Background

The overturning of Roe v. Wade in June 2022 led to the immediate death of one woman in South Carolina and delays and denials of reproductive care for countless people in states with trigger bans. One woman died from hemorrhage following self-instrumentation. Another patient hemorrhaged, and hospital administrators would not allow her physician to perform a dilation and curettage procedure to stop the bleeding. 

Duke physicians, led by Beverly Gray and Jonas Swartz, heard similar stories across the Southeast. By October 2023, providers in abortion ban states testified about the decision’s impact on their ability to carry out evidence-based practices. Their stories were shared in TV reports, newspaper articles and courtrooms. 

The bans, unconnected to the science of reproduction or evidence-based medicine, have caused enormous upheaval in the geographic distribution of care. Providers find they must move or travel to shield-states to continue to do their jobs. Some long-term impacts are already clear: the 65% of U.S. women, girls and gender-expansive people living in ban-states will experience challenges in receiving OB-GYN care, or even face criminalization. 

The end result of these restrictions will impact reproductive autonomy over the next two generations, even if the bans are overturned. Outside of providing evidence-based care, watching human rights being taken away in real-time has a profound impact on the mental health of providers and creates a tremendous moral injury when the ability to provide a necessary component of healthcare is taken away.

Project Description

Duke University Hospital’s location in one of few southern states without a near-total abortion ban, along with its institutional structure (private rather than public), make it an ideal place from which to bear witness to reproductive healthcare access in the post-Roe landscape.

Building on the work of a previous team, this project team will gather and organize archival research, document media coverage and conduct oral history interviews to add to a Reproductive Care Provider Archive, with a particular focus on the Southeast. Interviewees will include nurses, nurse navigators, clinic managers and other key staff involved in care provision post-Roe.

As they expand the Reproductive Care Provider Archive, team members will iterate and update protocols for data storage and sharing, innovating a safe and sustainable method for handling sensitive material. They will continue to develop social media channels and a student-created website as well as create a podcast with Dr. Gray and Dr. Swartz. These media will put the interview material into broader historic, legal and medical context to increase public understanding of this issue.

Anticipated Outputs

Expansion of Reproductive Care Provider Archive; new social media channels; student-created website; sustainable data storage and sharing protocols; podcast contextualizing excerpts from oral history archive

Student Opportunities 

Ideally, this project team will include 4 graduate students and 8-10 undergraduate students interested in healthcare, social justice, data management, the arts, documentary studies and journalism. Students from all fields who are interested in reproductive justice are encouraged to apply.

Undergraduates will have the opportunity to document at least five providers’ experiences of the post-Roe changes in reproductive healthcare. They will help to refine a secure workflow generating the best available ethical, legal and medical knowledge for the archive. Students will acquire a deep knowledge of the complexities of this era, as well as the reproductive justice framing it takes to understand it. In addition, graduate students will have the opportunity to lead subteams of undergraduates, use their analytical and research skills, and build influencer networks to help them disseminate their own scholarship in the future.  

In Fall 2024, the team will meet on Mondays from 12-2:30 p.m.

Timing

Fall 2024–Spring 2025

• Fall 2024: Learn medical content; train for and conduct interviews; transcribe and index interviews; refine communication plan; seek Institutional Review Board (IRB) approval for second qualitative study; record two podcast episodes; update social media and web platforms
• Spring 2025: Continue to conduct and process interviews; write, record, edit and launch all six podcast episodes; finish second quantitative study; update platforms and disseminate information

Crediting

Academic credit available for fall and spring semesters

See earlier related team, Women’s Reproductive Health Post-Roe (2023-2024).