The U.S. Supreme Court is set to hear oral arguments today in a case about whether patients have access to emergency room abortions in states banning the procedure.
Idaho v. United States could determine if providers can perform medically necessary abortions for women experiencing complications under decades-old rules known as the Emergency Medical Treatment and Labor Act.
Dr. Polly Wiltz, a second-year emergency medicine resident at University Hospitals in Cleveland, said she is worried about her ability to care for patients who need abortions, if protections end.
"We are putting ourselves at risk for allowing legislators -- allowing people who do not have medical training -- to pick and choose which procedures, which life-stabilizing treatments and medications can and cannot be applied in the emergency department," Wiltz pointed out. "It's infringing on patient rights."
The Center for American Progress said pregnant patients with severe complications who are denied abortions could develop severe sepsis requiring limb amputation, uncontrollable uterine hemorrhage requiring hysterectomy, kidney failure requiring lifelong dialysis, hypoxic brain injury and other severe conditions.
Wiltz added most of the patients with pregnancy complications coming into the hospital lack access to routine OBGYN-related care.
"Regarding pregnancy related complaints, I see first trimester pregnant patients every single day," Wiltz noted. "In my shift, I have caught ectopic pregnancies that have ruptured."
Hospitals made up 33% of the facilities providing abortions in 2020, according to data from the Pew Research Center. Last fall, a majority of Ohio voters chose to approve a constitutional amendment, "Issue 1," establishing a statewide right to abortion and reproductive care in the aftermath of the Roe versus Wade decision.
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Vice President Kamala Harris focused on reproductive rights at a campaign event in Michigan Wednesday.
Her remarks come as President Joe Biden has fallen behind former President Donald Trump in the state, according to the latest polls. In front of a crowd of hundreds, Harris stressed abortion rights are at risk if Republicans win in November. She said Biden has vowed to veto any attempts to ban abortion nationwide.
"We believe in freedom. Freedom from the government telling us what to do about matters of heart and home," Harris explained. "We believe in the right of people to make basic decisions, like when and if they will start a family and how."
Meanwhile, Trump's pick for vice president, Sen. JD Vance, R-Ohio, has supported national abortion bans and opposed exceptions for rape and incest. Democrats are hoping the distinction will lead them to a victory this year in the key battleground state of Michigan. It was a critical issue for voters in 2022, when Gov. Gretchen Whitmer won her reelection race easily and both chambers of the state legislature flipped to Democrats for the first time in decades.
In her speech, Harris condemned political violence following the recent attempted shooting of Donald Trump at a Pennsylvania political rally. She also praised the gun safety measures Michigan lawmakers passed in recent years, including universal background checks and safe storage requirements. She added politicians in Washington, D.C., should favor similar laws.
"The solutions don't really require that much creativity," Harris asserted. "What they do require is people in the United States Congress to have courage to act and do what we know is the right thing to do and not cower, based on special interests and powerful lobbyists."
One Michigan Democrat in Congress, Rep. Hillary Scholten, D-Grand Rapids, has called on Biden to drop out of the presidential race over concerns about his age and cognitive ability. Harris would likely be a top replacement choice in the race against Trump.
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Abortion bans and restrictions limit women's participation in the workforce, according to a new analysis that quantifies the negative impacts on state economies.
South Dakota saw an average loss in GDP of nearly 1% per year between 2021 and 2023, due to a drop in labor force participation by people who became pregnant and didn't have access to abortion care, according to data from the Institute for Women's Policy Research. That adds up to nearly $641 million in economic losses to the state.
Jamila Taylor, president and CEO of the Institute for Women's Policy Research, said the 16 states with abortion bans or extreme restrictions, including South Dakota, are costing the national economy $68 billion annually.
"Not only do these restrictions and bans have a clear impact on the health and well being of people with the ability to get pregnant, they also have an impact on their productivity and their economic position in life," Taylor said.
Taylor added abortion access not only helps family finances, but also allows women ages 15 to 44 to engage more broadly in society -- in local communities or politics, for example.
Despite restrictions, abortion numbers are rising. The first full calendar year after the Dobbs decision overturned Roe v. Wade saw an 11% increase in abortions since 2020 - or over one million abortions in the formal health care system in 2023, according to The Guttmacher Institute.
If voters pass South Dakota's constitutional Amendment G in November, it will enshrine protections to abortion.
Hannah Haksgaard, University of South Dakota law professor, said even if it passes, people seeking an in-state abortion would likely see a lag time before services become available.
"There would still likely be state legislation that would try to restrict abortion in certain ways, and then the question would become whether those restrictions violated the new constitutional amendment," she said.
Haksgaard added that could make providers move slowly on offering abortion services in the state, until the legal issues are settled.
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A ruling from the U.S. Supreme Court Thursday will allow for abortions in emergency situations in Idaho - for now.
The justices said they were dismissing an appeal, reestablishing a lower court decision allowing hospitals to perform abortions in emergency cases, despite the state's restrictive abortion laws.
Molly Meegan, chief legal officer for the American College of Obstetricians and Gynecologists, said the organization is glad to see temporary relief in this case but added it is far from a complete solution.
"The way these laws are set up in Idaho and elsewhere are that there are limits on what care can be provided," Meegan explained. "Those limits are not clearly defined, and they're not committed to the discretion, the judgment, the expertise and the training of the physician that's facing a particular patient."
The protection for emergency abortions stems from a federal law known as the Emergency Medical Treatment and Labor Act. The law requires Medicare-funded hospitals to perform abortions in emergency situations. The three dissenting justices in Thursday's case called the Act's ability to preempt Idaho's restrictive abortion laws "plainly unsound."
Dr. Stella Dentas, president of the American College of Obstetricians and Gynecologists, said there is still a lack of clarity around the law in Idaho and OB/GYNs are leaving the state as a result. She noted when doctors face the prospect of jail over restrictive laws like Idaho's, it makes their job more difficult in emergency situations.
"It's already hard enough to make these critical decisions in the moment," Dentas emphasized. "If you're stuck on, 'OK, I can go down path A, but I'm not allowed to go down path B,' that is very confusing for both clinicians and the patients and the shared decision-making that we do."
Meegan added legislators should not be determining what care is available to patients.
"These questions need to be decided by science, by evidence, by the individual case in front of you," Meegan contended. "The idea that you can have black and white worlds being created by people without the expertise, training or experiencing the emergencies is really fundamentally dangerous."
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