The Best Doctors Are Abortion Providers – The Cut

 

Report on Disparities in Reproductive Healthcare and Alignment with Sustainable Development Goals

This report analyzes the quality and nature of reproductive healthcare, contrasting prenatal and natal services with abortion care. It highlights significant disparities in patient treatment, autonomy, and respect, framing these issues within the context of the United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), and SDG 10 (Reduced Inequalities).

Patient Experience and Healthcare Quality: A Tale of Two Systems

Evidence suggests a profound divergence in the standard of care between abortion services and conventional prenatal and birth services. This gap directly impacts the achievement of universal health coverage and gender equality.

Contrasting Models of Care

• Abortion Care: Frequently characterized by a high degree of empathy, patient-centeredness, and meticulous attention to informed consent and autonomy. Providers in this field often operate under intense scrutiny, fostering a culture of compassionate and respectful care as a core tenet of their practice.
• Prenatal and Natal Care: Patients, including those with comprehensive insurance and choice of providers, report experiences of being treated as secondary to the fetus. This manifests as a paternalistic approach where patient comfort, dignity, and autonomy are often disregarded.

Reported Mistreatment in Maternity Care

Systemic failures in respecting patient autonomy are widespread. Data analyzed by the CDC in 2023 reveals a significant level of mistreatment during childbirth, undermining progress toward SDG 3.

1. Prevalence: 20% of all women reported mistreatment during their most recent birth.
2. Racial Disparities: This figure increases to 30% for Black women, highlighting a critical intersection with SDG 10 (Reduced Inequalities).
3. Common Forms of Mistreatment:
   • Being ignored when requesting assistance.
   • Being shouted at or scolded by healthcare staff.
   • Threats of withholding treatment.
   • Forced acceptance of unwanted medical procedures.

Alignment with Sustainable Development Goals

The observed disparities in reproductive healthcare have direct implications for several key SDGs. The quality of care during pregnancy and childbirth is a critical indicator of a nation’s commitment to health, equality, and justice.

SDG 3: Good Health and Well-being

Target 3.7 aims to ensure universal access to sexual and reproductive health-care services. However, access alone is insufficient without quality. The report indicates that while services may be available, the quality can be substandard, prioritizing the fetus over the pregnant person’s physical and mental well-being. The patient-centered model observed in abortion care—which is statistically 14 to 30 times safer than carrying a pregnancy to term—offers a framework for improving all aspects of reproductive health services.

SDG 5: Gender Equality

The treatment of pregnant individuals as “incubators” or “child-animals” is a fundamental issue of gender inequality, contravening Target 5.1 (end all forms of discrimination against women). When a healthcare system diminishes a person’s autonomy during pregnancy, it reinforces paternalistic structures and undermines their fundamental rights. The practice of ensuring a patient is not being coerced, common in abortion clinics, is a model of care that upholds the principles of SDG 5 by centering the individual’s agency.

SDG 10: Reduced Inequalities

The disproportionately high rate of mistreatment reported by Black women during childbirth is a stark example of systemic inequality. Achieving Target 10.3 (ensure equal opportunity and reduce inequalities of outcome) requires addressing the biases and structural problems within the healthcare system that lead to such disparate experiences and outcomes.

Historical Context and Institutional Failures

The current state of reproductive healthcare is rooted in historical developments that have marginalized patient-centered approaches.

The Marginalization of Midwifery

Historically, midwives provided holistic, whole-person care that encompassed the psychological and social aspects of pregnancy. In the 19th century, a rising male-dominated medical establishment pushed midwives to the margins, instituting a more clinical and paternalistic model of care. This shift contributed to the erosion of patient autonomy that persists today.

Legal and Institutional Frameworks

Legal decisions have profoundly shaped the landscape of reproductive care. The reasoning behind Roe v. Wade was noted to be as much about a doctor’s right to practice as a woman’s right to choose, reinforcing a physician-centric model. The subsequent isolation of abortion care from mainstream medicine, while creating challenges, inadvertently preserved a patient-first ethos born out of necessity and ideological commitment. This model stands as a powerful example for reforming mainstream prenatal and birth care.

Conclusion and Path Forward

The disparity between the patient-centered, respectful care common in abortion services and the often dehumanizing experiences in mainstream prenatal and natal care represents a critical failure to meet international standards for health and human rights, as outlined in the SDGs.

