I am a fourth-year medical student training in Missouri and an aspiring primary care physician. I have completed years of strenuous pre-clinical and clinical training. This includes hundreds of hours of patient care, where my job is to listen to people’s stories, understand their concerns, and help them make decisions that will allow them to be healthy and well. The core of my — and every provider’s — medical training is universal: everyone deserves equal, excellent health care, as a human right. Reproductive services are health care; abortion is health care.
Access to reproductive health care, including abortion, has remained an obstacle for many in Missouri and this past week our state almost lost its only abortion clinic. This is a reminder of how tenuous access to abortion is in Missouri. Further denying access to safe, legal abortions will only exacerbate disparities in health coverage, access, and outcomes for all Missourians, especially people of color. This is, in large part, due to the state’s bad decision to not expand Medicaid. Many pregnant Missourians lack access to adequate, comprehensive prenatal care, resulting in Missouri having a maternal mortality rate that is 50 percent higher than the rest of the country. It is ranked 42nd out of all 50 states for measures in maternal mortality including tobacco use, lack of access to prenatal care, and educational and economic opportunities. In fact, Missouri has one of the highest black maternal mortality rates, with maternal deaths among African Americans being almost three to four times more likely than among whites. People are literally dying from pregnancy-related causes, often due to lack of access to necessary resources for care.
The Missouri population has historically been faced with barriers to health care due to shortages of primary care physicians in the state and an outrageously large amount of uninsured citizens due to lack of Medicaid expansion. The patients I currently serve are directly impacted by this lack of resources. Health centers, including those of Planned Parenthood, that offer the full range of reproductive health care to all people have been for many the only source of affordable, reliable health care.
While there still remains a need for increased health centers and providers who are trained in reproductive care, Missouri requiring investigations of medical trainees and providers will only further deter and deplete well trained physicians who can provide care, particularly abortions. Medical trainees would also be affected by Missouri closing its only abortion clinic, as it would reduce training opportunities in our state. The licensing process is being utilized by the state in an attempt to intimidate doctors, fellows, and residents to comply with the government’s agenda to stop providing legal and necessary care. Penalizing and threatening providers with jail time for providing a safe, legal medical procedure forces us to act unethically. If the state of Missouri continues to allow politicians to have jurisdiction over health care, I will be forced to practice in another state. This will further burden Missouri’s need for primary care physicians, harming individuals of the state from accessing necessary health care.
As a medical student, who was sworn into my education by the Hippocratic oath, it is my duty to do no harm — which is why I will not stand idly and allow politicians to place my future patients in harm’s way and rob them of their intrinsic human rights. Allowing politicians, who lack the years of clinical training and experience that physicians possess, to attack abortion care is an insult to my training and disregards the experiences I have had with patients and the specialized knowledge I have attained. More importantly, it is jeopardizing the safety of my future patients.
On behalf of my future patients, I stand with Planned Parenthood and will continue to fight for abortion access and the opportunity for individuals in Missouri and our nation more broadly, to fully claim their fundamental human right to health care and bodily autonomy.
Shelley Kaur attends the University of Missouri School of Medicine and will graduate in 2020.