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The fiercest battle of the culture wars is raging over a woman’s right to make her own medical decisions in consultation with her medical professionals.

Ever since the Supreme Court overturned the protections of Roe v. Wade, each state has become a battle ground. Attacks on women by Republican-dominated state legislatures are escalating.

Fifteen states now ban abortion at conception: Alabama, Arkansas, Idaho, Indiana, Iowa, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, Oklahoma, South Dakota, Tennessee, Texas and West Virginia. No exception is made for rape. Other states have installed arbitrary cut-off dates of six weeks (Florida, South Carolina, Georgia); 12 weeks (Nebraska, North Carolina) and 15 weeks (Arizona). None of these dates are medically related to a woman’s health or the potential medical problems of pregnancy.

Although these bans are significant milestones, punishments in the various laws speak to a darker scenario. Texas offers a “bounty” for anyone who accuses a woman of ending a pregnancy. Other states penalize doctors for performing their medical duties. In Ohio, the state attorney general sought to penalize the doctor who sent a 10-year-old rape victim to another state for an abortion.

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Other states have laws that penalize obstetricians and gynecologists for performing or even referring a woman for an abortion. The decision to offer medical care, even in instances of pregnancy complications, is not in the hands of a medical professional. It has become the decision of politicians who run for election. Consequently, there is an emerging trend of OB-GYNs leaving states with strict laws, thus creating maternity care deserts.

The U.S military is in the middle of this fight.

Sen. Tommy Tuberville (R-Ala.) is blocking all military promotions until the Defense Department changes its rules on women’s health care. Current DOD policy states if a servicewoman and her loved ones cannot get the OB-GYN care she wants in the state where her base is, the DOD will pay her transportation cost to a state where she can get the necessary care. If Tuberville and his allies persist, national security will suffer.

The recent election in Ohio demonstrated the general population is opposed to overly strict regulations. But the culture warriors stand four-square for putting a lawyer between a woman and her health care provider at the earliest possible moment. We have seen reports from Texas in which hospital lawyers — not doctors — had to go to court to make the case for the care a woman needed.

In Virginia, the governor has promised he would sign any bill limiting OB-GYN care that came to his desk. Therefore, this November’s elections, especially for the House of Delegates, will be a fork in the road for Virginia and women’s health.

In the 62nd House District, Sara Ratcliffe has made clear that, as a woman and a mother, she considers fertility and reproduction a high-priority issue. She has written that “decisions around when, how, whether and with whom we have children are some of the most important and most personal decisions we make in our lives. People must have the right to make those decisions safely and privately, without political interference or judgment from those with a political agenda. Each of us should be able to make decisions about our own health and future with dignity and respect.”

Needless to say, Ratcliffe has been endorsed by Planned Parenthood and REPRO Rising.

The lines have been drawn. Either a woman and her medical professional are responsible for her medical treatment, or the government of Virginia is responsible for anticipating all possible medical outcomes as it decides when it will allow medical intervention.

Keep that in mind when you are in the poll booth this November. Women’s health and their right to self-determination are on the ballot.

David Reuther is a retired U.S. Foreign Service officer who served in Asia and the Middle East.

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