Prepared Comments for Academy Health Webinar to Highlight the National Academies of Science, Engineering and Medicine Workshop

Potential Impacts of Dobbs — Harms of Health Services Research

The scientific community has several responsibilities that go beyond documentation of harm. There are several domains that we need to pay attention to including maintaining an accurate scientific record, training the future workforce, and enduring trust and reducing misinformation and disinformation.

Alabama — IVF

3/26 — Mifepristone

· A note from Sage on retractions in Health Services Research and Managerial Epidemiology Today, we retracted three articles in the Sage journal Health Services Research and Managerial Epidemiology:

· “A Longitudinal Cohort Study of Emergency Room Utilization Following Mifepristone Chemical and Surgical Abortions, 1999–2015” (2021)

· “A Post Hoc Exploratory Analysis: Induced Abortion Complications Mistaken for Miscarriage in the Emergency Room are a Risk Factor for Hospitalization” (2022)

· “Doctors Who Perform Abortions: Their Characteristics and Patterns of Holding and Using Hospital Privileges” (2019)

Community-Partnered Research Approaches

I asked my good friend Dr. Terri Ann-Thompson (whose quote you heard earlier that Dr. Simpson read in her opening comments) who works at Ibis Reproductive Health to join me in a discussion about Health Services Researchers and thinking about community engagement in the context of Dobbs. Some key considerations for this audience are outlined in the workshop proceedings. However, I want to highlight the following:

1. Call out and do not perpetuate abortion stigma

a. Language — we have been lied to for 50 years! Pregnant people, all pregnancies end, they just don’t end in birth

b. Framing — justifications and rationalizations for abortion, providers of care who are conscientious providers and not just objectors

2. Have a community engaged research framework

a. CBPR

b. RPAC

3. Community Research Capacity

a. Invest!! Don’t extract, partner

b. Truth, Reconciliation; Rupture and Repair

4. Consider Dissemination Beyond Journal Articles

a. Infographics

b. Digital assets

I have been written a great deal of work to clearly articulate some of the principles that really gums up our work with community and elucidates why I believe we all are not having the same conversation. Some of us are retrofitters, some are reformers, and some of us are reimaginers. For those of you who are curious, I am all three.

· Retrofit — defining and living values — This means that structures as they currently exist, survive and that we begin to develop a shared language about the rules of engagement. This is acknowledgement, visibility, being heard, being seen.

· Reform — embracing accountability — This means that power has been defined, described, and a plan to share is established, it means we work with each other with a goal of working toward a shared goal.

· Reimagine — authentic engagement — Radically reimagining this goes beyond shared publication, and shared presentation of co-developed research. It means bringing community to funders and funders to community. It means reparations of humans, money, space, reputation and time. It means building something completely different from retrofit and reformers, without discrediting their important work.

We are currently in uncharted territory with Dobbs and we need to remember it was never enough and definitely not the best we could get. For pregnant capable people to have full rights as citizens, we need to ensure their capacity to be the experts of their own lives. In understanding this, we can be the true authentic partners they need to envision the kinds of care and interventions that should result in harm reduction and optimal health outcomes.