Recommendations

• Integrate Patient-Centered Models: All reproductive healthcare providers should adopt the principles of dignity, autonomy, and informed consent exemplified by the best abortion care providers. The pregnant person must be treated as the primary agent in their own healthcare journey.
• Address Systemic Bias: Healthcare institutions must actively work to dismantle the racial and gender biases that lead to mistreatment and unequal outcomes, in direct pursuit of SDG 5 and SDG 10.
• Elevate Midwifery: Reintegrating and valuing the midwifery model of holistic, person-centered care within mainstream medicine can help restore a focus on the patient’s overall well-being.

Achieving the Sustainable Development Goals requires a healthcare system that respects the dignity and autonomy of every individual. Learning from the patient-first ethos of abortion providers is a critical step toward ensuring that all reproductive healthcare is safe, respectful, and equitable.

Analysis of the Article in Relation to Sustainable Development Goals

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The article highlights issues directly connected to several Sustainable Development Goals (SDGs). The primary focus is on health, gender equality, and the reduction of inequalities, with underlying themes of justice and institutional frameworks.

• SDG 3: Good Health and Well-being

  This goal is central to the article, which extensively discusses the quality of reproductive and maternal healthcare. It contrasts the patient-centered care found in abortion clinics with the often dehumanizing and dangerous experiences women face during prenatal care and childbirth. The article explicitly addresses the health risks associated with childbirth versus abortion, as seen in Maggie’s traumatic birth experience where she “bled internally” and required a “full blood transfusion.”

• SDG 5: Gender Equality

  The article is fundamentally about gender equality, focusing on women’s bodily autonomy and reproductive rights. It critiques the paternalistic medical system that treats pregnant women as “secondary to the pregnancy,” like an “incubator” or a “child-animal.” The discussion of the Supreme Court’s overturning of Roe v. Wade and the rise of “fetal-personhood ideology” directly relates to the struggle for women’s rights to make decisions about their own bodies and health.

• SDG 10: Reduced Inequalities

  Inequalities in healthcare access and treatment are a significant theme. The article points out racial disparities, citing CDC data that “for Black women, the number [of those mistreated at birth] jumped to 30 percent,” compared to 20 percent overall. It also highlights geographical inequalities, where access to abortion is dependent on location (“lucky she lived in New York. It was 2021, and Texas had just banned abortion at six weeks”). Socio-economic inequality is also implied when discussing the “rapaciousness of American health care — the expense; the cold, unfair distribution of resources.”

• SDG 16: Peace, Justice and Strong Institutions

  The role of legal and judicial institutions is a critical part of the narrative. The article revolves around the impact of Supreme Court decisions like Roe v. Wade and Dobbs, which have fundamentally altered women’s access to healthcare. The mention that “by 1880, every state had enacted abortion restrictions” and the subsequent legal battles illustrate the connection between justice, law, and public health outcomes.

2. What specific targets under those SDGs can be identified based on the article’s content?

Based on the issues discussed, several specific SDG targets can be identified:

1. SDG 3: Good Health and Well-being

   • Target 3.1: By 2030, reduce the global maternal mortality ratio. The article directly addresses this by comparing the safety of childbirth and abortion. It cites data that “abortion is 14 times safer” and that “terminating a pregnancy is at least 30 times safer than staying pregnant.” Maggie’s near-fatal childbirth experience serves as a stark example of maternal health risks.
   • Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services. The entire article is a commentary on the state of access to these services. It discusses the immediate impact of the Dobbs decision, which “had almost instantly banned abortion in 13 states,” thereby denying access to essential reproductive healthcare.
   • Target 3.8: Achieve universal health coverage, including access to quality essential health-care services. The author’s and other women’s experiences of being “bullied,” “ignored,” and receiving substandard care during childbirth highlight a failure to provide quality care. The contrast between the “respectful, patient-centered reproductive health care” in abortion clinics and the mainstream prenatal system underscores this gap.

2. SDG 5: Gender Equality

   • Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights. The article’s core theme is the fight for and loss of reproductive rights in the U.S. following the overturning of Roe v. Wade. The narrative emphasizes the importance of patient autonomy and consent, which are central to reproductive rights, and contrasts this with experiences where women were “forced to accept unwanted treatment.”
   • Target 5.1: End all forms of discrimination against all women and girls everywhere. The article describes systemic discrimination within the medical establishment, where pregnant women are treated paternalistically. It provides specific examples of mistreatment, such as being “shouted at” or lied to by a doctor about the severity of a physical tear, which constitute discrimination in the provision of healthcare.

