Building Broad Public Health Coalitions in the Post-Roe World

As in every year’s April issue of the Journal, coinciding with National Public Health Week (#NPHW), we set up a dialogue between people of radically different political views who have in common a dedication to public health and an agreement that policy should be based as much as possible on scientific evidence. The dialogue has covered sensitive issues: racism and structural racism, gun violence prevention, single payer health insurance, public health advocacy, the Environmental Protection Agency, and more (e.g., https://ajph.aphapublications.org/toc/ajph/108/4). This issue is the first to address reproductive rights. It has proven to be the most difficult one to prepare.

The authors of the opinion pieces were invited to comment on the public health consequences of the US Supreme Court’s decision to overturn Roe v Wade and, in particular, which strategies, at the local and national levels, could best protect pregnant individuals and their children in the new context.

The comments we received, both from progressives and conservatives, stressed the disaster that the decision Dobbs v Jackson Women’s Health Organization has created for women in this country and beyond.

Frank C. Worrell, PhD, past president of the American Psychological Association, stresses that psychological research shows that the best strategy to prevent mental health issues for women seeking abortions is to make them safe, affordable, and accessible (p. 382).

Kristyn Brandi, MD, MPH, Darney-Landy Fellow at the American College of Obstetricians and Gynecologists, and Puneet Gill, third-year medical student, explain that abortion restrictions will negatively affect the gynecologic profession and the availability of patient care (p. 384).

For Megan Simmons, JD, MPA, policy director of the National Birth Equity Collaborative, and Deneen Robinson, director of religious spiritual policy strategy, National Birth Equity Collaborative, state legislatures codifying abortion rights and access is the best way to ensure bodily autonomy (p. 386).

Herminia Palacio, MD, MPH, president and CEO of the Guttmacher Institute, reminds us that states in which legislators have passed sweeping abortion restrictions concurrently have a terrible track record of promoting health and protecting against preventable maternal, infant, and neonatal deaths (p. 388).

All these comments are consistent with the evidence published in AJPH (https://ajph.aphapublications.org/toc/ajph/112/9). However, all of the conservative persons we invited who could be expected to support the Supreme Court decision in one way or another declined to submit or did not even respond.

I therefore asked Sanne Magnan, MD, PhD, senior fellow of the HealthPartners Institute and former Minnesota commissioner of health, to write an opinion editorial. Magnan belongs to a group of the Association of State and Territorial Health Officials alumni, which has been advising for the preparation of the April issues of the Journal since 2018. I know she is both dedicated to public health and in favor of alternatives to abortion.

Sanne Magnan is not alone in public health in thinking in these terms, and we need to face this discussion and find, as she insists, “common ground.” The cancellation of a federal right to abortion requires broad coalitions to protect reproductive rights in states. Immediate objectives may include preventing unwanted pregnancies using contraception, protecting parents through family and child development policies and Medicaid expansion, and, when possible, avoiding total bans on abortion and the health disasters associated with illegal procedures.

The conclusion of my previous piece titled “Reproductive Rights and Fascist Threat” still reflects my thinking: “Altogether, these [common ground] policies may reduce health inequities and decrease children living in poverty, until the right to abortion and contraception is inserted in the US Constitution.”^1(p1229)