1 - Post-Roe America: The Day Roe Fell
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What prompted The Nocturnist to launch a post‑Roe series?
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You're listening to The Nocturnist. I'm Emily Silverman. When the leak about the overturning of Roe v. Wade happened back in May 2022, we knew we had to do something at The Nocturnists. Rarely has a single Supreme Court ruling had such a wide-ranging and immediate impact on the practice of medicine. And rarely have those impacts been so dangerously misunderstood by those outside of healthcare. So our team decided to track the fallout of Dobbs through the voices of the clinicians at the heart of it all. In a project headed up by The Nocturnist executive producer Dr. Ali Block, who is a practicing family medicine physician and abortion provider, we started collecting stories from reproductive healthcare workers from Texas to Tennessee, from Kansas to California, and beyond.
What has the Dobbs decision meant for these clinicians and their practices? And what do these changes mean for American healthcare at large? This is The Nocturnist's Post-Roe America. Allow me to introduce you to your host, Dr. Ali Block.
In 2014, the year I graduated my family medicine residency and started officially performing abortions on my own, 87% of US counties had no known abortion provider. As a young attending entering the field, I saw the potential of a better future for the world of reproductive care. I had high hopes. What if everyone in the country who needed an abortion was more than just allowed to get one, but able to access one as well? The Dobbs decision changed everything. My hopes for the field I love so much haven't gone away, but the script beneath them has changed. Because today, in many places across the country, people who a little over a year ago may have been providing abortion care daily, people with my same job, face the risk of criminal charges if they do the work they're trained for.
In our conversations with healthcare workers over the past year and a half, one thing has become clear. There's no single unified story of what this decision has meant. Instead, it's more of a tapestry of experiences. Because Dobbs didn't only make it harder to get an abortion in red states, we're also experiencing the ripple effects in the way reproductive care is taught and practiced, in how our hospitals and clinics keep us safe, and in how we calculate risk for pregnant patients. If we once had a clear sense of how this puzzle all fits together, the pieces were just shaken up and dumped on the floor. So where to begin when everybody's experiences are so varied? For this episode, we decided to start the day of the Dobbs leak in May 2022, when the world first found out that the United States Supreme Court was set to overturn Roe v. Wade.
That day just so happened to also be the day of NAF, the biggest abortion conference of the year, put on annually by the National Abortion Federation.
So NAF was in Orlando. It was one of those resorty hotels where it was like, there was a bunch of pools and, you know, it had a conference center in it. But it was, you know, it was like 80 degrees and beautiful as it is in Florida, even though like in New York, it was still barely above freezing in like the first weekend of May.
That's Jonna Menendez, a primary care abortion provider based in New York City.
It was a normal conference. In our realm of medicine, unfortunately, politics is always like part of the CME conference. So there were, you know, talks about political climate and trap stuff. But that's like normal enough for any of our spaces.
It's actually a great meeting.
That's Diane Horvath, an abortion provider based in Maryland.
I think this care can feel really siloed because a lot of us are not working in hospitals. We're in freestanding clinics. And so the community that we have is the community that we make. Nobody is like holding get togethers for us, you know?
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