To the Journal editor:

Donald Trump is now trying to distance himself from the written Republican Project 2025 plan for a nationwide ban on abortion by claiming that he just wants to leave it up to the individual states to vote and decide for themselves.

That may sound to some at first, to be somewhat democratic and rational.

But letting the states individually decide on whether to ban abortion or to have freedom of choice, would result in different standards of medical care in different geographic locations within the U.S.

That means that the standard of care in the “choice” states would be based on traditional medical practice using rational scientific, physiologic, evidence based, treatment algorithms as well as many decades of real world clinical experience.

However, the “standard” of care within the abortion banned or restricted states would be based on emotional, dogmatic, political agendas that lack nuance and most importantly lack medical expertise.

These states, would in effect, be allowing politicians, without medical training or a medical license, to be dictating, directing and restricting a doctor’s medical practice for their citizens with the threat of criminal punishment.

The evidence on what happens when you allow politicians to practice medicine without training or a license was clear even before the U.S. Supreme Court displayed their ignorance on this, in striking down Roe.

Before their decision, from 201-18, the states with more abortion restrictions experienced a 29% higher maternal mortality rate than the States without such restrictions (Vilda, D et al 2021).

More recently, (Gonzalez, O. 2023) found that mothers in states with abortion bans were nearly 3 times more likely to die during pregnancy and childbirth than states with legal abortion.

This may partly be due to the fact that states with strict abortion bans are experiencing a decrease in qualified obstetric doctors working in those states, as well as a decrease in new medical school graduates seeking speciality obstetric and gynecology residency training in those states (Rover, J 2024).

“Just letting the states decide on abortion,” as is happening now, actually amounts to state driven medical malpractice, targeting pregnant women on a massive scale within these abortion restricted states. The states do not have a right to make a poor decision on an issue that creates fear, suffering, chaos, documented increased dangers with pregnancy, and a lower quality of life within their political boundaries.

Evidence based standards of health care are one of those essential commons that everyone expects within all our United States, just like national defense, law and order, clean water etc.

Evidence-based standards of care are not just limited to reproductive and psychological health, but also act to preserve patient safety across a wide range of medical and surgical fields of medical practice.

This “let some states decide” on a lower medical standard of reproductive care for the women that just happen to be living there, is a reckless, poorly thought out, intrusion into sound evidence based patient, family and physician decision making.

SCOTT EMERSON, MD

Chocolay Township