Today , September 28, is International Safe Abortion Day . All across the planet, supporters of reproductive freedom and health are taking action, speaking up and promoting the Twitter hashtag #IResistWePersist . In commemoration of this day, a group of North Carolina physicians have authored the following essay. We’re proud and happy to share it here.
North Carolina: Still denying access to basic reproductive health and freedom
As medical doctors, our patients trust us with intimate stories about their lives. This is a privilege and something we take seriously. At times our patients need safe abortion care and we are committed to supporting them in this choice. Our patients have many reasons for why they may choose an abortion. They may be caring for sick children or a newborn; dealing with chronic mental illness; leaving an abusive relationship; trying to fulfill their dreams of education; learning that a desired pregnancy went terribly wrong after infertility treatment; or finding themselves financially and/or emotionally unprepared to care for a child at this point in their lives. Nearly one in three women will have an abortion in her reproductive life, but few will think about the ability to access this health service until they find they need it.
In North Carolina, access to safe abortion care, either through taking medication or having an outpatient procedure, is inequitable. Our patients’ lives are made more difficult through unnecessary restrictions that fail to improve their health and safety, and instead punish those with the fewest resources. Abortion has a strong safety record , yet is still subject to often arbitrary, politically motivated and burdensome restrictions.
Federal regulations restrict people with Medicaid or any federal health insurance program from using their insurance to pay for abortion care. In North Carolina, state law excludes abortion coverage for any state, city, or county employee; or for anyone who purchases private health insurance on the ACA marketplace. This often puts safe, quality abortion care out of reach for many of our patients. And when some patients do come up with the money needed, we know they may be skipping rent or medication payments, or putting their safety at risk by revealing their situation in order to borrow money.
In North Carolina, state law also requires minors to get parental consent in order to have an abortion, and that patients wait unnecessarily for 72 hours prior to receiving abortion services once they have contacted a clinic. These laws interfere in our ability to provide the best care for our patients.
And at clinics offering abortion care, there are often protesters who harass and intimidate our patients as well as the health care staff who try to help them. Instead of trusting and supporting our patients to know what decisions are best for them and their families, our state makes access to genuine health care more difficult. So-called Crisis Pregnancy Centers (CPCs) are funded with an increasing amount of tax dollars , despite the fact that they have been documented to give false medical and health information, and often deceptively delay or deny access to abortion care.
We chose to practice medicine to reduce suffering, and to support families and our communities regardless of the challenges they face. We find ourselves in a climate that is increasingly hostile to our patients based on race, immigration status, sexuality, and financial resources. As doctors and public health professionals we will continue to support our patients and resist laws that do not promote their health. International Safe Abortion Day  is a reminder that all people have a right to health care, and this includes safe abortion care.
Dalia Brahmi, MD MPH
Leslie Montana MD, MPH
Erica Pettigrew MD, JD, MPH
Surah Grumet, MD, MPH
Lalita Sidana, MD, MPH
Taylor Goodnough, DO