GRAND RAPIDS, Mich. — Doctors are on the frontlines of a political battle raging across the country, as abortion rights are added to the ballot in the first election since the Supreme Court overturned Roe v. Wade. Michigan is at the heart of the struggle.
“Doctors fought hard for these rights because we’re sick of watching women die,” Melissa Bayne, an OB-GYN in Fremont, Mich., told the audience at a rally Saturday in Grand Rapids. Her voice shook as she told the stories of patients who’ve died from pregnancy complications. The risks of forcing rape victims to carry their attacker’s child are all too real, she said: “As much as I don’t want patients or you to go through this, they do and have. Every day, I see women who’ve had consent stolen from them. Every day.”
For decades, Roe v. Wade blocked a 1931 law that banned abortion in nearly all circumstances in Michigan. With the Dobbs decision, the state is at risk of reversing close to a century’s worth of abortion rights. State courts have held it off so far, but Michigan’s Republican House and Senate have shown interest in bringing an appeal to the Supreme Court. On Tuesday, Michiganders will on Proposition 3, which would enshrine abortion access in the state constitution, permanently protecting abortion rights. It is one of five states, alongside California, Vermont, Kentucky, and Montana that will vote on an abortion bill in the midterms.
The prospect of having to deny patients medical care has turned normally apolitical health care workers into a legion of campaigners. Physicians, medical assistants, and nurses rallied to help get Prop 3 on the ballot. More than 1,500 health care professionals signed an open letter to support it, backed by leading medical organizations like the American College of Obstetricians and Gynecologists. Medical professionals, fearful for their patients’ lives, have increasingly embraced advocacy as a part of their role. The weekend before Election Day, physicians made phone calls, canvassed colleagues, and spoke at rallies.
Around 70 supporters listened to Bayne’s talk in Grand Rapids, in a wood-paneled room of a restaurant in a red brick mansion, set back from the road, and shielded from the loudspeaker of a small group of protesters outside.
“These are issues our patients will deal with on a daily basis,” said Greg Goyert, an OB-GYN and maternal-fetal medicine specialist at Henry Ford Health in Detroit. Goyert said he only waded into politics after Roe was overturned and, while not at the rally, has spent the past few months advocating for Prop 3. “The stakes are so high and the dangers so real, myself and so many other physicians felt the need to speak.”
Bayne isn’t usually so politically active, she said. But as Michigan debates the future of abortion care, she can’t stop thinking about one young woman she saw 17 years ago. The patient’s water had broken in her second trimester, meaning the fetus wasn’t viable and she was at risk of infection without intervention. But the hospital where Bayne worked, a religious institution, refused treatment. She was sent home.
When she came back a week later, she was in septic shock. She stopped breathing. Bayne pumped down on her chest, going through the motions of CPR, but the threat to the mother’s life could no longer be reined in. The young woman died beneath her hands.
“It nearly broke me,” said Bayne. “She could have been saved.” If Prop 3 doesn’t pass, she said, pregnancy will become that much more deadly in Michigan.
The odds of it succeeding are close to a coin toss. Although 80% of people in Michigan believe abortion should be legal at least in cases of rape and incest, and the majority disagree with the Supreme Court’s reversal of Roe, the polls for Prop 3 are tighter, at around 55%. Those in opposition claim that Prop 3 goes too far, and have spread disinformation that it will permit abortion throughout a pregnancy, mean children can get sterilized without their parents’ knowledge, or allow non-physicians to perform abortion. Some of those false claims were echoed by the protestors on Saturday, from a group called Progressive Anti-Abortion Uprising.
Kansas, which voted to keep existing abortion protections, was the first state to show that reproductive health care doesn’t follow traditional political divides. Organizers in Michigan are hoping to repeat their success. Planned Parenthood, together with ACLU and advocacy group Michigan Voices, banded together to create Reproductive Freedom for All. The campaign raised $34 million, according to campaign finance reports, and spent $26.2 million before the end of October to get their message across. Physicians have been a major part of the strategy.
“Health care workers advocate because their practice is on the line,” said Nicole Wells Stallworth, executive director of Planned Parenthood Advocates of Michigan. “This is a health care decision, period.”
The issue has not fallen neatly along partisan lines. At Saturday’s rally in Grand Rapids, Stallworth and Bayne were joined by former Republican strategist Jeff Timmer, Republican philanthropist Judy Frey, and Alexis McGill Johnson, president and chief executive of Planned Parenthood Federation of America.
Timmer told the audience he has five children, one of whom is adopted, and advocates for adoption over abortion. “Not long ago, I would have been advising the no side,” he said. But the reality of a post-Roe world made him grapple with the implications of forcing people to carry pregnancies. The 1931 law would ban abortions even in cases of rape, incest, and threats to the pregnant patient’s health.
“Making someone carry a rapist’s baby is insane and monstrous and most people know that,” said Timmer.
