Abortion was difficult to obtain in Missouri years before the U.S. Supreme Court overturned it. Roe v. Wade.
Lawmakers enacted regulations that put hurdles on abortion care: Clinic doctors had to get admitting permission from nearby hospitals, patients had to listen to state-mandated counseling that discouraged abortions, and they had to wait 72 hours to receive an abortion. Just 150 abortions were performed in the state in 2021. Missouri Independent Reported.
Supreme Court Dobbs v. Jackson Women’s Health Organization The June 2022 ruling made Missouri the first state to ban abortion. The ban includes: Medical EmergenciesDoctors say the law is unclear and vague, putting patients’ health at risk, and provides for prison sentences of five to 15 years and the suspension of medical licenses for doctors.
Last year, the political action committee Missourians Seek Constitutional Freedom The group, which formed to restore abortion rights, spent much of last year fighting in court over the ballot’s title and financial summary along with Attorney General Andrew Bailey and Secretary of State Jay Ashcroft, both Republicans who oppose abortion rights.
Ashcroft’s office has not yet confirmed whether the group’s bill will appear on the ballot this fall. If it does, voters would decide whether to enshrine the right to abortion up until the fetus is viable, or later in pregnancy if a health care provider, in their “good faith judgment,” believes it is necessary to protect the patient’s health or life.
Missouri doctors are joining a campaign to expand access to abortions and reduce government interference in their work. Dr. Iman Alsaden, chief medical officer for Planned Parenthood Great Plains, has spoken at petition drives across the state, explaining how the ban has negatively impacted pregnancy care. Dr. Alsaden has a history of providing abortions in areas with restrictions, Oklahoma When Texas passed its six-week ban in September 2021, the ban prevented abortions from being provided in Missouri.
Alsaden is Iranian-American and comes from a medical family — his father is a doctor and his mother is a nurse — and was always there to help friends in need. He said he was initially hesitant to follow in his parents’ footsteps because of the pain they felt treating sick patients.
In a conversation with States Newsroom in June, Dr. Alsaden spoke about why she practices obstetrics, how her identity influences her work, and how anti-abortion rhetoric impacts doctors and patients.
The following interview has been edited and condensed.
State Newsroom: What inspired you to become an obstetrician-gynecologist, specifically one who provides abortion care?
Iman Alsaden: As an obstetrician-gynecologist, you will always be serving an underserved population. Fertile people are treated very poorly in this country, and it shows in our maternal mortality rate.
I believe in bodily autonomy and fundamental human rights. It’s been great for me to blend that with my career in medicine and be kind of a physician activist. I’m queer. Growing up, I was always told, “You’re in the wrong bathroom. You’re dressed wrong. You’re not girly. You can’t do this or that.” But there was no voice to say, “Maybe it’s because I’m not a girl, maybe it’s because I don’t like boys,” or anything like that, and I was silenced. But I always knew I was doing the right thing, and it was my body, my rights, my life, and I didn’t understand why so many people cared about what I was doing with my life.
If I could make life a little more fair every day throughout my career, and give people the power to exercise their basic human rights, to take control of their lives, and to live the life they envision, then that was a very powerful idea to me.
SN: Many physicians in your position avoid the media and public political discourse, especially since the Dobbs decision. Why did you decide to support Missouri Constitutional Freedoms and its efforts to restore abortion rights up to fetal viability and allow abortions later in pregnancy for the patient’s life and health?
IO: I recognize that there are problems with the Viability Act. But I think restoring abortion access to thousands of people who haven’t had access to abortion for nearly a decade would be truly meaningful. And it would also mean that people would be able to get the care they need in the communities where they live. To me, that alone is enough to support this initiative. I believe people should be able to live the lives they want, and part of that is having the ability to control their lives and their bodies. Supporting this measure will hopefully restore that right and access to many who have struggled.
SN: Currently, abortions are only permitted in Missouri in cases of medical emergency. Are you able to provide care in the state under that exception?
IO: No. I do not perform any abortions in Missouri and medical emergencies occur in hospitals. Currently, I do not practice medicine in any hospital in Missouri. These medical emergency laws are written with contradictions in them. There is no doubt that they are a huge obstacle to patient care because people are leaving septic pregnancies longer than necessary. I have heard that people are hesitant to treat ectopic pregnancies. The laws are interfering too much with medicine and creating dangerous situations for patients. It is truly dangerous. The politicians should be ashamed of themselves.
SN: Missouri abortion opponents have opposed the petition, including the Secretary of State and Attorney General, and there were counter-attacks before the group submitted nearly 400,000 signatures in May. How has the rhetoric of the anti-abortion movement perpetuated misunderstandings of your work?
IO: There are too many to list. Let me start with the fact that when I walk into work, I get called a killer. It’s really dangerous to tie doctors’ hands and prevent them from doing the right thing for their patients. When you’re a doctor, your responsibility is to the patient, and the fact that the government is interfering with the fair and proper practice of medicine is disgraceful. Shouldn’t doctors be afraid to practice medicine? That fear that’s been instilled in people is worsening patient outcomes. We’re in a sad situation. We’re in a public health crisis.
SN: How does the intensity of political debate affect patients seeking reproductive health care?
IO: The impact on patients is unquantifiable. It is enormous. Anti-abortion laws impact people of lower socio-economic status, non-whites, and people who live in rural communities. The amount of resources it takes for someone to get in a car and drive 10 hours… You need a car. You need gas. You need a driver’s license. You need to find someone to take care of the family you were caring for, because we know that most people who get abortions are already parents. When you start making a long list of what it takes to get an abortion, it becomes a very huge list, and very few people can actually do it. Thank goodness for abortion funding. But at the same time, we must never lose sight of the fact that this care needs to be available where people live. People should not have to struggle to get basic medical care.
SN: How does your identity influence your work, especially when treating marginalized patients?
IO: I’m part of a marginalized community, not economically, but socially and racially, so it’s easy for me to treat people with respect and care. It’s really important to keep your identity in mind when you’re a physician. We don’t want to be complete robot physicians. But we also need to be mindful of things like implicit bias. I try to say the same thing to all my patients, because I know that everyone has implicit biases. And one of the ways to reduce that is to treat people with the same level of respect and care, regardless of who they are and where they come from.
