In 2025, June 24th is more than just another day of summer. Today marks the three-year anniversary of the 2022 Dobbs decision, that resulted in the overturning of Roe v. Wade, ultimately ending constitutional protections for abortion access.
During these last three years, we have witnessed drastic changes in our health care landscape, specifically regarding access to abortion, contraception, and full-spectrum sexual and reproductive health care. The Dobbs decision has and will continue to have escalating implications for patients, providers, advocates, and the future of health care as we know it.
Since the Dobbs decision, there has been a significant uptake in the criminalization of patients seeking care, and people who are just experiencing the complex nature of being a pregnant person. We have seen patients travel from state to state under immense pressure and fear to receive the care they need, a Black woman be charged with a felony for a miscarriage, policy induced refusals of abortion care resulting in the loss of countless lives, and so much more devastation and confusion—all of which was, and still is, preventable. Simultaneously, the overturning of Roe has completely altered the work of physicians who provide abortion care, with cascading adverse effects on other landmark protections like the Emergency Medical Treatment and Labor Act. These laws have forced physicians to choose between uprooting their lives to states protective laws or remaining in restrictive states and risking further criminalization for providing the care they were trained to offer.
For decades, Physicians for Reproductive Health has remained committed to leveraging evidence-based practices to address misinformation, abortion stigma, and support the needs of our patients, especially those who face intersecting systemic barriers that exacerbate health disparities for those who are marginalized. A significant part of that advocacy work involves the resilience, authority, and lived experiences of Fellows in our Leadership Training Academy (LTA). This year, we called on LTA 2025 Fellows to share not only how the Dobbs decision has impacted their work, but also what the path toward restoration looks like in a post-Dobbs world.
Here we explore the grief, frustration, uncertainty, and hope of those on the frontlines of abortion care – featuring the perspectives of Dr. Elizabeth Sulger in New York, Dr. Kendra Harris in Massachusetts, and Dr. Janelle Lee in Arizona.
QUESTION 1:
Think back to summer 2022, what were things like for you as a provider when you first heard of the Dobbs decision?
“In June 2022, I was in the middle of my ob/gyn residency training, spending long hours at the hospital between labor and delivery and the operating room. The health care that I was honored to be providing was suddenly jeopardized overnight. I remember feeling the immediate impact of these injustices even in a protective state like New York. There were periods of confusion and delays in care, with patients suffering complications while waiting for life-saving treatments.
“I was caring for a pregnant patient in the second trimester with her family at the hospital bedside when she started developing sepsis. Earlier that week, I had reviewed the evidence-based medical recommendations, guidelines that would now be impossible for most doctors in the country to follow. Sitting with my patient, I felt angry and devastated for the countless people who would be denied abortion care and whose lives would be forever changed without this essential health care.
“Even as it was happening, it seemed surreal that our basic reproductive freedoms could be thrown into question overnight because of a ruling determined by people who had never practiced medicine, let alone cared for a pregnant patient.”
“The Dobbs decision was announced at the end of my final year in ob/gyn residency, at which time I already knew I was headed to fellowship. My entire Complex Family Planning fellowship was in a post-Dobbs world, and I was privileged to train in a state protective of abortion access with few restrictions.
“While completing my training I was simultaneously aware of my colleagues training and providing care in severely restricted states, as well as the harrowing journey patients were taking to receive basic health care.”
“June 24, 2022, was the day I graduated from Family Medicine residency. It had been over a decade of training that culminated in this moment. It was a moment that signified that I would be able to provide comprehensive reproductive care, including abortions, to help pregnant people who desperately needed access to safe and effective procedures.
“This was also the fateful day that the US Supreme Court issued the crushing blow of the Dobbs decision, overturning Roe v. Wade, stripping patients across the country of their constitutional right to abortion. As the news came flooding in, rather than celebrating the momentous occasion of graduation, my thoughts turned to wondering what would happen in Arizona, where I had committed to start my first physician job.
“This was a state that I knew already had profound legal restrictions with implications on patient access, including restricted gestational age limits, 24-hour consents, and further constraints on abortions that were not founded on medical science, but rather on political control. How would this further limit access? How would clinics stay open when the future was so uncertain? How many more people would be harmed by this decision?”
QUESTION 2:
How has the Dobbs decision influenced your ability to do your work and care for your patients? What has life looked like for you over the last three years?
“The Dobbs decision falling squarely within my residency training motivated me further toward reproductive justice and the pursuit of a fellowship in Complex Family Planning. I knew that the capacity to provide abortion care would be unpredictable and limited in a future without Roe v. Wade, and I wanted to do everything in my power to meet those challenges as an advanced provider.
“The restrictions on providers were forcing many to move out of areas where they were being newly persecuted for their services, which has further widened health disparities. Subsequently, we saw an influx of referrals and complex cases coming into our network. This has meant more time learning about the logistics of travel and transportation, seeking additional resources and support for patients, and being flexible and adaptable to consistently changing circumstances. It has meant working tirelessly towards better patient care, even while knowing that the future is uncertain.
“The Dobbs decision and subsequent abortion bans created greater physical, financial, and administrative barriers for people, and have also created more fear about the criminalization of pregnancy. I do this work, centered around advocacy and increasing access, so that people are not afraid to seek medical care for their pregnancy complications due to the fear of being arrested.”
“Training in a post Dobbs world, I have continuously prioritized my goal of learning to be a physician advocate who influences state and institutional policy, through lobbying, testifying and protesting, with the goal of connecting it all back to patient care.
“Policy has become increasingly hostile towards abortion and sexual health providers like myself and sadly this has emboldened some in the anti-abortion movement to become violent. My job is to advocate for and provide evidence-based, compassionate, equitable health care for my patients while keeping myself and my family safe.”
