Parvaneh (“Pari”) Nouri, an MD/MPH candidate at Wright State University Boonshoft School of Medicine, has testified three times against anti-abortion bills in the Republican controlled Ohio state legislature, and she’s gearing up for a fourth – a D & E ban has been introduced. In a hostile state like Ohio, advocacy work can be discouraging, but Nouri doesn’t let that stop her. She believes these anti-abortion bills create a “resource drain” of future and current ob-gyns, thereby harming the entire medical field, in addition to the dangerous barriers they create for patients. As a medical student and student leader of Wright State’s Medical Students for Choice (MSFC) chapter, Nouri wants to make her voice heard.
In the last six months, Nouri has testified in the Ohio house and the senate against the Down syndrome abortion ban bill and again in the house against the fetal heartbeat bill. “Each time I testify, I try to frame my argument in regards to how these laws will impact medical education, how medical students will make choices on residency, and how this will impact where physicians practice due to legal restrictions on the reproductive care services they can provide.” Nouri is intent on speaking from her unique stake in these issues as a future family planning provider.
This sentiment was echoed by Noel León, a lawyer with the National Women’s Law Center, who states that ob-gyns and residents may determine where they practice based on the reproductive health training legally available in each state. States hostile to abortion access create obstacles for providers. In determining abortion related legislation, lawmakers often overlook the medical perspective completely. “Lawmakers often know little about abortion, what it looks like, and how it affects other kinds of health care,” says León, “It’s important for them to hear: if you restrict training and abortion services, you make it more difficult for physicians to work with pregnant patients generally.”
Despite the lack of medically informed decision-making and the efforts of pro-choice advocates like Nouri, anti-choice bills, like Ohio’s upcoming D & E ban, will continue to crop up. The Down syndrome bill, HB214, was signed into law by Gov. Kasich and will go into effect in March of 2018. In 2016, Gov. Kasich vetoed the heartbeat bill and simultaneously signed a 20-week ban, but the heartbeat bill is now moving through the state legislature once again. Nouri sees no other option than to continue to push back.
After being contacted by the Vice President of Government Affairs and Public Advocacy for Planned Parenthood Ohio, Nouri first testified against SB164/HB214, which bans abortions in cases of a prenatal Down syndrome diagnosis and criminalizes physicians who perform an abortion in these cases. “Planned Parenthood or NARAL will reach out before every reproductive health related bill that comes through the state congress and often provide an executive summary,” Nouri explained. “Planned Parenthood and NARAL reps have even offered to edit my testimony, and submit it on my behalf.” This support makes it feasible for a busy medical student to participate in advocacy, as local organizations provide information on the legislation, the legislative committee, and hearing dates.
Ultimately, patients are the victims of legislation that strips away access to reproductive health care, but the medical community can and should advocate on their behalf. León points out, “Patients sharing their own stories about abortion is incredibly powerful and important, but abortion stigma makes it hard for many patients to feel comfortable being public. Residents and physicians are able to speak to patient experiences in a way that can be hard for patients to do.” Although many medical students don’t yet have patient experiences to draw from, León thinks student voices still carry weight. “Testifying fortifies a student’s confidence to speak up in the future for the next abortion restriction proposed. Additionally, it is important for lawmakers to hear from the next generation of health care providers, whether they become abortion providers or not, saying ‘access to abortion is important and this bill is harmful’.” Medical students, residents, and physicians have the expertise to highlight the medical ramifications of anti-choice bills to lawmakers who are unaware of the collateral effects their legislation will have.
When testifying against the fetal heartbeat bill, Nouri concluded with an appeal for her future as a physician providing reproductive care. “Our healthcare system and government have the great potential of operating as a mutual partnership; one that facilitates positive patient outcomes and preserves our global leadership in the highest standard of care. As a physician, I want to serve my patients under that standard of care, regardless of which state I practice in.” For medical students planning on being providers in hostile states, advocacy skills will prove essential. Their careers, and the patients they serve, will depend on it.