Eva’s Excerpt June 2019

While there are a number of issues, events and priorities that I could and should talk about this month, I am going to stay focused on one—the recent Missouri legislation that will curtail women’s access to comprehensive reproductive health care. Abortion and a woman’s right to choose are divisive and often deeply held beliefs that are uncomfortable to discuss and create chasms between people who otherwise are or would be fast friends. My intent is not to debate that issue, but instead to discuss the potential implications of this specific law for our city, state and institution as it relates to education and clinical care.

This law, and those like it in other states, criminalizes the actions of physicians providing federally legal care to women. As we train our young doctors, we continually emphasize that the doctor-patient relationship is paramount to providing the best medical care to patients and families. Such relationships are built on trust, open communication, and a willingness by physicians to put their personal feelings about these complex issues aside to ensure that a patient receives timely, effective, evidence-based and compassionate care. Under this legislation, a physician could lose his or her medical license and face up to 15-years in prison for complying with this sacred physician obligation.

By prohibiting terminations of pregnancy after 8-weeks, this law differentially impacts the poorest among us—both rural and urban. Women without timely access to care, adequate money or insurance for care, or a lack of transportation are at a significantly greater risk of falling outside the parameters of this timeline. The United States has the highest maternal-fetal mortality rate amongst any developed country and Missouri is amongst the worst states in the nation on this important metric. This law has the potential to further exacerbate this tragic issue. See the recent Op-Ed by Dean Perlmutter and BJC CEO Richard Liekweg for more information on the details of this.

Finally, there is the issue of ensuring that our students, residents and faculty are effectively trained, and adequately supported and protected. We currently have one of the very best Ob-Gyn departments in the country, with outstanding faculty who not only advance women’s health daily, but who train our exceptional students, residents and fellows. How will this legislation impact our ability to train them in the full scope of their fields? How will it impact recruitment and retention of the best and brightest to our school, residencies, fellowships and clinical programs? How will it impact our institution and the ability of the state to recruit providers and scientists? And what are the potential downstream consequences of this to our city, state, country and the world? We can only speculate, but at least some students have already spoken out in other states with similar legislation. See Medical Students Explain What’s at Stake with Georgia’s Proposed Abortion Bill by Alisha Kramer and Preetha Nandi.

I am deeply concerned. And I feel grateful to work in an institution that understands the complexity of this issue, while remaining committed to protecting our mission and the patients we serve. Meanwhile, in this issue of the EdUpdate, we talk about some of our many accomplishments in education over the last few months. In addition to awards, fellowships, and new faculty, we have reached an important milestone in the curriculum renewal process. Now, more than ever, we must move forward with our vision of advancing human health as a diverse and inclusive community that inspires learners to create the future in medicine, science and society.