“As a parent and as a full-spectrum family physician who provides comprehensive reproductive care that spans preventative care, family planning, contraception, obstetrics, and pregnancy termination, I struggled deeply with this government ruling that interfered with a person’s right to choose. The ban forced me to evaluate whether I could be more effective serving on the Board of Directors of an abortion organization, versus providing direct patient care as an abortion provider. I ultimately chose to continue using my skills by providing direct patient care, ensuring quality access, and collecting the many stories my patients share. Six months after the decision, I became an abortion provider in a restricted state.
“As a rural health provider, I did not let a 200-300-mile commute to the nearest abortion clinic limit my resolve to provide safe and equitable abortion care. It was a distance many patients face who do not have the luxury of traveling out of town to access the full spectrum of care needed to complete an abortion. The hardships of taking time off work, the logistics of travel, and child-care arrangements were palpable and real. While I committed to making that commute two or sometimes three times a month, provider availability was often the limiting factor of whether someone could have their abortion scheduled within their gestational age limit, versus requiring an out-of-state referral, which was often more costly and intangible.
“While the Dobbs Decision felt like a sobering blow, the ensuing Arizona State Supreme Court ruling in April 2024 that upheld the 1864 pre-Roe, pre-constitutional, pre-statehood, near-total ban (limiting abortions except for in cases of saving a pregnant person’s life without exceptions for incest or rape) sent a wave of profound concern across all fifty states. Fortunately, we had the support of newly elected Democratic Governor Katie Hobbs, along with another fierce advocate, Attorney General Kris Mayes, who worked tirelessly to repeal the draconian ban and allow procedures to continue while deliberations were happening at the Capitol.
“While this was unfolding, lawmakers and politicians had also been busy promoting Proposition 139, a ballot measure that would amend the state constitution to provide for the fundamental right to abortion in Arizona. This would protect people by limiting the State’s interference with that right before fetal viability, which would repeal the current gestational age restriction of 15 weeks and increase access up to 24 weeks. Quickly, I mobilized with fellow supporters to petition for signatures and phone-banked for a full year until the initiative passed in November 2024, which superseded the 1864 ban, demonstrating that 62% of voters cared deeply enough to show up at the polls and demand access to abortions in Arizona.”
QUESTION 3:
What does the path to restoration following the Dobbs decision look like? If you could design the next phase of reproductive health care, what would you include in it?
“The path to restoration starts in the community, focused on those we can help with our own hands, words, and network. There’s no question that universal access to safe and dignified reproductive health care, free of fear and stigma, would make our communities happier and healthier. In the next phase of reproductive health care post Dobbs, I would make louder the call to all providers regardless of specialty to find the ways that they can advocate care and access within their own communities and resources.
“Reproductive health care does not just include abortion care, management of pregnancy, prenatal care, and contraception. It encompasses all aspects of our society: sex education, adolescent health, menopause health, paid parental leave, gender equity, income equality, food and housing security, climate safety, and so much more. The intersectionality of our social issues and how we navigate ourselves and our families are intertwined in all that we do.
“Once we all feel the urgency around a communal approach, acknowledging that reproductive health is an inherent part of being human and something that we all share, we will be better able to find ways to help each other. This is what motivates me to provide care despite the constant barriers, opposition, and risk; there will always be a need for reproductive healthcare and abortion.”
“Universal healthcare that is not dependent on a person’s zip code, employment status or immigration status is crucial to the restoration of reproductive health care following Dobbs.
“The Dobbs decision eroded my trust in America, yet throughout the last 3 years I’ve been amazed by the ingenuity and unyielding resilience of the reproductive health community, and it is those individuals who have kept me grounded and determined.”
“Looking back on the last three years since Roe fell, I have met incredible people involved in this movement, from allies who support abortion legislation to political candidates, patients, families, and powerful storytellers who vocalize their truth. I have witnessed patients, nurses, doctors, lawyers, doulas, and people running for office who have come forward to fight for what is right. Whether they are coming forward with their abortion stories or supporting someone else’s harrowing narrative, the bottom line is THIS FIGHT IS NOT OVER, and people must continue to put their hearts on the line to remind each other of one another’s humanity.
“The deep divide in our country traps patients in a vicious web of disruption, misinformation, and uncertainty about their rights. Emergency care is being delayed, with dire consequences, and women are dying in the process of doing what they feel is right for their bodies. WE MUST TRUST OUR PATIENTS. We must trust them to know when the right time is to continue a pregnancy or when to stop one. We must listen to their stories and advocate for what we know to be true and accurate. We must strengthen our alliances to be smarter and better. We must not back down. WE MUST WIN.”
Conclusion
In a world post-Dobbs, there is much to be learned from providers on the frontlines of sexual and reproductive health care. Despite living in different areas throughout the country, we see many parallels throughout the stories and reflections of abortion providers. Their candor bolstering that the Dobbs decision did not just shift policy but reshaped the entire reproductive health care landscape for patients and providers.
While things may seem bleak, the influence of community advocacy and storytelling alongside the compassion of providers, and their commitment to centering the needs of the induvial patient over the pushback from anti-abortion law makers give us more than hope—it gives a blueprint for reimagining care on our own terms as we continue to resist the carceral state. At PRH, we believe and will continue to emphasize that politicians have no business making permanent decisions about if, when, and how people access full reproductive health care –especially as their targeting is rooted in junk science, misinformation and stigma. Even under these circumstances, we will not faulter as we know that truth, evidence, and integrity are far more sustainable than the lies and threats from anti-abortion extremists.
