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Dr. Janet Lefkowitz Reacts To A Post-Roe World

The Alabama woman was in her early 30s. She had an 8-year-old son. Now she was pregnant again,

But the father was no longer in the picture. And she had just been diagnosed with stomach cancer.

Her doctor refused to treat her. Though it was early in her pregnancy, drugs that could save her life might harm the cells in her uterus. In her state — and many others — that could be a felony.

Dr. Janet Lefkowitz was horrified by that story. And it was not hearsay. The woman was one of the 1983 Staples High School graduate’s patients.

Dr. Janet Lefkowitz

Dr. Lefkowitz does not live in Alabama. But once a month, she leaves New England — where she is an assistant professor at Brown University’s Warren Alpert Medical School, and affiliated with Women & Infants Hospital in Providence — and spends a week down South.

Her other title is medical director of reproductive health services for Alabama. The organization provides reproductive health care, advocacy and education throughout Planned Parenthood Southeast.

Until June 24, that included abortions. After last month’s Supreme Court decision, Dr. Lefkowitz could be arrested. Even if her patient was a victim of rape or incest.

Or 9 years old.

Or diagnosed with stomach cancer.

Dr. Lefkowitz did not set out to work as an obstetrician/gynecologist, or become a reproductive rights advocate. She did not even plan on becoming a doctor.

After Staples and Sarah Lawrence College, she did children’s theater. She temped.

But her family — including her father, orthopedist Dr. Larry Lefkowitz — and Temple Israel had imbued in her a strong belief in Tikkun Olam: acting as constructively and beneficially as possible, for as many people and as long as possible.

Eventually she found her way to medical school. During her OB/GYN residency in Hartford, she realized the field was perfect for her.

Her clinic work in places like Birmingham, Montgomery and Mobile was fulfilling. She worked too with Mississippi’s Jackson Women’s Health Organization, the defendant in the seismic Supreme Court decisions.

Supreme Court members who decided Dobbs vs. Jackson Women’s Health Organization. Katanj Brown Jackson has since replaced Justice Stephen Breyer.

That ruling — a cause for anger, fear and despair in some Americans, relief and jubilation in others — was both expected by reproductive rights advocates. Still, the reality felt stunning.

“Abortion is safe, normal health care,” Dr. Lefkowitz says emphatically.

“The first priority of any doctor is that patients get the compassionate care they deserve. Abortion is part of that.”

The Supreme Court decision will not change access to abortion for “people with resources,” Dr. Lefkowitz says.

But those without — including marginalized populations —  will be “forced or coerced” to deliver a baby they may not be able to properly care for.

“We trust our patients. They know their bodies and themselves. Restricting healthcare for them is frustrating.”

Dr. Lefkowitz and her colleagues are turning their attention to “self-managed” abortions: pills. She calls them “safe and effective.” However, information about and access to that medication is no longer assured.

Her initial reaction to the Supreme Court decision was “sadness and numbness,” the doctor says. Now, the medical community is coming together to explore next steps.

Hundreds turned out for 3 pro-choice rallies in Westport this year. (Photo/Bobbi Essagof)

“We need to use our training and expertise to serve patients, to the best of our ability. Otherwise, they — and their families — will suffer.”

There is still a stigma around abortion, Dr. Lefkowitz notes. She is encouraged that in the wake of the Court’s ruling, women are speaking up about their experiences.

She adds, “We know the decision to have an abortion is not made lightly. Each story is personal. Everyone needs to hear the stories of those who feel they can tell them.”

Now, Dr. Lefkowitz is focusing on the realities of the Supreme Court’s judgment.

“If there’s a ‘heartbeat’ — really just electrical activity — doctors can’t do anything. If I see a fetal anomaly that’s not compatible with life” — for example, lack of brain development — “I can’t do anything. I’ve delivered those babies. They don’t live.”

She worries too about women who suffer ectopic pregnancies and miscarriages. New laws can lead to criminal investigations, of themselves and their doctors.

In fact, Dr. Lefkowitz says, because the situation is so unsettled, attorneys for Planned Parenthood in Alabama and Mississippi have told employees not to provide women with information about abortions in other states, or make referrals there.

Meanwhile, Dr. Lefkowitz can’t shake some of the images she’s witnessed — and wonders about those she may no longer see.

A mother took a day off work to bring her 15-year-old daughter — a victim of sexual assault — to a Southern clinic. The girl was just starting high school. A good student and athlete, her future had been bright.

She had an abortion, and moved on with her life.

Now, Dr. Lefkowitz says, she’d have to travel hundreds of miles.

Or have the baby.

“Abortion will always be a key part of healthcare,” Dr. Lefkowitz says.

“People need it. They need autonomy of their body. And they need to be able to care for the kids they already have.

“This decision doesn’t take away abortion. It takes away only safe, legal abortion. It’s sad, terrifying and frightening.

“All we want to do is help.”

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