‘Healing is fundamentally a political act’: Future doctors grapple with the encroachment of anti-abortion laws on Iowa health care

Do No Harm Rally for Reproductive Justice at the Iowa State Capitol, Saturday, Oct. 15, 2022. — Eva Long/Little Village

Medical students in Iowa watched with growing concern as the Iowa Supreme Court decided in June to no longer recognize the right to abortion as a fundamental right. A week later the U.S. Supreme Court overturned Roe v. Wade.

Both of the state’s medical schools, the University of Iowa’s Carver College of Medical and Des Moines University (DMU), have chapters of Medical Students for Choice (MSFC), but the two groups had never worked together until Saturday, when they met for the Do No Harm Rally for Reproductive Rights at the Iowa State Capitol.

Alina Beltrami told the crowd of protesters in white coats and scrubs gathered in the Capitol’s rotunda that the precarious state of reproductive rights in Iowa made her think about the pledge she took when she began her medical training at DMU.

“I do solemnly pledge that my efforts will be focused on the ultimate goal of serving my future patients,” Beltrami said, repeating the pledge for roughly three dozen protesters. “I believe that this oath is being called upon now to defend reproductive rights in Iowa, as the elimination of abortion care in Iowa will cause significant harm to people in this state.”

Beltrami, now a second-year student at DMU, took the lead in organizing the Oct. 15 rally, working with Hanora Van Ert, an MD/Ph.D. candidate at UI and co-president of its MSFC chapter.

“As a medical student and future physician, I know that I am not alone in having these concerns about the future of healthcare,” Beltrami said. “For example, our colleagues working in pharmacies are already having to be hyper-aware of the consequences for dispensing drugs which could lead to a termination of pregnancy, i.e. methotrexate, that is widely prescribed for common ailments including autoimmune diseases and cancer.”

“These concerns extend to other healthcare professionals who wish to support their patients without fear of incurring criminal or civil legal battles.”

Students from related healthcare professions — nursing and dental students, as well as social work students — joined the MSFC members at the rally in the State Capitol.

“We are the future of healthcare, and we have concerns about entering the practice of medicine in this changing environment, where physicians are being asked to carry out the acts of the legislators in a way that’s harmful to patients,” Margaret Fuller, another MD/Ph.D. candidate at UI, told Little Village after the rally. Fuller was one of the co-presidents of the MSFC chapter at Carver during its founding in 2015.

Fuller described the situation one of her colleagues — “a resident at the University of Iowa who is studying high-risk pregnancy [and is] really passionate about women’s healthcare, reproductive healthcare” — finds himself in.

Participants work on signs before the Do No Harm Rally for Reproductive Justice at the Iowa State Capitol, Saturday, Oct. 15, 2022. — Eva Long/Little Village

“He’s from the South, and he wants to go back to the South. But he doesn’t have it in him to tell patients that they have to just go home and die from conditions that are treatable with abortion,” she said. “So, he’s not going to go back.”

“And the same is going to happen in Iowa. We’re going to lose people who don’t have it in them to tell patients what legislators are asking us to tell them. Which is ‘I can’t do this really easy, safe procedure and save your life, I have to watch you get sicker and sicker, until you have a risk of dying. That’s when I can actually perform the procedure that I know how to do and would be safer to do now, but they’re making me wait until you’re really at risk of dying.’”

That is the situation that will confront doctors if the Iowa Legislature passes the same six-week abortion ban it did in 2018. That law did have exceptions for rape and incest, provided the victim officially reports the crime within a set period of time (45 days in the case of rape, 140 days for incest), and in order to save the life of the mother. But as Fuller said, other states that have enacted similar abortion bans have seen doctors prohibited from taking action, regardless of the facts, until the situation is critical.

Reynolds has avoided speaking about abortion during this election cycle, except when in front of like-minded audiences. Instead the governor has used a long-shot legal challenge, seeking to have the permanent injunction against the 2018 law lifted to deflect questions about her intentions.

During the Iowa PBS debate with Democrat Deidre DeJear on Monday, Reynolds said she didn’t want to comment on the six-week abortion ban, because “when it’s going through the courts I’m not going to weigh in either way.” That might have been a reasonable response, if the governor wasn’t the person who brought the legal action seeking to lift the injunction against the ban.

Using the lawsuit to deflect questions also allows Republicans candidates for the Iowa Legislature to avoid having to take a position on the ban. When it was passed in 2018, even supporters of the bill acknowledged it was clearly unconstitutional. That allowed them to vote for it, but not worry about having to answer for the obvious consequences of the bill. That changed with the actions of the state supreme court, six of whose seven justices were appointed by Reynolds or Gov. Branstad, and the Republican-appointed majority of the U.S. Supreme Court. Now the consequence of voting for a six-week abortion ban are clear.

MSFC members are preparing to make sure legislators hear their voices when the new session starts in January. Organizers provided a template for emails to the lawmakers, and as the rally was drawing to a close, passed out green ribbons.

“I want you to take a few moments of silence now,” Fuller, who was the final speaker at the rally, told her colleagues. “As you put on this green ribbon, I want you to think about your commitment to the fight for reproductive justice as well as your commitment to the larger fight for progress.”

“The act of healing is fundamentally a political act. In this profession, we can either ignore that fact or we can make the uncomfortable choice to demand more from those in power. I think the choice is obvious.”

A green ribbon, a symbol of commitment to the fight for reproductive rights at the Do No Harm Rally at the Iowa State Capitol, Oct. 15, 2022. — Eva Long/Little Village

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