An article in Arthritis & Rheumatology describes how the Supreme Court’s June 24th decision to overturn Roe v. Wade portends grave consequences for the practice of rheumatology.

Abortion bans that have been drafted by more than half of US states can now be implemented, and many more are in development. For patients with rheumatic diseases, family planning choices will be limited, thereby restricting their options for medical treatment. Providers will be forced to weigh delivering evidence-based clinical recommendations against the personal, professional, and legal risks of violating constraints on reproductive rights.

The authors stress that pregnancy can be dangerous for some individuals with rheumatic diseases, and many of the medications that benefit patients with conditions such as rheumatoid arthritis and lupus have been linked to birth defects. 

“Many patients with rheumatic diseases are reproductive aged women whose complicated diseases are exacerbated by pregnancy, especially when unplanned. This burden of illness is more pronounced in racial and ethnic minority women, who face both greater morbidity and mortality due to their illness and often live in states with the most restrictive abortion legislation,” said lead author Bonnie L. Bermas, MD, of UTSouthwestern Medical Center. “Thus, the recent Supreme Court Dobbs v. Jackson Women’s health organization decision not only negatively impacts our ability to provide the best healthcare for all of our patients, but also furthers the existing structural racism that impedes the delivery of appropriate reproductive and rheumatic disease care for our minoritized patients.”