Many life factors impact our access to health care: insurance, age, availability of quality providers, out-of-pocket expenses, distance from a health care center, cultural norms and beliefs about modern medicine. Instead of trying to increase access by eliminating some or all of these barriers, our elected officials in Jefferson City are adding additional obstacles, leveraging their power to prevent a large group of Missourians from accessing much needed health care.
When the US Supreme Court eliminated Americans’ constitutional right to abortion access last summer, Missouri was the first state to activate its trigger law banning abortion, severely compromising reproductive health care for all Missourians. Providers are now experiencing fear and confusion about what they can and cannot say when counseling their pregnant patients. Patients are also subjected to similar fear and confusion, leading to an increased demand for long-acting reversible contraceptives, increased concern about irregular menstrual bleeding and a desire among young women to conceal information about their menstrual cycles. These fears threaten the quality of medical care throughout our state.
Health care education in Missouri is also impacted. Students are reluctant to stay or relocate to Missouri to attend our prestigious medical schools and residency programs because they will receive significantly limited abortion care training and have limited access to such care for themselves. Several recent studies have shown that applicants won’t even consider applying to states with strict abortion bans. Without access to abortion care, Missouri will become a state that has a number of diverse medical providers, with limited training and skills in the area of ​​reproductive health care. This translates to poorer health outcomes, particularly for women.
There is significant evidence that a majority of Missourians support a right to abortion, and on March 8, the political action committee Missourians for Constitutional Freedom submitted a citizen initiative petition to make access to abortion a constitutional right in our state. With access to abortion, Missourians would not have to travel to other states (often hundreds of miles) to seek the care they need, want and deserve. They would not have to miss work and potentially lose their employment when choosing to end a pregnancy. Women with medically complicated or dangerous pregnancies would be safer because they could access care closer to home. The right to abortion in Missouri would mean lower maternal mortality because women would not be forced to remain pregnant.
Missouri currently ranks as the 12th highest state for maternal mortality in the US (25.2 per 100,000), in a country that already has the highest maternal mortality rate among all developed countries. The right to abortion in Missouri would greatly improve health care for its residents.
Unfortunately, the attempt to make abortion a constitutional right for Missourians recently hit political obstacles. Attorney General Andrew Bailey, who was not elected by the voters (Gov. Mike Parson appointed him to complete US Sen. Eric Schmitt’s remaining term) is not our state auditor, nor does his office have the legal authority to act on behalf of the auditor . Yet he refused to accept Missouri State Auditor Scott Fitzpatrick’s fiscal note for the proposed ballot initiative. Bailey’s actions are a political attempt not only to get attention in the press for his AG election campaign, but also to deny Missourians their constitutional right to the initiative petition process.
Until a court orders Bailey to comply with the Missouri law, the initiative petition will not move forward and will become significantly harder to get on the ballot and pass. This single unelected individual is interfering with democracy and impacting access to reproductive health care throughout the state. As long as Bailey and other politicians in our state use their political power to thwart attempts to broaden access to reproductive care, our elected officials in Jefferson City will remain the biggest threat to Missouri women’s health.
Jennifer B. Hillman is a board certified physician in pediatrics, internal medicine and adolescent medicine, and a member of Missouri Healthcare Professionals for Reproductive Rights, an unincorporated advocacy group that does not lobby. She lives and practices in St. Louis.