3. SDG 10: Reduced Inequalities

   • Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices. The article highlights how state-level abortion bans create profound inequalities of outcome based on geography. Furthermore, the statistic that Black women are significantly more likely to report mistreatment during childbirth (30%) is a clear example of an unequal outcome based on race that needs to be addressed.

4. SDG 16: Peace, Justice and Strong Institutions

   • Target 16.3: Promote the rule of law… and ensure equal access to justice for all. The article demonstrates how judicial rulings by the Supreme Court directly impact “equal access to justice” for women seeking to exercise their reproductive rights. The reversal of a 50-year precedent with the Dobbs decision shows how institutions can either uphold or dismantle access to essential services.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Yes, the article mentions or implies several quantitative and qualitative indicators that can measure progress.

1. Indicators for SDG 3

   • Maternal Health Risk (Proxy for Indicator 3.1.1 – Maternal mortality ratio): The article provides comparative risk statistics: “abortion is 14 times safer” than giving birth, and a more recent analysis suggests it is “at least 30 times safer.” This data serves as a powerful indicator of the relative risks and can be used to measure the health impact of policies that restrict abortion access.
   • Legal Access to Abortion (Indicator for Target 3.7): The number of states with abortion bans is a direct indicator of access. The article specifies that the Dobbs decision “almost instantly banned abortion in 13 states” and mentions the Texas ban at six weeks. Tracking this number measures the legal framework for access to reproductive healthcare.
   • Patient Experience and Quality of Care (Indicator for Target 3.8): The article cites specific survey data from the CDC: “20 percent of women reported that they’d been mistreated at their most recent birth.” This percentage is a quantifiable indicator of the quality of care. The types of mistreatment listed—”being ignored when asking for help, being shouted at, being threatened that treatment would be withheld, and being forced to accept unwanted treatment”—are specific sub-indicators.

2. Indicators for SDG 5 & 10

   • Prevalence of Mistreatment/Discrimination (Indicator for Target 5.1): The CDC statistic that 20% of women report mistreatment during childbirth is a direct measure of discrimination and poor treatment within the healthcare system.
   • Racial Disparities in Care (Indicator for Targets 5.1 and 10.3): The article provides a specific data point on inequality: the rate of mistreatment for Black women is 30%, compared to the overall rate of 20%. This disparity is a key indicator for measuring racial inequality in healthcare outcomes.
   • Legal Status of Reproductive Rights (Indicator for Target 5.6): The legal status of abortion, as determined by Supreme Court rulings (Roe v. Wade, Dobbs) and state laws, serves as a primary indicator of whether reproductive rights are being upheld. The article’s entire premise is built on the shift in this legal indicator.

4. Table of SDGs, Targets, and Indicators

SDGs	Targets	Indicators Identified in the Article
SDG 3: Good Health and Well-being	3.1: Reduce maternal mortality. 3.7: Ensure universal access to sexual and reproductive health-care services. 3.8: Achieve universal health coverage and access to quality essential health-care services.	– Comparative risk statistics showing abortion is 14 to 30 times safer than childbirth. – Number of states with abortion bans (e.g., “13 states,” Texas ban at six weeks). – Percentage of women reporting mistreatment during childbirth (20% overall, according to CDC data).
SDG 5: Gender Equality	5.1: End all forms of discrimination against all women. 5.6: Ensure universal access to sexual and reproductive health and reproductive rights.	– Qualitative descriptions of discrimination (being treated like an “incubator,” “shouted at,” “bullied”). – The legal status of abortion as determined by judicial rulings (e.g., overturning of Roe v. Wade).
SDG 10: Reduced Inequalities	10.3: Ensure equal opportunity and reduce inequalities of outcome.	– Disparity in mistreatment rates during childbirth based on race (30% for Black women vs. 20% overall). – Geographical disparity in access to legal abortion (e.g., available in New York, banned in Texas).
SDG 16: Peace, Justice and Strong Institutions	16.3: Promote the rule of law and ensure equal access to justice.	– Impact of Supreme Court decisions (Roe v. Wade, Dobbs) on access to healthcare rights.

Source: thecut.com