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Iowan Physicians: Fetal Heartbeat Law Devalues Medicine and Devalues Women

The following manuscript was submitted to the September 2018 Women in Medicine theme issue.


by Melissa Palma, MD, graduate of the University of Iowa Carver College of Medicine; Sarah Gross, MD candidate and president of Medical Students for Choice at the University of Iowa Carver College of Medicine; and Deepika Raghavan and Hannah Pope, MD candidates and co-presidents of the American Medical Women’s Association at the University of Iowa Carver College of Medicine


For most of our childhoods growing up in the Midwest, the Iowa we called home was a swing state proud of its investments in education, was welcoming to refugees from around the world, and was the third U.S. state to legalize marriage equality. We used to proudly tell friends the University of Iowa had a historic number of women, eight to be exact, in the inaugural medical school class of 1870.

We are now ashamed to admit the Iowa governor just signed the most restrictive anti-woman law in the country.

As citizens, as physicians and physicians-in-training, and as Iowans, we submitted our opinions to the Office of Governor Kim Reynolds in strong opposition to Senate File 359: An Act Prohibiting and Requiring Certain Actions Relating to a Fetus and Providing Penalties. In face of its passage, we urge other Iowans to do the same.

For every woman seeking an abortion, the law now requires doctors to perform an abdominal ultrasound to detect a fetal heartbeat. If a heartbeat is detected, which could be as early as six weeks into a pregnancy, the physician cannot perform the abortion.

Working in primary care clinics, we have counseled countless women who carefully consider the complex social, financial, and medical considerations whether to continue or end their pregnancies. No matter what their choice, we connect with our patients as human beings first through respect and support.

No doctor should have to practice in an environment where doing their job and caring for patients is a crime. The bill in question grants women legal immunity for seeking an abortion, but it does not offer the same protection for physicians.

The medical student community, the University of Iowa Hospitals and Clinics OB-GYN department, and the Iowa Board of Regents are strongly opposed to S.F. 359. This bill is detrimental to women’s health care across the entire state, and the people of Iowa deserve better.

According to the American College of Obstetricians and Gynecologists, Iowa ranks second to last in number of OB-GYN physicians per capita of women. The only OB-GYN residency in the state is at risk of losing accreditation.

The state of essential women’s health care services was already decimated by then-Governor Terry Branstad’s rejection of over $3 million dollars of Medicaid funding in 2017. That choice closed four of 12 Planned Parenthood clinics, particularly in southwest Iowa, robbing women of vital preventive health services such as Pap smears, mammograms, and contraceptive care to women in rural Iowa.

We cannot afford to pass more draconian, restrictive legislation that devalues medicine and devalues women.

While independent, women-centered facilities such the Emma Goldman Clinic still exist in Iowa City, a non-existent public transportation system between rural and urban areas of the state means women forego essential health care.

As medical professionals, we cannot turn our backs on our patients. Abortion is health care. It is a common surgical procedure backed by evidence-based medicine. This law doesn’t put patients first. It could destabilize the entire women’s health care system in Iowa.

We urge our representatives to oppose this dangerous legislation. Let doctors be doctors. Trust Iowa women, who in turn trust their physicians, to provide sound, scientific, and safe medical care.

Author’s note: This article was also published by the Daily Iowan.

Melissa Palma, MD Melissa Palma, MD (4 Posts)

Resident Physician Contributing Writer

Melissa Palma is an aesculapian advocate who trained in family medicine at a Latino-serving community health center. Her writing reflects on the privileges and responsibilities we have as physicians to advance health equity for our patients and our communities. When not in the hospital, you can find her studying or reading non-fiction while nursing a taro boba tea.