Dr. Melissa Welch contributed to this article in a personal capacity. The views expressed are her own and do not necessarily represent the views of Health Catalyst or its leadership.
Throughout the early days of my upbringing, while still an aspiring physician formulating my opinion of the world, and to this day, the right to choose has always seemed a certainty. Amid political discourse on the right to healthcare – “healthcare is a right, not a privilege!’ — I had always assessed the right to choose as a very American principle.
While I’m encouraged by some of the recent midterm responses to healthcare rights, I was stunned when Roe v. Wade was overturned – almost frozen and left void of feeling, unsure of what to do or how to respond. It was not until I had the opportunity to weigh in on how my employer would support all employees after the ruling that I woke up. I awakened with clarity of thought, unsettled grief and lingering questions as to the implications of the Supreme Court’s ruling.
As an intern in the emergency room at San Francisco General Hospital, I recall being stunned by the first time I held the hand of a woman as she spontaneously aborted the growing fetus in her womb. I felt helpless because there was nothing that could be done to prevent her body’s rejection of her never-to-be-born child. I held her hand and was certain that I would do everything I could to ensure her safe care. I spent zero time questioning her identity, pronouns, race, socioeconomic status, or any other feature. She was simply my patient, and I needed to care for her during this vulnerable time. The safety net hospital I trained in never forced me to question the essence of who this woman was nor the choices she made. I remain grateful that we could be there for her.
In the post Roe v. Wade world, will this be the case? If presented with a similar patient in a locale where choice is not an option, will other young interns be forced to consider the need to call around to treat an obvious emergency?
As a mother of three who was assessed as high-risk during my pregnancies, I never contemplated – nor could I imagine – a world in which any of my children, male or female, would not have the choice to bear a child or not, irrespective of the circumstances. Yet, here we are, in that world. The reality of this ‘new world’ is that we continue living with a set of facts that cannot be ignored: equitable care is still not within the reach of all Americans, high-risk pregnancies ending in abortion still happen, we still see disparities in the risk of maternal morbidity and mortality among black and Latina women like me, intended and unintended pregnancy and births are inevitable, and contraceptive preferences still exist.
However, choice – much like change – is a constant in life. I recall the words of my Harvard Medical School faculty advisor during my first month there: “You have the power to choose how you change.” I feared that being at an Ivy League school and leaving my beloved California would somehow change who I was, but this advisor’s words reassured me that the choice of who I was and what kind of physician I would become was mine, and mine alone. My perspective immediately changed: the power of choice was never lost.
As a healthcare provider and professional with more than 20 years of experience, I would offer that in the ‘new world,’ post-Roe v. Wade, we still have the power of choice. We can choose to offer employer benefits that ensure equitable access to emergency reproductive services for all. We can choose to ensure that anyone who presents in our emergency rooms, regardless of their ‘essence’ or choices, will get the care they need. We can choose to act and not just talk about diversity, equity and inclusion in healthcare and the workplace. We choose what does or does not happen to our bodies.
Americans expect choice, and the power of choice is still ours. What do you choose?
About the author
Dr. Melissa Welch is the Chief Medical Officer at Health Catalyst, serving as the physician voice supporting growth across all areas of the business to drive data-informed healthcare improvements. She is an accomplished senior executive physician and a veteran in the advocacy for diverse and under-served populations.
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