The Supreme Court’s decision to overturn Roe v. Wade delivered a deadly blow to reproductive health in the U.S. But the threat to the health of women, trans-men and non-binary people is not likely to end there.
For Dr. Mary Jacobson, an OB-GYN and the chief medical officer at digital healthcare company Alpha Medica, women’s health as a whole is at a pivotal moment in history, and employers need to be aware of what may be on the horizon.
“To revoke the right women had to terminate a pregnancy from 50 years ago is to potentially revoke other rights,” says Dr. Jacobson, noting that women’s health also impacts patients who may not identify as women. “I’m concerned about our democracy being threatened by autocracy and what will play out in the next eight years.”
Read more: Two moms share their experiences with abortion care
Dr. Jacobson notes that recent legislative action has already put contraceptive access and gender-affirming care into question. In fact, more than half of the states have sought to restrict or eliminate gender-affirming care, with total bans passing in Arkansas and Alabama and partial bans being passed in Texas and Florida by the state’s medical board. The Right to Contraception Act has been blocked by Republican Senator Joni Ernst and is currently stuck in the Senate.
But abortion care, contraceptive access and gender-affirming care can be life-saving for any individual who was assigned female at birth as well as trans women, explains Dr. Jacobson. A study published in the peer-reviewed journal Obstet Gynecol found that the risk of death associated with childbirth is approximately 14 times higher than that with abortion. Research published in JAMA Network Open found that gender-affirming care, including puberty blockers and gender-affirming therapy, was associated with a 60% less likelihood of moderate or severe depression and 73% less likelihood of suicide.
For Dr. Jacobson, the negative rhetoric surrounding these aspects of healthcare is not concerned with Americans’ well-being, but rather with control.
“This is a way of minimizing women, making them second-class citizens,” she says. “There seems to be this movement towards wanting to get back to this idea of the 1950s.”
But that ideology does not align with the majority of the American public. According to Pew Research Center, 61% of U.S. adults agree that abortions should be legal in all or most cases. Alpha Medical, which focuses on delivering women’s health services digitally and discreetly, saw a five-time increase in demand for emergency contraception after the overturning of Roe v. Wade. Notably, in six states — namely Arizona, Arkansas, Georgia, Idaho, Mississippi and South Dakota — pharmacists can legally refuse to fill somebody’s prescription based on a moral or religious objection. But companies like Alpha Medical can still ship emergency contraceptives to people living in these states.
Read more: How Plume is making gender-affirming care accessible across the U.S.
“To be clear, emergency contraception prevents pregnancy. It’s not an abortion,” says Dr. Jacobson. “But if emergency contraceptives get banned in states legally, we cannot prescribe patients emergency contraceptives. Let’s hope that we don’t cross that abyss.”
Dr. Jacobson underlines that women’s health is already often undermined if not ignored in medical research and healthcare benefits, especially since a majority of research in the medical field is centered on white cis men’s bodies.
“Unfortunately, the way we train in medicine is on the male model, which leads to a lack of understanding about the intricacies of women’s health,” says Dr. Jacobson. “Reproductive health isn’t just about ovaries, uteruses and breasts — it’s about a whole person.”
This lack of knowledge comes with consequences for employers and employees alike. One of the most prominent ways companies are seeing this is with menopause. Dr. Jacobson notes the menstrual cycle itself can increase the rate of migraines, autoimmune disorders as well as anxiety and depression. Menopause can raise one’s risk of heart disease, stroke and osteoporosis. In a survey of over 1,000 women over the age of 35, fertility care company Mira found that one-third of respondents have been taking more sick days since the start of menopause, and two in five women are planning to retire early.
Read more: 4 ways to support employees who have lost access to abortion care
“These are high-level career women who are basically quitting because of their lack of options,” says Dr. Jacobson. “Because there is a lack of understanding in healthcare and the stigma they face after lost time at work.”
It doesn’t help that nearly half of the counties in the U.S. do not have an OB-GYN, according to MobileODT, a company that specializes in diagnostic devices for early cancer detection.
Dr. Jacobson advises employers to learn about reproductive health as a healthcare issue rather than a political one. If employers and company leaders lack a fundamental understanding of the health of their employees, they will not be able to effectively address it let alone support their workers, explains Dr. Jacobson.
“Try to develop an awareness,” she says. “Some of the employers we’ve spoken to do not really see a need for primary care focused on women or see a difference in women’s and men’s healthcare.”
Still, Dr. Jacobson has hope, especially as she seen more companies have questions about menopause and fertility benefits in the last year. However, she knows there is a lot at stake on a nationwide level.
“I’m cautiously optimistic,” says Dr. Jacobson. “I’m also mindful that the democracy we’ve built for the last few hundred years is at risk.”
