5 - Post-Roe America: Culture of Silence
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Why is there a culture of silence around abortion in medical spaces?
At the Nocturnist, we are careful to ensure that all stories comply with healthcare privacy laws. Details may have been changed to ensure patient confidentiality. All views expressed are those of the person speaking and not their employer. Welcome back to the Nocturinous Post Ro America. I'm Doctor Allie Block.
I was in the middle uh taking care of patients in the ICU. And the question of abortion has been returned to the state overturned Roman Way as soon as I heard it. I continued on with doing the work. But obviously I didn't realize the effect it actually had taken on me until one of my colleagues said Did I do something to upset you? Are you okay because Your acting in a manner that you normally don't act. And I didn't realize it was that apparent on my face. I remember thinking, how could you not be this angry? How could you not know this is what I'm actually angry about? And I had to say to my colleague, who's a really nice male physician I work with, it's not you at all. It's it's a fact that we we just lost rights as women.
And He looked at me, I think he understood what I was talking about, but he didn't really know what to say about it. Nobody else seemed to be talking about this, the nurses, respiratory therapists, or the physicians. the isolation of it with looking back now, I think make me even more angry. Like, how are we? not stopping everything to just acknowledge it for a minute and say Oh my God, how do we repair this and how do we approach this or how do we acknowledge it? We just weren't.
When I first heard this story from Venetia, I was struck by how different her experience of the Dobbs Day was from mine. I remember people around me were crying, making phone calls, texting. Everyone was talking about it. And everyone seemed to be on the same page. But this was a big deal. Part of that is because of where we each worked at the time. I was in San Francisco, and Venetia was in an ICU in rural Tennessee. But there's something else, something we've been talking about as a team that we're gonna explore in today's episode. It's the idea of the culture of silence that surrounds abortion. Abortion is taboo. We don't talk about it, even in healthcare spaces. But it can be more subtle than that. For example, even in the San Francisco Bay Area, where it seemed everyone was on the same team.
The day the Dobbs decision went down, I remember wondering, could things have been different if we had been louder sooner? Of course, there are so many people who have been outspoken and doing incredible work championing abortion rights. But many more of us have been quiet. Today we examine the culture of silence, both within the field of abortion care and beyond, in the broader world of healthcare. What's behind the silence?
How did the Dobbs decision affect physicians on the front lines, like those in the ICU?
And what are the costs, both to the status of abortion rights, but also on healthcare workers at an individual level? What does it mean to not talk about this very basic aspect of healthcare? To start, let me introduce Emily Patel.
I grew up in Omaha, Nebraska. My family has lived here for decades, so Nebraska is definitely home.
Emily stayed in the state for both undergrad and med school, before heading to North Carolina for her maternal fetal medicine fellowship at Duke. Soon after she finished, she headed back to Omaha. For Emily, abortion was never a central part of her pull towards medicine.
For maternal fetal medicine, it is not a specific part of our training. That being said, there are situations as a maternal fetal medicine specialist where knowing how to do An abortion procedure is incredibly important. And I understood that. So during my training as a specialist, I opted to get additional training. So I knew how to do that type of procedure. And now I'm one of only a couple of people in our state who can provide that service.
Had she not moved back home, Emily would likely rarely have put that training to use. There were so many other providers at Duke who offered that kind of care already. But when she found herself back in Nebraska, she discovered that if she didn't provide DNEs for patients with miscarriage or life threatening complications, there were very few other providers who could.
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Chapters
8 chapters
1
Why is there a culture of silence around abortion in medical spaces?
0:00–3:16
2
How did the Dobbs decision affect physicians on the front lines, like those in the ICU?
3:16–6:46
3
What is the ‘culture of silence’ and why does it persist after the overturn of Roe?
6:46–9:50
4
How did Emily Patel’s training and her return to Nebraska shape her approach to abortion care?
9:50–13:59
5
What legislative actions in Nebraska targeted abortion providers and how did doctors respond?
13:59–17:31
6
How did Dr. Caitlin Bernard become a target of legal and political retaliation?
17:31–21:14
7
What were the outcomes of Dr. Bernard’s medical‑board hearing and its broader implications for physicians?
21:14–24:52
8
How can listeners help break the silence and support reproductive‑rights advocacy?
24:52–29:40