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Dr. Daniel Grossman Profile picture
@DrDGrossman
Sep 22 • 11 tweets • 3 min read • Read on X
Aha! Dr. Marchand wants peer-reviewed literature on the impact of abortion bans in the US. I love talking about the data and educating my colleagues.

Let’s walk through the literature, shall we?
This peer-reviewed study looked at 2 hospitals in Texas after the 6-week abortion ban went into effect among patients presenting <22 wks with a complication like PPROM, bleeding, severe preeclampsia. sciencedirect.com/science/articl…
Since abortion was not possible, all received expectant management. Maternal morbidity occurred in 16/28 patients (57%), compared to 33% who elected immediate abortion in similar clinical situations. Image
Bottom line: when abortion is no longer an option when patients present with an obstetric complication in the second trimester, complications increase.
Another peer-reviewed study was based on interviews with maternal-fetal medicine specialists in the Southeast since the Dobbs decision. sciencedirect.com/science/articl…
“In restricted states, most MFM physicians reported cases in which they did not provide an abortion in the setting of maternal health risk or fetal anomaly that they would have provided or facilitated before the Dobbs decision.”
“In these situations, they cited fear of legal liability as the main driver for this shift in care.”
Yet another peer-reviewed study reports on interviews with ob/gyn residents training in states with abortion restrictions since Dobbs and describes the moral distress they experiencedwhen they were unable to provide abortion care. ncbi.nlm.nih.gov/pmc/articles/P…
“Residents described challenges to their physician identity caused by inability to do the job, which led to internalized distress and reconsidering career choices.” — @JodySteinauer Image
Here’s another peer-reviewed article: a moving (and anonymous) account from ob/gyn residents in Missouri about the cases they have witnessed of care denied or delayed since abortion was banned there: meridian.allenpress.com/jgme/article/1…
The data are clear. Your ignorance of it doesn’t change the facts. I hope you’ll read through it and learn something for the health of your patients.

The patients who trust their health care to us deserve better than this system and anti-abortion laws that threaten their lives.

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More from @DrDGrossman

Dr. Daniel Grossman Profile picture
Sep 10
I’m sure the debate tonight will be a wild ride full of misinformation about abortion. So in preparation, here are some facts from our Care Post-Roe Study documenting cases of poor-quality medical care due to bans on abortion.
We just issued an updated report from the Care Post-Roe Study, which includes 86 narratives from health care providers describing patients from 19 states with abortion bans whose care deviated from the usual standard. ansirh.org/research/resea…
More than two years since the Dobbs decision, we are continuing to receive submissions describing poor-quality care that are very similar to those we received back in 2022. More time hasn’t provided clarity around the laws.
Read 28 tweets
Dr. Daniel Grossman Profile picture
Feb 24, 2023
Gather 'round. Let's talk abortion pills.

Mifepristone is pretty awesome, and its approval by the FDA in 2000 changed the way people
obtain abortions in the US. In 2020, 53% of people having abortions in facilities had a medication
abortion with mifepristone and misoprostol.
But with mifepristone under attack in the courts, we need to figure out how we will provide abortion
care without this medication.

Fortunately, there is a good alternative: misoprostol-only medication abortion. cdn.who.int/media/docs/def…
This thread comes from a commentary led by Beth Raymond at @Gynuity, @IbisRH, and many other authors, including @carafem, @UshmaU, and myself. It will be out shortly!
Read 21 tweets
Dr. Daniel Grossman Profile picture
Feb 24, 2023
I am really proud of our Care Post Roe study and heartbroken over the stories that we're hearing coming from providers who are concerned about the legalities of treating their patients and patients who are scared to seek treatment for fear of criminalization.
In some cases, patients traveled long distances to another state to be evaluated. And sometimes it turned out they weren’t even pregnant. Sometimes it turned out they had had a miscarriage that had actually already been completed and they didn’t need any treatment.
In other cases, patients had a premature rupture of membranes in the second trimester and our standard of care would be termination. Instead, patients were being sent home and developing very severe infections that required very complicated management in the intensive care unit.
Read 5 tweets
Dr. Daniel Grossman Profile picture
Feb 7, 2023
Hi @MikeKellyPA, I’m a professor of Ob/Gyn at @UCSF, an abortion provider, and researcher at @ANSIRH.

Unsurprisingly, you got a few things wrong in this tweet that I’d like to clarify. Do you mind if I outline them for you? Facts are critical when discussing medical treatments.
First, let’s address the issue of the safety of medication abortion with mifepristone. We have over 22 years of experience with this treatment, and all the data indicate that it is very safe.

You can read the science for yourself here: ansirh.org/research/brief…
Of course, every death in pregnancy is a tragedy, but fortunately, deaths with mifepristone medication abortion are exceedingly rare.

Between September 2000 and June 2021, the FDA reported 26 deaths among 4.9 million people who’ve used the medication. fda.gov/media/154941/d…
Read 14 tweets
Dr. Daniel Grossman Profile picture
Jan 6, 2023
For @thenation @RBraceySherman, @TracyWeitz, and I wrote about the FDA's decision to allow retail pharmacies to dispense medication abortion. While it is historic news, the fine print contains significant red tape that will continue to serve as a barrier.
thenation.com/article/societ…
"Despite years of peer-reviewed, evidence-based research, the FDA chose to alter rather than eliminate the REMS for medication abortion."
thenation.com/article/societ…
"The long list of requirements for pharmacy certification won’t improve the safety of medication abortion, but it will serve as a barrier to expanding the number of pharmacies that dispense mifepristone."
thenation.com/article/societ…
Read 4 tweets
Dr. Daniel Grossman Profile picture
Sep 2, 2021
This morning has been painful, upsetting, and full of despair. I am so proud of all of my colleagues who are working around the clock to make sure patients have care.

Please donate, if you can: secure.actblue.com/donate/txfunds

Let's also talk about what is possible to rebuild.⤵️
I see some folks are asking "what else we can do" and worrying about returning to the time before Roe. I have some thoughts. It's important to remember that the practice of abortion care has changed significantly in 50 years, particularly with the invention of abortion pills.
In light of Texas banning most abortions, folks have been talking about “advance provision” of abortion pills. You might be asking, “what does that even mean?” Here are some answers…
Read 15 tweets

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