It’s No Surprise the AMA Is Leaving Abortion Providers Twisting in the Wind
In fact, the American Medical Association led the charge to criminalize abortion in the United States in the mid-1800s.
One week after the Supreme Court eliminated the constitutional right to abortion last June, Dr. Caitlin Bernard, an Indiana abortion provider, shared a particularly crushing story with local media: One of her patients that week was a 10-year-old girl who had been raped. The girl was unable to get an abortion in her home state of Ohio, where a six-week ban was then in effect (it has since been blocked in state court). She was forced to travel across state lines to Indiana, where Bernard provided her with care.
Bernard was immediately attacked by conservative pundits and politicians who labeled the story a hoax. Ohio Attorney General Dave Yost, who publicly questioned Bernard’s story multiple times, claimed his office hadn’t heard “a whisper” of any such crime. In Indiana, Attorney General Todd Rokita announced an investigation into Bernard, alleging she may not have reported the abortion in accordance with state law. But documents proved that she had, and a few weeks later, a man was arrested and charged in connection with the rape.
Bernard told the truth. More importantly, she provided compassionate care to a child who needed help. Yet despite all the evidence backing her story, Rokita filed a formal complaint against her with the state’s medical licensing board, potentially jeopardizing her ability to practice medicine and sending a chilling message to other abortion providers.
A doctor did her job and is being attacked for it. So where is the outrage from the rest of the medical community? Though fellow doctors have spoken out in Bernard’s defense and raised funds for her legal expenses and security needs, the only professional organizations that have issued statements or even acknowledged the case are the American College of Obstetricians and Gynecologists and Physicians for Reproductive Health.
Doctors such as Caitlin Bernard, MD, FACOG, who provide respectful, appropriate, patient-centered care to women, children, and people needing abortion care are being targeted and attacked. Legal intimidation and unchecked aggression against medical professionals are unacceptable.
— ACOG (@acog) November 30, 2022
“It really speaks to where organizational loyalties lie,” said Dr. Katie McHugh, an Indiana-based OB-GYN, abortion provider, and board member of Physicians for Reproductive Health. “The American Medical Association and similar organizations should be rushing to the defense of and helping with emotional and financial support for any physician that is targeted in this way for doing their job. The fact that they haven’t flies in the face of everything that they’re saying about caring about safe access to abortion.”
However, the AMA’s absence of public support comes as little surprise due to a widely unknown bit of history: The charge to criminalize abortion in the United States in the mid-1800s was led by the AMA itself. The organization has never acknowledged or apologized for this fact, even as it has adopted a more openly supportive stance on abortion care.
At the time of its formation in 1847, the AMA didn’t wield anywhere near the kind of social and political power it does today, said Karissa Haugeberg, an associate professor in the Department of History at Tulane University.
“In the 19th century, doctors in general didn’t have much social power,” she said.
That’s because university training for physicians was relatively new. People didn’t necessarily see these doctors as any more proficient or accomplished than practitioners they already relied on for medical care, ranging from skilled midwives to quacks and everything in between.
“As the American Medical Association was being formed, their big issue was to try to criminalize abortion, arguing that doctors are the only ones who should be trusted to do this because it’s exceedingly dangerous,” Haugeberg said.
Up until this point, abortion was broadly legal and, like most obstetric and gynecological services, had largely been the domain of midwives. Male physicians were especially eager to push these women out of practice, particularly the Black women who had long been caring for their own communities. They were successful: By 1880, every state had some kind of law restricting abortion on the books, and by 1910, it was illegal in every state. Some exceptions to these laws existed, and only doctors were empowered to determine who qualified.
“I hesitate to use the term ‘reparations’ in this context, but the American Medical Association owes everyone an apology” for that history, McHugh said. Instead, “with their silence, the AMA and state chapters are endorsing the behavior of the Indiana state attorney general.”
After all, the AMA’s campaign to legitimize physicians—at the expense of pregnant people and midwives—was extraordinarily successful.
“Today, of course, physicians have so much cultural authority, that it almost makes it worse that they’re not coming to [Bernard’s] defense,” Haugeberg said.
The AMA did not respond to a request for comment.
Another powerful organization that could be better supporting Bernard and all abortion providers? The American Hospital Association.
“Now, hospitals have so much power. Yes, there are physicians and there’s the AMA, but most of those doctors work for hospitals that are so risk-averse,” Haugeberg said, pointing to media reports of hospitals denying abortion care even in emergencies, or limiting it in ways that go beyond state law.
This is actually a departure from the past. For example, Haugeberg said, in New Orleans prior to Roe v. Wade, it was widely known that doctors in the emergency room at Charity Hospital provided abortions after hours even though it was technically illegal—an unthinkable arrangement in today’s climate.
In the 1960s and ‘70s, Haugeberg added, public health physicians were powerful allies who could sway elected officials and public opinion regarding the harms of abortion bans.
“It’s notable that public health has been so gutted in the last 20 to 30 years, so we don’t have as robust a coalition of public health physicians,” she said. “And it’s not helpful that this is coming on the heels of COVID, where public health has become so politicized.”
That’s precisely why power players like the AMA should be getting involved, McHugh said. In her words, abortion care isn’t “cowboy medicine.” It’s safe, evidence-based, and necessary—something major medical societies should go to bat for.
“In some ways, I am grateful that this happened to Dr. Bernard, because I know how excellent she is. I know how cautious and compassionate she is, and I know how careful she is to comply with all of the laws,” she said, adding that the outcome of such a firestorm would likely be far worse for anyone other than a “white, picture-perfect physician.”
“On the other hand,” McHugh continued, “I am so devastated, not only for her, but for all of us, that it has come to this. I live in constant fear of something like this happening to me, and I live and work in an area where I feel constantly scrutinized and surveilled. But I believe that this work is worth those risks.”