Thoughts on Roe v Wade: the Australian ED Trainee Perspective

Author: Emily Williams, BM BS, BMedSci

Keywords: abortion, healthcare, abortion rights, abortion access

I am an Emergency Medicine Trainee in Australia, and here are some things I believe are fundamental to my job and role:

• Healthcare needs to be free at the point of delivery

• People need to be able and empowered to make informed wise OR unwise decisions

• No one person or life is more valuable than another

• The vulnerable present in society need to be protected and advocated for

I have looked after hundreds of patients and none of them have the same story. People and disease can not be forced into a trajectory or outcome that is desired or undesired—all we can do is provide modern, focussed and appropriate care and deal with what comes or doesn’t.

I have looked after patients who have had a termination of pregnancy, those who are seeking a termination, those who’s pregnancy has been unsuccessful despite how hugely desired it was (both spontaneously conceived and via medical assistance), those who may still lose the pregnancy, those who are pregnant and miserable (some from physical symptoms others from their social or environmental circumstances), those whose pregnancy is causing direct harm and risk to their health, those with foetal anomalies who may or will not survive after birth, and those that have uncomplicated desired healthy pregnancies.

All of my patients however have been able to seek care freely, with the knowledge that the law allows them to do so, and that doctors will support their choices and target care to fit their specific needs. 

Waking up to the overturning of Roe v Wade in the US was distressing, and I feel for my international colleagues and their patients in the wake of this. 

The fundamental autonomy of both clinical practice and independent decision making has been taken away from providers, placing a barrier to care in some locations and an extra burden to delivering this in others.

This will come at not only a high financial cost (no universal healthcare) but a massive societal one.

How is someone able to make an informed decision if they are too scared about punitive action? How do they then live with their choice?

How are they meant to find the money to pay for antenatal care let alone financially provide for a child, when they couldn’t afford to terminate the unplanned pregnancy that occurred because they had to chose between contraception and making rent.

How can doctors feel safe to provide targeted and appropriate care when the law isn’t necessarily supporting them to do so?

How does it make a person feel when the state has declared that their life and the choices they make does not take precedent over a pregnancy that before the gestation of viability could not be sustained without them.

I am grateful for my rights, my training and ability to care for all my patients in the best way I can and know how. I’m grateful I don’t live and work in a polarised country where individuals are forgotten or decidedly ignored. I’m grateful I can look after the scared, desperate, compromised and vulnerable and truly help them to make informed decisions and am protected to do so. 

In one of the richest nations in the world I’m frightened that this ruling means others will have their decisions and rights questioned by those who do not live in their circumstances and have no concept of their lives, struggles or trauma.

I thought that in the modern world, personal freedom was inherent— I guess in the case of the USA, perhaps not.

About the author: Dr Emily Williams, BM BS, BMedSci is an Advanced Trainee in Emergency Medicine based in NSW. Originally from the UK and graduating from University of Southampton, she worked in hospitals in Surrey and southwest London prior to relocating to Australia and joining the Australasian College of Emergency Medicine. Dr Williams has worked in large metropolitan referral centres as well as smaller rural hospitals over the course of her career and takes particular interest in women’s health, palliative care and acute mental health presentations. She also provides clinical teaching for the University of NSW and has a keen focus on the mentoring of junior colleagues as well as peer support.