Bayne’s remarks followed those by Lauren Coman, who spoke about nearly dying from an ectopic pregnancy that ruptured her fallopian tube, and was only able to have a second child because her following four ectopic pregnancies were all treated with medication rather than surgery, so her remaining fallopian tube remained intact. “Whose lives are we considering here?” she said.
After the talks, Bayne compared notes with other physicians on the rising hostility doctors face from patients who are fed disinformation. Covid has made them a target.
“Who do you think doctors are?” she said. “They’re me. We spend our whole lives protecting children.” The same patients who refuse transfusions because the blood was donated from vaccinated people also railing against abortion rights, according to her colleagues.
“It’s the same people saying fuck you just for wearing a mask,” said Jehanna Erho, an OB-GYN in Fremont who works with Bayne.
She is Canadian, and never expected health care to become political. But she has already watched patients suffer because of the Dobbs ruling. A few months ago, a woman came in whose water had broken at 15 weeks. The fetus would not survive, but because it still had a heartbeat, Erho couldn’t provide treatment. “She had to sit and wait for the fetus to die. Can you imagine that trauma?”
She’s angry, and not asking rhetorically. She waits for a response to an unanswerable question. “I have to tell patients our hands are literally tied,” said Erho, holding her hands in front of her, wrists pressed together. The 1931 law will allow abortion if a woman’s life is at risk, but not her health. Doctors and lawyers have no idea how to interpret that wording.
“How many liters of blood do they want?” said Erho. “Is it enough if it’s filling her shoes, do they need 2 liters of blood?” The decision has already forced health systems to reconsider how they provide care: For 72 hours after Dobbs, when Michigan physicians were unsure what law governed their decisions, they planned to transfer patients to counties where county prosecutors promised not to target doctors, said Goyert, the Henry Ford Health OB-GYN.
Doctors say patients’ approach to their own reproductive health has already changed. Before Dobbs, Bayne saw three patients a month who wanted to talk about sterilization. Recently, she saw three patients in just one day. The fall of Roe changed not just demand, but the risk calculus. She talks them through their options if they did get pregnant or faced complications. Would they have the resources to take time off work, pay for child care, and travel to a state where they could access care?
Faced with those options, she said, it is predominantly lower-income women who choose sterilization. The risk of pregnancy putting their life in danger is far too real for those who already struggle to access care, said Bayne. “Women like me who are Caucasian, have financial income, we will always be protected, we’ll be able to travel and go.”
Although she left the Catholic church soon after her hospital prevented her from saving her patient, Bayne sees her medical work as deeply intertwined with her Christian faith. She’s not alone.
On Sunday morning, in the city of Royal Oak just outside Detroit, Planned Parenthood’s McGill Johnson spoke to a congregation about both.
A community of around a hundred people, many older and most Black, listened and prayed on the importance of personal choice at Renaissance Unity Church, which holds its services in a movie theater. Church leaders stood in front of a movie screen backdrop of running water or lit candles, a gospel group singing “Listen to my choice.” Two-thirds of the congregation raised their hands to show they’d cast their vote early. “To stand silent is acceptable,” said church director Brett Tillander.
Rev. Glenn McIntosh spoke, with a knowing smile, about that one neighbor who always loves to gossip and pass judgment. Going outside yourself is a form of avoidance, he said, so much easier than looking inside. “When it comes to a woman’s body, it’s her decision,” he said ahead of the sermon. “God’s love supersedes everything. No matter what her choice, God supports you.”
Then McGill Johnson talked about faith as a precondition of hope. Her campaign had a lead in the polls, but a narrow one.
“You have the power. Don’t squander it,” she told the congregation, close to tears. “The cavalry isn’t coming to save us, because the cavalry is you.”
Her message was embraced by the Christians in the audience, including several health care workers like Barbara Floyd, a 66-year-old who distributes medication at a mail-order pharmacy. Floyd, like physicians in Grand Rapids who’ve worked to raise awareness of the stakes, said she’s been telling those around her to vote.
“You’d better step it up if you want your rights to be supported,” said Floyd. She grew up in foster care, and Planned Parenthood provided the first medical advice she got when she turned 18. “We need the right to govern our own bodies.”
Another church member, 80-year-old retired nurse Marion Vesely, cast her ballot for Prop 3 early. After a career spent under the protection of Roe, she cannot fathom patients having fewer rights now than they did under her care. “We’re not making much progress,” she said.
If Michigan doesn’t cement abortion protections, several physicians said they would stay in the state to help those left to navigate the new laws. “Where would we go?” said Diana Davidson, a family physician at the rally on Saturday.
Bayne isn’t so sure. She is nervously awaiting results of the vote, knowing well the devastation her patients will face if the measure doesn’t pass.
She can’t stop thinking about the young woman who died 17 years ago, and her own helplessness as she stood over her, unable to save her. It went against everything she has worked towards as a doctor. “I don’t know if I could practice in an environment where I’d be at risk of choosing between breaking the law and …,” she trailed off. “I can’t imagine being in that situation.”