Abortion Bans and High-Risk Pregnancy: What Happens When the Law Is in the Exam Room

Prefer to watch? View the full interview below.

Pregnancy is not medically predictable, and the decisions made during a pregnancy do not always fit neatly into political language.

In this episode, I sit down with maternal-fetal medicine specialist Dr. David Hackney, author of Impossible Choices, to discuss what happened when the Supreme Court’s Dobbs decision overturned Roe v. Wade and Ohio’s abortion ban immediately took effect.

Dr. Hackney was on call for high-risk obstetrics that day. Suddenly, the medical decisions he might be required to make over the weekend carried the possibility of criminal consequences.

Our conversation moves beyond the usual political arguments to examine what abortion bans mean in real clinical situations—including miscarriage, cancer, heart and kidney disease, severe pregnancy complications, and fetal conditions in which the baby will not survive.

In this episode, we discuss:

• What a maternal-fetal medicine specialist does and why abortion laws affect every area of medicine
• Why the medical term “abortion” includes more circumstances than many people realize
• What changed for Ohio physicians and patients immediately after the Dobbs decision
• The crucial legal difference between an abortion “exception” and an “affirmative defense”
• Why placing the burden of proof on physicians can create fear, hesitation, and delays in care
• What happens when a wanted pregnancy develops a devastating complication
• Why abortion bans also affect oncologists, cardiologists, anesthesiologists, emergency physicians, and other healthcare providers
• How uncertainty can lead to decision paralysis when a patient’s condition is worsening
• The human stories hidden inside legal language and court filings
• Why Dr. Hackney believes physicians have a responsibility to speak openly about laws that affect patient care
• How Ohio voters responded through the 2023 reproductive-rights amendment
• What patients need to understand about the emotional and psychological pressures physicians face when making these decisions

This conversation is not about reducing a complicated issue to a political slogan. It is about understanding what happens when the law enters the exam room and limits the choices available to patients and the physicians caring for them.

About Dr. David Hackney

Dr. David Hackney is a maternal-fetal medicine specialist who cares for patients experiencing high-risk and medically complicated pregnancies. He is the author of Impossible Choices, which explores the medical, legal, ethical, and deeply human consequences of abortion restrictions following the Dobbs decision.

Book: Impossible Choices

Content note: This episode includes discussion of pregnancy loss, serious pregnancy complications, fetal diagnoses, and maternal death.

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Until next time, be brave enough to be real.