Reflecting on My Journey to Women’s Health Care a Year After Dobbs

From the July 14, 2023 issue of the Transformational Times - One Year post Dobbs

Reflecting on My Journey to Women’s Health Care a Year After Dobbs

Amy H Farkas, MD, MS

Dr. Farkas shares her longtime passion and perspective on the advances and freedoms in women’s health care, both locally and globally, as the nation marks one year since the Supreme Court ruling on Dobbs v. Jackson Women’s Health Organization ended the constitutional right to abortion...

My path to women’s health care began in 9th grade world geography class. Mr. Nickels required us to report on a current world event each week, which meant I often found myself reading the world news section of the Kansas City Star. One day, as I read a story about the treatment of women by the Taliban in Afghanistan, I found myself wishing I could do more to help women around the world. Recognizing that I would not be traveling to Kabul any time soon, I decided to call my local Planned Parenthood to volunteer. I honestly can’t remember if I even knew what Planned Parenthood did, other than I had a vague understanding they were active in women’s health care and were a lot closer than Afghanistan.

My first job as a volunteer was to learn about local anti-abortion groups, specifically the Army of God, an organization known for acts of violence against abortion facilities and clinicians. I was shown pictures of known members in hopes that I could pick them out from the mostly peaceful protestors. Within a few weeks, I was the Saturday morning clinic escort. My main job was to stand opposite the protesters who showed up each Saturday and be a friendly face to women who were coming for care. Most Saturdays it was just me and the security guard standing across from five to fifteen protestors who were yelling and holding signs.

My time as a clinic escort was mostly uneventful. The police would frequently drive by and sometimes park across the street until everyone had gone home. But there were incidents of violence, real and threatened. One day, the clinic had to close when all its windows were shot out. Another day, it closed when someone committed suicide in the parking lot in protest. My fellow escort had a rock thrown at her head. Most staff at the facility had their pictures published on the internet by anti-abortion groups, and my picture might have been out there, too.

I remained a volunteer for Planned Parenthood throughout high school. In college, I founded a chapter of Planned Parenthood’s student advocacy organization. While I entered college as an international studies major, my time with the student advocacy organization grew my passion for women’s health care and specifically, reproductive care. It inspired me to pursue medicine.

I was fortunate in medical school to meet another educator, Dr. Melissa McNeil, a general internist, and leader in women’s health, who became my mentor. Throughout medical school, residency, and fellowship, she helped foster my knowledge and skills in clinical women’s health and the practice of academic medicine. She also connected me to the VA.

Since I began working at the VA in 2018, I have become convinced there is no other healthcare organization in the US more committed to serving women’s health care needs. You may find this surprising, given the military and VA's reputation for being male dominated.

Yet, women Veterans represent the fasting growing demographic group within VA, and the VA invests in their care across all its missions. It supports women’s health fellowships for physicians, researchers, psychologists, and nurses. This, in turn, helps grow the next generation leaders in academic medicine and women’s health. It funds research in contraception, maternal mortality, intimate partner violence, and breast cancer. It offers targeted educational programs for primary care teams, including physicians, APPs, and nurses to ensure they have the skills necessary to provide comprehensive, gender-specific care.

And in the post-Roe v. Wade world, the VA committed to ensuring women Veterans have access to the full range of reproductive health, including access to abortion care to “promote,preserve, or restore the health” of Veterans.

To achieve this goal, educators will be key to success. Educators will be the ones who translate government policy into clinical practice. They will teach clinicians who likely have never engaged in pregnancy options counseling and certainly not abortion care to provide compassionate and comprehensive reproductive health care. This change at VA will take time, and there are many pieces left to be figured out. But the VA's commitment to women’s health gives me hope that in the post-Roe world, medicine will not allow six justices to define health care.

The VA’s commitment to all aspects of women’s health care takes me back to my early passion to serve women’s health, both locally and globally. Thankfully, American women have far more options than were allowed to their counterparts living under the Taliban, both then and now. I am reminded that the advances and freedoms in women’s health remain only when we fight for them.

As a physician and educator, I can do my part in my clinic with my patients and in the classroom with students by helping to ensure the next generation of physicians have the necessary skills to provide comprehensive care to women. I’m grateful to have the VA as an ally in my own work to ensure health freedom for women.

Amy H Farkas, MD, MS, is an associate professor of Medicine at the Medical College of Wisconsin and works clinically as a women’s health primary care physician at the Milwaukee VA Medical Center. She also serves as faculty at the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education, where she is Director of the KICS program and part of the GME Pillar.