A Conversation with a Texas Abortion Provider

The following is a conversation with Dr. Ghazaleh Moayedi, a Board Certified OB/GYN and Complex Family Planning specialist who provides birth and abortion care in Texas. She serves on the board of directors of Physicians for Reproductive Health and Texas Equal Access Fund. The interview has been edited for length and clarity.

I want to start off by saying, I think that you have very succinctly been explaining what has happened with providers and patients on the ground throughout Texas. What has happened since Senate Bill 8 went into effect September 1? And not even just the legislation, but the fear and uncertainty that it’s unleashed?

I think we can think about what’s happened since this law went into effect into two buckets. I always hate to use that because they’re not two separate buckets, it’s like a continuum bucket. But one of them is very clearly that almost all abortion care has stopped in our state. Those with means are traveling outside of Texas, as close as New Mexico and Oklahoma, but as far as Washington state and New York state. So we really have a crisis happening in our state right now, as far as access to a human right and to control your own reproduction is concerned. But on top of that, both care and pregnancy care in the state has also dramatically changed since September 1. And I think that piece is also important for people to understand. Every single abortion restriction impacts the health and safety of pregnant people as well. And I mean, pregnant people in general. And that’s not unique to SB 8, that has been an ongoing problem in our state and many others with abortion restrictions.

Could you talk a little more about that?

Even prior to SB 8, life and death decisions around intervening with complicated pregnancies are shadowed by the doubt and misunderstanding and misapplication of abortion restrictions. And so even if you’re not an abortion provider, abortion restrictions impact the way that you are able to counsel patients and care for them with desired pregnancies to have complications. And this is actually well-documented. Right now with my colleagues at Texas Policy Evaluation Project, this is a topic that we’re diving deeply into with research as we speak. I actually spent the day yesterday reviewing interviews from different types of physicians across the state, talking about how abortion restrictions impact their care. And these are not just abortion providers, right? Where ordinarily someone, for example, that comes in at 15 weeks pregnant and their bag of water has ruptured, typically there would be a clear path that this is a life-threatening emergency

and whether or not the patient has become sick yet that this pregnancy cannot continue and immediate delivery must be pursued. And what I’m hearing from colleagues across the state right now is that they are being prevented from their hospitals, from providing the standard of care.

There was a recent story on NPR about a pregnant patient who was informed that the fetus had developed anencephaly. I believe a case where normally there would be that pathway to terminate. And now that is not the case. I would imagine that for a patient you’ve already just been told something truly terrible. And now SB 8 adds more of a burden to that. What is your fear now with patients?

I have personally witnessed, and many others [have as well], the effects of abortion laws on the health and safety of people with desired pregnancies. People that have died and people that have been severely injured because abortion was not offered. And so that is my deep fear of SB 8 based abortion restrictions. What I keep telling journalists is we need to focus on these stories now, but let’s talk in nine months and see what’s happened to folks.

You testified last week at the U.S. Congress and had an exchange with an anti-choice OB/GYN that made a lot of headlines. Is there anything that you’d like to say about that?

I think one of my first impressions was just about how deeply saddened I was to know that potentially so many have been cared for by a person that holds such, frankly, deeply racist beliefs and deeply anti-science beliefs. That’s not a surprise for me to some extent. I think that it’s important to highlight that institutions like healthcare and medicine are deeply ingrained in white supremacist systems. I don’t think she was being cruel or opportunistic when she said that, it was a deeply held belief. I often give this history of reproductive coercion and control in the United States. It is the reason that physicians need to be thinking outside of just the walls of our exam rooms, to understand the context in which we deliver healthcare in the United States.

The Women’s Health and Protection Act has passed the U.S. House. It’s dubious to pass in the Senate, but is there something nationally that you would like to see this country do? Even maybe beyond the Supreme Court or codifying Roe V. Wade?

I wish I had the answer. I think I said on MSNBC this week that we need an executive order. But, really, I don’t even have the words to describe how terrifying it is that physicians need to go on TV and beg for human rights for the people that they take care of. Of course, this is something I do, but this isn’t supposed to be [what I’m] doing.

Not what you signed up for.

I signed up to care for people with compassion and respect. That’s what I was trained to do. And if I could just spend every single day doing that. We need bold solutions that think outside of the box. Incrementalism has moved us backwards, not forwards. We have to demystify and destigmatize abortion and care. We have to center the people that are most affected. We really need to move towards a whole culture change, right? That everyone deserves to live with dignity and respect, and that we cannot continue to govern this country through the extreme religious beliefs of a few. I’ll just say just yesterday during our special session, another sham session at that, a bill is moving forward to stigmatize and harass trans children. And these are the same legislators that cried over the lives of embryos. They cried over saving the lives of children when they’re actively working to harm children. We know that bills like this harm trans children, they harm their mental health, they harm their safety, they harm their physical health. But somehow those children are not worth protecting,

There is a temporary injunction against SB 8 at the moment. But it’s not clear if abortion providers will resume services. There is that carve out in SB 8 that essentially says that providers could be liable even if the law is stayed then resumed, which is such an insidious legal argument. Can you describe just how just horrifying this law is for yourself as a provider, but then also for someone like a rape crisis counselor who might be trying to help someone? Or even a person providing transportation?

The reality is that everyone is still at risk and that has been true from the beginning. It’s been something I’ve really been trying to talk about and uplift in our conversations with folks that we have to accept that under this law actually everyone is at risk, no matter what they do. And even if they’re doing the “right thing” and I’m using air quotes on right thing, even if they’re complying with the law, they’re still at risk because of how insidious this law is. Even if you don’t intend to aid or abet, you can be [liable]. So really for me as a physician, as a mom, as a community activist, my approach is that none of us are safe. And so we need to center our values and we need to lead with our values. We’re not going to be protected no matter what we do. So we need to be doing the right thing. We need to be on the right side of history. There’s no way to protect ourselves. The target’s already on our backs.

Is there anything else that you would like to add about the last couple of weeks?

I definitely have thought about the ruling from Judge Pittman. It was historic just in its use of inclusive language. And I really applaud our coalition here in Texas because we’ve really been leading the way on pushing folks to use that inclusive language. I also remain ready to resume and care for my community at any moment. But, I reserve my own celebration or congratulations until this ruling actually translates into Texans being able to access their human right to abortion care.

Photo: Bill Clark/CQ Roll Call