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An OB/GYN in Texas reflects how the end of Roe will affect her work


We're going to hear from someone now who has already been living with restrictive abortion laws. Dr. Ghazaleh Moayedi is an OB-GYN in Texas who had offered abortion care as part of her practice. We spoke with her after Texas passed a law in September that banned abortions after six weeks.

Following the Supreme Court's decision to overturn Roe v. Wade, a so-called trigger law in Texas will take effect in a matter of weeks that bans abortions, with no exceptions for rape or incest. Abortion practitioners will be allowed to prevent a pregnant woman from dying or to provide the procedure if there is risk of, quote, "substantial impairment of major bodily function."

We wanted to check back in with her to hear more of her thoughts and how the Supreme Court's decision may affect her work and her patients. And Dr. Moayedi is with us now. Welcome, doctor. Thank you so much for talking with us once again.

GHAZALEH MOAYEDI: Thank you for having me back. I wish it was, again, under better circumstances.

MARTIN: What went through your mind when you heard this news?

MOAYEDI: We've been expecting this decision. We knew it was going to come. It doesn't make it any easier.

MARTIN: Well, to an extent, the state of Texas has given us a preview of what a post-Roe world looks like last September, when the state banned abortions after about six weeks, which is before many people even know they're pregnant. Could you just remind us of what the impact had been on your practice? Did you cancel appointments? Did you immediately stop doing the procedure? What happened?

MOAYEDI: I transitioned my work from within the state of Texas to Oklahoma so that I could take care of Oklahomans and Texans. And what I saw over the past nine or 10 months was extreme delays for not only Texans but people from Oklahoma, people from Louisiana, people from Arkansas, people from Kansas - delays in seeking and being able to get abortion care because of just the Texas ban.

So where normally in Texas, the majority of the people I take care of would be presenting for abortion care eight weeks or less, 10 weeks or less, because of the abortion ban in Texas, the majority of the people I took care of in Oklahoma were 12 weeks or above. And what we're going to see now as a result of this decision is an even more devastating delay in care for the few that will be lucky enough to be able to travel and get that care.

MARTIN: Texas will have to wait 30 days after the Supreme Court issues its formal judgment, which could take about a month, for the trigger law to take effect. So we don't know the exact date, but let's say in about two months, most abortions will be illegal in Texas. And there is an exception to prevent a pregnant person from dying if there is the risk of, quote, "substantial impairment of major bodily function." What does that mean for you? Is there some process that you have to undergo to assert that fact, or what does that mean?

MOAYEDI: Yeah. So we do have this trigger ban, but I - it's also important for folks to know that there are many states, including Texas, that actually have pre-Roe bans from the 1800s that remain on the books and were only overturned through Roe v. Wade. Yesterday, the Texas attorney general made a statement implying that these laws from the 1800s are actually immediately effective. And so what we've seen in our state, actually, as of yesterday, is that abortion funds halted their work in assisting people to get out of state and that clinics halted their work immediately as well. And that's because they have signaled that they plan on arresting us.

What does that mean in the day to day? Someone right now who is pregnant and maybe isn't even considering an abortion at all but has a pregnancy-related complication is going to be forced to reach the point of death before someone will intervene.

MARTIN: Are you concerned about women who have complications of pregnancy that result in miscarriage? That - and I'm wondering if women in your practice who have high-risk pregnancies, who - that they would like to carry to term are worried about being scrutinized or prosecuted because of some condition that results in miscarriage, particularly later in pregnancy. Is that a concern that you and your colleagues are talking about? And if so, what is your - how will you deal with that?

MOAYEDI: My colleagues at Texas Policy Evaluation Project and I, we have been actually studying this for the past several years. And just this week, we published one of our first studies outlining some of the details of what providers and patients have said, and that was published in the New England Journal this week. What we found is that people are being offered substandard care because of how abortion restrictions also regulate the care of pregnancy in general.

People were told with ruptured membranes, so a miscarriage but later in pregnancy, prior to viability - their bag of water has broken. There is no way to save the pregnancy, but they were told that they were better off leaving the hospital, getting on a plane and flying to another state. And it's unconscionable that physicians are being forced, health care providers are being forced to provide substandard pregnancy care in our state because of abortion laws.

MARTIN: Before we let you go, there are different perspectives within the medical field about this. There are - obviously there's a whole group of physicians who refuse to perform abortions who do actively believe that this is wrong and should be outlawed. And I'm just wondering if there have been any conversations within the medical field, you know, about this, given all the things that you talk about, given for - even from a health equity perspective, like the Black maternal mortality rate being so high in the United States compared to peer economy countries and things of that sort. And I just wonder, within your field, have conversations taken place with people who do have a very different perspective? Or at this point, has everything been said that people are going to say to each other?

MOAYEDI: I guess what I would say is that, yeah, there are physicians that are completely racist. There are physicians that don't think COVID exists, and there are physicians that don't think abortion is lifesaving. But our field is about evidence and the application of science. And so sure, there are people that hold extremist ideologies, and it's important not to give weight to those sorts of beliefs just because they're physicians. Physicians are wrong, too.

MARTIN: That's Dr. Ghazaleh Moayedi. She is an OB-GYN in Texas. Dr. Moayedi, thank you so much for talking with us once again and sharing your expertise and your professional experience with us.

MOAYEDI: Thank you for having me, Michel.

(SOUNDBITE OF MIXK AND MARCO APICELLA'S "SUNSET") Transcript provided by NPR, Copyright NPR.