In the year since the U.S. Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision, overturning Roe v. Wade, women in many states with restrictive abortion laws have been blocked from receiving medications, like methotrexate, that successfully treat medical conditions such as Crohn’s, lupus and rheumatoid arthritis. Why? Because methotrexate can also cause pregnancies to end. Some clinicians and pharmacies worried about violating strict state abortion laws are refusing to provide these necessary medications to any female patient of child-bearing age—even if they are not pregnant.
We previously reported that immediately after the Dobbs decision, women in multiple states were blocked from receiving methotrexate to treat their chronic and, in some cases, life-threatening conditions. One year later, this is still true. Myisha Malone-King, a 42-year old patient advocate for inflammatory bowel disease and chronic illnesses from Baltimore, Maryland, confirms that she is still unable to get methotrexate to treat her Crohn’s disease. For Malone-King, a wife and mother of four, this means she had to go on other medications that had previously failed to treat her illness adequately. “I’m still in a flare-up from losing access to methotrexate,” says Malone-King.
The fallout from Dobbs will likely not end there. “Now that states have the right to block abortion, the FDA and some legislators are concerned that contraception is next, and I’m terrified they are correct,” says Chris Stallman, a certified genetic counselor, expert in medication impact during pregnancy and a clinical instructor of pharmacy practice science at the University of Arizona R. Ken Coit College of Pharmacy. “The powers that be have told us, and showed us, they are coming for contraception.”
Stallman is referring to Supreme Court Justice Clarence Thomas arguing last June, soon after the Dobbs decision, that the court “should reconsider” its past rulings codifying rights to contraception access, same-sex relationships and same-sex marriage. Stallman points to the June 2014 ruling, Burwell v. Hobby Lobby, in which the Supreme Court allowed certain companies to block their female employees’ access to birth control. The decision on this birth control case applied to more than half of all U.S. workers—that’s tens of millions of employees at companies in which five or fewer people own more than 50%. Of note, these employers did not block access for their male workers to have vasectomies, a form of birth control, or medications for erectile dysfunction.
Since the Dobbs decision, struggles over birth control rights have been increasingly linked with those regarding abortion. In December 2022, U.S. District Judge Matthew Kacsmaryk found that a federal program granting teens access to birth control denies a parent “a fundamental right to control and direct the upbringing of his minor children.” Teens in Texas now require parental permission to get birth control. Thomas’ comments and these actions have spurred reproductive rights advocates to push for new protections for birth control at the state level.
Female oral contraception is used not only for birth control, but as treatment for many medical conditions, including polycystic ovary syndrome, ovarian cysts, uterine fibroids and endometriosis. Oral contraception is also used to reduce the risk of ovarian and endometrial cancers for women at high risk to develop these malignancies, including women who carry a BRCA1 or BRCA2 mutation or those with Lynch syndrome. Blocking access to oral contraceptives to patients using them to treat or reduce the risk of serious health issues is equal to blocking access to methotrexate for women who use it to treat disease: It is an opportunity for our government to interfere with women’s bodies and their medical care, outside of pregnancy.
One year after the Dobbs decision, we have learned that this ruling is the gateway to government overreach, discrimination against women and interference in medical care. Our federal government must act swiftly to protect women and clinicians from further abuse.
– Chris Stallman, MLS, MS, CGC is a genetic counselor interested in health law and policy and expanding access to accurate health information.
Read the full article here
