A lack of trust toward medical organizations, or “medical mistrust,” is a barrier to safe and timely health care, especially for Black, Latinx and immigrant patients. It can result in missed appointments and delayed procedures, which in turn lead to higher risks of adverse health incidents and potential death.
And now, as abortion bans are set to go in effect in 22 states if Roe v. Wade is overturned, this mistrust will increase and, along with it, the danger to people who can get pregnant.
In the early 1960s, my grandmother went to her physician in New York and asked for an abortion. Like most people seeking abortions, she already had children and was concerned about finances, especially because she had only been in the United States for a year. She didn’t understand the horrified look on the doctor’s face. Abortion was available in Istanbul, Turkey, where she had emigrated from, even though it was not officially legalized until 1983.
Her doctor said he could get arrested and was “shocked that Turkey was so advanced.” How could a poorer, mostly Muslim country be ahead of the United States on reproductive rights? He spoke over my grandmother, dismissed her concerns and sent her home with confusion, worry and no alternatives.
This adverse experience made my grandmother wary of doctors, so much so that she was silent when in terrible pain from a uterine prolapse after my mother was born. Years passed before she finally received treatment for the condition. Sixty years and two generations later, I am enraged that history is poised to repeat itself with the leaked draft to overturn Roe v. Wade.
As a public health professional, I fear that criminalizing abortion will exacerbate medical mistrust beyond reproductive health. If people cannot confide in their health care team and seek support, they — like my grandmother — might put off treatments of any kind.
The fact that some states are trying to convict those attempting abortion is already having a chilling effect, as in the case of Lizelle Herrera, who was arrested and held on a $500,000 bail for an alleged self-induced abortion in Texas. Someone at her hospital had reported Herrera to the police.
And while the charges were later dropped, a Texas bill — which would become law, post-Roe — would allow citizens to report and sue anyone who facilitates an abortion, including a medical provider. Other states, such as Idaho, have followed Texas’ lead.
If people cannot trust their health care providers without fear of criminal charges, the health consequences are far-reaching and immeasurable. Withholding medical information and positive health outcomes directly conflict, and I have seen this firsthand.
One of the deadliest health secrets a pregnant person might not share is that they’re in an abusive relationship. When I was a crisis counselor for sexual and domestic violence, several pregnant survivors struggled to tell doctors what care they needed. Hospitals left many feeling judged and discriminated against. Survivors learned to use past health care experiences as a litmus test for how much a provider could be trusted.
The more mistrust that exists between a patient and their health care institutions, the less health care is used. If the goal of restricting abortion access is to truly protect children, growing medical mistrust between doctors and pregnant people will negate the desired affect.
To counteract medical mistrust, we must fight to hold health care institutions accountable to their patients and make them worthy of trusting.
Amber Gipson-Fine is a Project Manager for COVID-19 clinical trials at Rush University Medical Center, public health activist, and Public Voices Fellow with The OpEd Project.
