Who Makes the Call? Physician Fears and Abortion Access Post-Dobbs

Abstract

Following the Supreme Court’s Dobbs v. Jackson Women’s Health Organization ruling in 2022, Texas was one of several states where previously passed abortion bans were triggered to become immediately enforceable. The restrictions placed on physicians were both vague and harsh, with the conditions for medical exceptions unclear and the potential punishments strict. Damla Karsan, a Houston-based obstetrician-gynecologist, sought to push back against the laws that restricted her ability to provide care and force the state to set legal precedent for medical exceptions to the bans. When Kate Cox, a woman facing severe pregnancy complications and desperately seeking an abortion, came to her, Karsan was faced with a question: with the risks so high for Karsan’s freedom if she performed an abortion and so high for her patient’s health if she didn’t, where would she draw the line? What was she willing to risk to set precedents for her patients and colleagues?