The Supreme Court’s June 24 overturning of Roe v. Wade ignited rapid changes in state abortion laws, with eight states having already banned abortion and four more expected to do so over the summer.
Abortion remains legal in Michigan due to a preliminary injunction against the state’s 1931 law criminalizing all abortions except to save the pregnant person’s life. The 1931 law was nullified by the 1973 Roe v. Wade decision but never officially repealed. In light of the uncertainty surrounding abortion access in Michigan, a coalition of organizations created the Reproductive Freedom for All ballot initiative, a constitutional amendment to protect reproductive rights that received over 800,000 signatures in support.
The draft decision to overturn Roe v. Wade was initially published by Politico in May, after which the University of Michigan announced the creation of a “Post-Roe Task Force” composed of individuals across various areas and occupations, including healthcare professionals, legal representatives and students and faculty working in relevant research areas. The task force is designed to mitigate the effects of a potential abortion ban in Michigan.
Dr. Lisa Harris, a physician at Michigan Medicine who provides abortion care and a co-chair of the task force, said this task force covered a wide variety of topics that arose when Roe v. Wade was overturned.
“There’s two broad buckets of work that the task force is doing,” Harris said. “One is campus work, so thinking about all the ways in which students and faculty and staff across all the different campuses and schools will be impacted. And the second bucket is around clinical care and treatment.”
Harris described the task force’s sub-committees, which are working to address individual issues, such as which abortions Michigan Medicine could still provide if the 1931 ban, or a ban like it, were to take effect, as well as clarifying Title IX protections and student insurance policies.
Following the official overturning of Roe v. Wade, Michigan Medicine released a public statement reaffirming its commitment to providing abortion care and resources, so long as abortion remains legal in the state.
“U-M Health remains committed to providing high-quality, safe reproductive care for patients, across all their reproductive health needs,” the statement read. “This includes abortion care, which remains legal in Michigan while challenges to various state-law criminal statutes continue to proceed.”
According to Michigan Medicine, many of the patients for whom they provide abortions are experiencing serious pregnancy complications or underlying health conditions. While they can provide outpatient medication abortions in some cases, they also outline various local clinics such as the Planned Parenthood Ann Arbor Health Center that do so more often.
Michigan Medicine still provides access to abortion care, but Dr. Dee Fenner, chair of obstetrics and gynecology at Michigan Medicine and co-chair of the task force, said that access would change if a ban were to be put into place.
“Obviously, we would follow the law,” Fenner said. “That would significantly impact our ability to care for patients.”
Under the 1931 ban, Michigan Medicine would still be available to provide abortions in life-threatening events. However, according to Harris, there is little clarity on if a doctor can provide an abortion in a situation where the threat to the pregnant person’s life is uncertain or evolving.
“It’s unclear if we would be able to provide abortion care early in pregnancy, when there’s not an imminent threat to someone’s life, in order to prevent an imminent threat later,” Harris said. “So that’s one thing that’s ambiguous: the timing of it. Do they have to be imminently at risk, or what if their risk is later?”
Harris highlighted ectopic pregnancies, a condition in which the fertilized egg implants outside of the uterus — most commonly in the fallopian tube. The uterus is the only organ in which a pregnancy can be carried to term, so the treatment for an ectopic pregnancy is medical or surgical termination of the pregnancy. Left untreated, ectopic pregnancies can rupture and cause a life-threatening hemorrhage.
However, according to Harris, healthcare providers often diagnose ectopic pregnancies before there is an imminent threat, creating confusion as to whether or not treatment can be provided soon after diagnosis. Harris said, in her experience, doctors do not view the treatment for ectopic pregnancy as an abortion but rather as a necessary medical treatment.
“For many doctors, it’s very clear…that treating an ectopic pregnancy is not an abortion,” Harris said. “The very first weekend after Roe was overturned, we saw a patient here at Michigan from out of state with an ectopic pregnancy where there was fetal cardiac activity because doctors (in her state) weren’t able to treat her.”
Harris said there is little guidance provided to doctors on the legal specifics of abortion regulations in their states, often leaving them to make decisions on whether to provide care based on the risk to themselves.
“There’s no national or international standards to turn to that could reassure doctors 100% that someone’s not going to charge them with a felony,” Harris said. “Individual doctors right now are in the position of making decisions about patient care based on the risk to them, the doctors, as opposed to what is in the interest of the patient herself.”
According to Harris, the task force is trying to identify what kind of abortions Michigan Medicine could provide under the 1931 abortion ban or one like it.
While access to abortions may change alongside Michigan’s regulations on abortion, Fenner claimed that access to education on abortion at Michigan Medicine will remain constant, regardless of what ban is put into place, due to external requirements by the Accreditation Council for Graduate Medical Education (ACGME) and other organizations.
“(Education on abortions) is part of the requirements for accreditation through the ACGME for an OB/GYN residency, and it’s also part of learning requirements for the American Board of OB/GYN,” Fenner said. “So for all those national educational bodies, we are required to teach our students and our residents and our fellows on how to manage patients who desire an abortion.”
According to Harris, an abortion ban in the state of Michigan would mean residents training at Michigan Medicine would have to travel out of state to view and perform abortions. Harris said this possibility has already created concern among prospective students considering whether to attend an institution in a state where the future of abortion care is up in the air.
“Faculty and staff are hearing that there are already people who don’t want to come here or train here or learn here because of the potential for loss of reproductive rights,” Harris said.
LSA sophomore Emma Sklar, a Central Student Government representative whose campaign platform included providing free transportation to Planned Parenthood for students, suggested that the University consider implementing an online module as a part of student orientation discussing abortion access in the state of Michigan.
“Maybe we should have a module for all of our new students directly tied to this issue so they know, ‘Hey, you are coming into this swing state, you are coming into a state where it’s a little uneasy, we don’t know what it’s gonna look like two, three, four months from now, but we have your best interest (in mind),’” Sklar said.
Sklar said the University’s top priority should be protecting and advancing student safety and well-being.
“At the end of the day, we know what everybody on our campus wants,” Sklar said. “They want to feel safe, they want to feel heard and they want to feel protected.”
While abortion remains a controversial issue in Michigan and across the country, Harris said the task force’s focus remains on addressing the needs of the campus community and Michigan Medicine’s patients.
“Abortion is an issue that divides many people, and people tend to think of it as a political issue,” Harris said. “However, on the grounds of where I sit as both a doctor and faculty member and teacher of students, it’s also a clinical care issue and very on-the-ground practical issue of how we care for our campus community, and that’s what the task force is organized around. It’s not organized around political goals, it’s organized around the very practical issues of how we will care for the people who turn to us for care and support.”
Summer Managing News Editor Riley Hodder can be reached at rehodder@umich.edu. Summer News Editor Samantha Rich can be reached at sammrich@umich.edu.