Evaluating the impact of Dobbs on management of Pregnancy-Associated Cancers (The PAC Study)
Awarded 2023
High-risk pregnancy care, post-Dobbs
Katherine Van Loon, MD, MPH
University of California, San Francisco

On June 24, 2022 the Supreme Court decision in Dobbs v Jackson Women’s Health Organization reversed the constitutional right to abortion previously protected under Roe v Wade. As a result, there is mounting concern that patients diagnosed with PAC in states with restricted access to abortions will not have the option in to terminate their pregnancy if needed to receive oncologic therapy. While there are exceptions for abortions to be performed for “medical emergencies” in many states, these laws are not clearly defined, and efforts to pursue these approvals may require time-consuming legal interventions that compromise the ability to provide timely care to the mother. Meanwhile, physicians and reproductive health providers who perform terminations have been threatened with felony-level charges for performing pregnancy terminations and may fear criminalization. At present, 22 states have passed laws that ban abortion entirely or that restrict abortion access earlier than the previous standard set by Roe v Wade. The overall objective of this proposal is to understand how the Dobbs decision impacts the care of patients diagnosed with PAC in states with restricted access to abortion compared to states without abortion restrictions. We hypothesize that since the Dobbs decision, patients with PAC are more likely to experience barriers and delays to oncologic care delivery in states with laws that restrict access to abortion.