After fearfully waiting for this day, I set my alarm to be sure not to miss any of the Supreme Court’s arguments in my rush to get the dog walked and my son headed to school. I tuned in on December 1 before beginning my day as a doctor who provides abortion care.

Listening to the justices and attorneys discussing Mississippi’s 15-week abortion ban, I was overwhelmed by what is at stake for people needing abortion care in half of the states in this country. I’m grateful the decision won’t directly affect me and my patients, because I am fortunate to practice in California, where strong laws—and Gov. Gavin Newsom’s recent announcement that he wants our state to be an abortion “sanctuary”—will protect access to abortion regardless of what the Supreme Court might decide.

On the day the Court was debating the fate of millions, I provided abortion care to two teens who wanted to finish high school. I cared for a pregnant woman whose embryo had died. And I cared for a young mother so torn about her decision that she passed 20 weeks before coming to us. Sad but sure that having an abortion was what she needed to do, after her procedure she met with a chaplain to have the baby blessed.

Another patient had gotten pregnant by IVF, only to learn the baby would be unable to survive long. She asked me to share her story:

In being able to have an abortion, I am grateful not to have to have a stillbirth or possibly die in childbirth or have to watch a seemingly healthy baby be delivered and die too soon because its heart couldn’t sustain it. Nobody in that courtroom understands that when you’re past 15 weeks, you’re not making this decision lightly. Adoption is not a possibility. Who’s going to adopt a child who will spend its life in the ICU until it dies? I wouldn’t be able to leave the child alone. At 15 weeks, I had no idea—I found out at 17 weeks. I can have this abortion because I can afford it. What about those other women who don’t have the means or access?

Providing safe and respectful care to patients is at the core of who I am as an obstetrician-gynecologist, whether I’m supporting a woman during the birth of her third child or enabling this same woman to later have her first abortion. I cannot imagine practicing medicine in a state where people have lost the right to access abortion care after they have determined it is the right decision.

We often talk about abortion as a matter of bodily integrity. I’ve found with my patients that they experience it as something much larger than that. It is their lives, their families, their kids, their futures. They understand the circumstances that brought them to the clinic, what they need, and what is right for them. To have strangers impose their beliefs on something this intimate is unimaginable.

My heart would break if my hands were tied, because I’ve seen how much getting an abortion has meant to people seeking that care. Pregnant people beyond 15 weeks are often the most vulnerable—they are the ones who face the most compelling challenges. Most recognized late they were pregnant and then were unable to find a provider or make the necessary child care, job, and travel arrangements. These barriers loom even in California, where our laws support people who need abortions and where we are fortunate to have providers—even if patients have to travel long distances to get to them.

Because the majority of people having abortions are in part driven by their sense that they can’t have the baby because they don’t have resources, abortion bans are inherently discriminatory within our society, where Black, Indigenous, and other people of color are more likely to live in poverty.

In the United States, Black women die in childbirth at rates much higher than white women. Abortion is medically far safer than childbirth. When legislators or Supreme Court justices take abortion away from pregnant people, they not only negate people’s humanity and autonomy but simultaneously expose them to much higher risks for a pregnancy they had determined they could not continue given their circumstances. As a physician who cares for people having abortions and people giving birth, being unable to provide abortion would be unconscionable.

With Texas having eliminated access to most abortion care, we in California and other less restrictive states can’t realistically protect those people in need. They’re caught in the circumstances of their lives and can’t reach us. Our clinic already has received calls all the way from Texas as a result of the state’s extreme abortion ban. We’ve cared for some of them, but the sad truth is that most don’t make it here.

As the justices asked what had changed that should make Mississippi’s blatantly unconstitutional ban pass muster now, the answer was based in politics—not medicine—and certainly not in the experiences of people who have had abortions. What hasn’t changed is that politicians and justices who want to ban abortion are out of touch with the lives of the people their decisions will affect, like the ones I care for in my clinic.

When I hear a justice argue that a woman could “just place the baby for adoption” instead of having an abortion, I think that person understands nothing about humanity, because “just give it up for adoption” never describes a woman’s experience. We can’t “adopt our way out” of what it would mean to restrict or eliminate abortion access. To suggest otherwise is at best naïve and at worst willfully cruel.

The Supreme Court signaled that we can’t rely on the courts to protect us from the wave of attacks on abortion access. As we await their ruling in June, patients, policymakers, providers, advocates, and communities have to think boldly and creatively about how we in California can help make sure everyone gets the abortion care they need and deserve.