Are women’s health care and our business economy in peril?
Published on 4/1/2023
A diverse crowd of more than 60 people gathered at the Crawfordsville District Public Library last week to learn about Indiana’s new reproductive health policies. How are last summer’s Supreme Court Dobbs Decision and the passage of Indiana’s Senate Bill 1 affecting the economic and public health profile of our state and our community?
Women of childbearing age are at the center of this discussion. Currently abortion continues to be legal in Indiana while the Indiana Supreme Court considers the two injunctions filed against Senate Bill 1: One case claims SB 1 is illegal under the Indiana Constitution privacy clause; the other case claims illegality based on equal rights and religious freedom. Nonetheless, the passage of SB 1 has had a chilling effect on Indiana’s medical and business communities. These directly affect our economy. Indiana’s flagship and smaller businesses alike have raised the red flag about worker retention and hiring. They are deeply concerned that a substantial change in healthcare policy would be “at best detrimental and at worst reckless” to their workforces and to hiring potential. Two of Indiana’s largest employers, Indiana business juggernauts, Eli Lilly and Company and Cummins, Inc. wrote public letters with this warning the day after SB1 passed the Indiana Senate last August.
Mayor Todd Barton led off the evening, welcoming our guest speakers and the audience. He also provided perspective on our local economic and medical care situation. As “Cheerleader-in-Chief” for Crawfordsville he is deeply involved in the economic development of our community. When businesses choose to come here, many things are considered: land, utility rates, and healthcare are central in the decision-making process. Businesses and individuals rank health care as a high priority: its cost, its access, its quality. Since young families are especially concerned about reproductive and child health, we have to discuss this as a state.
Barton suggested that our legislators meet in General Session to address this issue directly. He encouraged citizens to let their representatives and senators know how vital this is to us right here, right now. The League of Women Voters of Montgomery County reminds the public that they are invited to register for the Chamber of Commerce State Legislative Breakfast to be held April 15.
How did we get in this worrisome situation? A panel of three professionals in the fields of medicine, business affairs, and economics were on hand at the “Indiana’s New Reproductive Policies” event to provide the local audience with more information. Local Nurse Practitioner Christine Amidon moderated the panel.
Dr. Caroline Rouse is a maternal-fetal medicine specialist in Indianapolis. She is a highly regarded spokesperson for her profession. Maternal-fetal doctors serve patients before pregnancy, during pregnancy, and post partum. They also monitor fetal health. Rouse and most of her colleagues are qualified to provide abortion as part of overall care. Abortion care has been part of Rouse’s women’s healthcare practice.
When asked during the questioning period, Rouse reported that 96-97% of all abortion surgeries (performed legally and safely under physician’s care) occur during the first trimester; virtually all other abortion surgeries are performed either because of risk to the mother’s health or because of major fetal anomalies or morbidity.
To help the audience see the bigger picture, Rouse set women’s health in context: even before 2022’s Supreme Court decision striking down Roe v Wade and prompting Indiana’s Senate Bill 1, Indiana was already in a public health and maternal care crisis. Indiana currently ranks 45th in the nation in public health care spending. This has significant impact on general health and maternal heath care in our state. In Indiana, maternal deaths at the time of birth are 26/100,000 for white women and 70/100,000 for women of color. More than one-third of Indiana’s counties lack obstetric care (Montgomery County is one of them). For a significant amount of Indiana women, obstetric medical care is more the 30 minutes away. This can cause a dire situation in an emergency.
In states when near total bans on abortion are in force, the risk of maternal death climbs significantly — as much as 33%. It is also important to know that maternal death in childbirth is 14 times higher than deaths associated with abortion care.
Data from the nation’s public health departments show that lack of reproductive care — good prenatal care, fetal care, and abortion care — has morbidity effects on women over the course of a lifetime. Women in poverty and women of color bear disproportionate burdens in this regard. In response to a question from the audience, Rouse noted that 70-80% of women seeking abortions through a legal provider already have one living child and that one in every four women in America has received abortion care.
Rouse also reported that currently “abortion restriction is a physician workforce issue.” On “Match Day” last year, the day when c. 2000 medical students are matched with residencies, 80% of them said they would not accept residencies in states with restrictions to reproductive care. “Match Day” is for doctors of all specialties.
In Idaho where strict abortion restrictions are in place, a survey showed that 45% of their OBGYNs want to leave the state. Hospitals are closing. This is a dire situation. While Gov. Holcomb has proposed significant increases in public health funding, it remains to be seen what the legislature will do.
The next State Legislative Breakfast takes place at 9 a.m. April 15 at the Hoosier Heartland State Bank Success Center, 1623 S. US 231, Crawfordsville. Cost to attend (with or without breakfast) is $10. Space is limited. Register to attend online at www.CrawfordsvilleChamber.com by April 12. Contact Chamber of Commerce Director Stacy Sommer for more information at: ssommer@crawfordsvillechamber.com.
Next week’s column will continue this conversation by looking directly at how businesses and our state’s economy stand to be affected in this medical climate.