The U.S. Supreme Court this morning announced a ruling overturning Roe vs. Wade, the 1973 Supreme Court decision that made abortion legal throughout the United States. The court’s decision in a closely watched case that challenged Roe v. Wade means that each individual state now will follow its own laws regarding abortion, with at least 26 states poised to immediately ban or heavily restrict access to abortions.
Under current state law, abortion will remain legal in Illinois, and RUSH University Medical Center will continue to provide the full spectrum of reproductive health services for patients as part of the RUSH’s commitment to their health. The Department of Obstetrics and Gynecology offers services including options for contraceptive care, prenatal care, high-risk pregnancy care, parenting, adoption, and safe, compassionate and confidential abortion care without judgment, and they are available to all patients who need care. (RUSH Copley Medical Center and RUSH Oak Park Hospital also provide reproductive health care but do not provide elective abortion services.)
The Department of Obstetrics and Gynecology provides care for 40,000 patients a year, delivering nearly 3,000 babies and performing nearly 2,000 surgeries annually. “This piece of what we do is a part of the full breadth and depth of reproductive care,” says Cynthia Brincat, MD, PhD, chairperson of the department and interim dean of RUSH Medical College.
“Abortion and access to this full spectrum of maternal, sexual and reproductive health care options are absolutely essential to people’s health, safety and well-being and should be looked at as a core principle for what obstetricians and gynecologists provide,” adds Sloane York MD, MPH, associate professor of obstetrics and gynecology and director of the ob-gyn residency program.
RUSH is committed to safeguarding providers’ ability to deliver health care and to the confidential relationship between providers and their patients regarding every health care decision, including reproductive and pregnancy care. RUSH respects and affirms the needs, desires and privacy of all our patients.
“We don’t want outside influence to interfere with the relationship between the health care provider and their patient, and we know that most physicians and other health care providers provide medical care without that outside interference,” York observes.
Illinois Offering Care Not Available in Neighboring States
Illinois is a destination for people seeking abortions, many of them coming from neighboring states that already had imposed limits on abortion. According to the Illinois Department of Public Health, about 10,000 pregnant people traveled to Illinois for abortion care in 2020, about 29% more than in 2019.
This number is expected to increase dramatically now that Roe v. Wade has been overturned, causing an estimated 100 million people to no longer have any access to legal abortion in their state of residence. The Chicago area alone is expected to see at least twice as many abortion patients coming from other states, with some estimates projecting 20,000 to 30,000 more.
“We’re expecting to see patients drive from Michigan, Wisconsin and Indiana, but also fly from Georgia, Missouri, Mississippi and likely more,” says Laura Laursen MD, MS, assistant professor of obstetrics and gynecology and medical director of inpatient obstetrics.
“Regardless of the law, patients are going to access abortion. If you look at studies for years and years, abortion restrictions don’t change the actual number of abortions, but they do change how abortions are done,” Laursen adds. “Historically, it was unsafe abortion. We’re hoping in this iteration, we will not have to go through that as much.”
Preparing for Additional Out-of-state Patients
Whether from within Illinois or out of state, most patients seeking abortions will receive services at community-based centers, but a proportion of them will have complex conditions related to their pregnancy that will require a level of care not available at these facilities. As part of one of the country’s best academic medical centers, the Division of Family Planning within the Department of Obstetrics and Gynecology is highly qualified to provide both routine care for patients with unplanned pregnancies and advanced care for patients with complex medical conditions, patients who are carrying fetuses with congenital anomalies or patients who are unable to be seen at other clinics due to medical or surgical issues or for any other reason.
RUSH University Medical Center also is working with several other Chicago-area hospitals and health systems to prepare to manage the surge of patients expected. “We’ve been talking about how we build capacity across the ambulatory side, where they will be inundated with patients at the free-standing clinics, as well as the notable number of patients who will need to be seen in inpatient settings such as RUSH University Medical Center,” says Sadia Haider MD, MPH, director of the Division of Complex Family Planning and of the division's fellowship program.
This work includes creating a cash payment program for out-of-state patients who have medical insurance that RUSH doesn’t accept and subsidies for those patients who can’t afford to pay for the care out of pocket. In addition, the RUSH Family Planning Fund, which is supported by charitable donations, covers ancillary costs such as travel, lodging and child care, and RUSH University Medical Center’s charity care program covers the costs of additional care for complex conditions, such as pre-operative screening.
RUSH’s commitment to providing comprehensive reproductive health care also is part of an overall commitment to advancing health equity. The health, economic, and social burdens of being unable to access abortion care will fall disproportionately on lower-income individuals, worsening inequities in health outcomes. RUSH will continue to ensure that our patients have access to quality and affordable reproductive care, especially those patients with the least resources and greatest challenges to access.
The Rush BMO Institute for Health Equity is dedicated to the elimination of all health inequities. At the foundation of efforts to eliminate health inequities is the promotion of human rights. The Institute will continue to advocate for the rights of historically marginalized people to achieve the very best in health and health care, including the right of all women to access abortion and other reproductive health care.
“All races, all ethnicities are represented in abortion patients. That being said, access to quality reproductive health care has great inequities,” York says. “We see this dramatically occurring in access to reproductive health care, access to safe contraceptive care, maternity care, but also who accesses abortion care, who has unplanned pregnancies or medical complications that make it unsafe for them to continue a pregnancy, and we know that low-income individuals, poor individuals are three-quarters of our abortion patients.”
“We already take care of the most historically marginalized patients, both in and out of state,” Haider adds. “These restrictions are just going to increase the numbers and will exacerbate the inequities.”