for nearly two months. A study from the University of Texas at Austin found that the number of abortions performed last month dropped 50% compared to last year.

Back in August, before the bill went into effect, we spoke with Dr. Ghazaleh Moayedi, a physician who offers abortion care as part of her practice, and this is what she said.


GHAZALEH MOAYEDI: This law threatens my livelihood. It threatens my ability to care for my family. It threatens my career simply for doing what I was trained to do right here in Texas.

MARTIN: We wanted to check back in with Dr. Moayedi about the state of abortion in Texas, and she's with us now. Doctor, thank you so much for joining us once again.

MOAYEDI: Thank you for having me back, Michel. I appreciate it.

MARTIN: I cited that 50% drop in abortion from the Texas Policy Evaluation Project at UT Austin. And that, I guess, would be an early indicator of what this law has meant. So I wanted to ask about your practice. What's it been like since September 1?

MOAYEDI: The news from the Texas Policy Evaluation Project is not surprising, and it has been devastating, just like we expected. I have, unfortunately, not been able to provide abortion care in Texas since this law has gone into effect. Personally, I've increased the amount of time that I'm traveling to Oklahoma City to take care of Texans that are leaving the state. And pregnancy care has completely changed as well. You know, every week, every day almost, I'm getting messages from my colleagues wondering how to advise patients with very severe pregnancy complications and what they're supposed to do as well. So it's been devastating, really, across my entire practice.

MARTIN: Well, that was one of the things I wanted to ask you about, because when we last spoke, one of your big concerns was that this bill, you feared, would cause confusion for doctors. They might actually avoid providing certain types of care.


MARTIN: How big of an issue has that been?

MOAYEDI: A huge issue. You know, I'm hearing from my colleagues that refer to me but also to the learners that I have taught and do teach. And what they are telling me is that major hospitals across the state have made policies where they will not intervene in someone who is having a miscarriage if there are heart tones detected unless the person is hemorrhaging or is septic - so until they are critically ill, which is just horrifying to hear about, not how we practice medicine at all. We don't wait until things get worse. We intervene when we know we should.

I, just this week, received two separate referrals, one for a patient with very severe diabetes, causing very severe pregnancy complications that will make life for her pregnancy impossible, but also will endanger her life as well. She has no options for abortion care in the state. And I received another consultation for someone with a pregnancy that has a very severe genetic diagnosis, again, not compatible with life. Continuing the pregnancy could endanger her health, but she's not able to get care in the state. Physicians and health care providers are prevented from offering lifesaving care.

MARTIN: Are they prevented even from talking about it? Like, is there that concern that if you even raise the issue that then you could be liable?

MOAYEDI: Theoretically, no, but this is up to every person to interpret what they think their risk is. And that's what I really want to be clear about, is that there has been no indication that the architects of this law are trying to come after hospitals that treat miscarriages. But because of, really, the lack of foresight of the architects of this law, this vagueness has turned into local interpretation, and we have no case law for people to base their opinions on.

MARTIN: You mentioned earlier, you work in Oklahoma in addition to Texas.


MARTIN: Are you seeing patients from Texas finding their way to Oklahoma? Has that - what's that been like?

MOAYEDI: Yeah, you know, before SB 8, I traveled to Oklahoma, and I would say maybe 10 to 15% of the people we took care of in Oklahoma were from Texas already. Since SB 8 has gone into effect just this last week, 80% of the patients I took care of in Oklahoma were from Texas. That doesn't mean that people in Oklahoma stopped needing abortion care. That means that people from Oklahoma are now being pushed out of their state for care. We're seeing more people from Oklahoma going to Kansas, for example, and further out. You know, in Oklahoma City just this week, I took care of three people from my own neighborhood here in Dallas, like, literally, my own neighborhood. And I took care of people from as far as Galveston.


MOAYEDI: That's about an eight or nine hour drive one way.

MARTIN: Hmm. Before we let you go, I'm just wondering - you started your practice in a post-Roe world. I don't know whether you ever anticipated this, I mean, but obviously, you know, there have been fights about abortion ever since then, and, you know, we can all debate why that is. But I just wondered if there's anything about this whole thing has made you just rethink things. I mean, it just - what thoughts has this brought to your mind that you weren't having, like, a year ago or two years ago?

MOAYEDI: I became a doctor, and an OB-GYN specifically, to provide abortion care in Texas. So this has always been at the forefront of my mind. Now that we're here, I wouldn't say that I was prepared for it in any way. Honestly, it's hard. You know, when I am here in Texas, getting referrals for people I can't care for, it's hard to take in as someone who's committed their career to helping people and feel like I'm helpless, right? But when I travel to Oklahoma and I work with the staff there and we just take care of people so well, I'm reminded and reinvigorated about why I do this work, why we all do this work and why we're here. They're not going to make me cower. They're not going to make me afraid. I'm here to fight for my community and my family and my kid.

MARTIN: That was Dr. Ghazaleh Moayedi. She is a physician who provided abortion care as part of her practice in Texas and continues to do so in Oklahoma. Dr. Moayedi, thank you so much for talking to us once again.

MOAYEDI: Thank you so much for having me, Michel.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

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