Since the fall of Roe v. Wade in 2022, the United States has been navigating a reproductive health crisis unlike anything in modern history. Now, in mid-2025, the picture is even more stark, and more urgent.

In the wake of the Dobbs decision, nearly 1 in 5 patients seeking abortion care, including care for miscarriage, have been forced to travel out of state. That is more than double the number from just three years ago. And as lawmakers across the country push forward with new restrictions on medication abortion, defund essential clinical programs, and exclude family planning clinics from Medicaid, we face a growing fracture in our health care system that endangers lives.

As leaders of Doctors for America and the American Medical Women’s Association, and co-founders of the Reproductive Health Coalition, we represent over 180 organizations and 150 million individuals. We are physicians; we are advocates; and we are witnessing firsthand the harm being done to patients, not just in theory, but in our exam rooms, hospital wards, and communities.

This is not a debate about politics. It is a matter of basic health and human dignity.

Take miscarriage care. In a functioning system, a patient suffering a miscarriage should receive swift, compassionate, and evidence-based care. But in states with restrictive abortion laws, we have seen horrifying delays as providers navigate vague legal threats or fear prosecution. Patients have been forced to wait until they are hemorrhaging or septic before they receive treatment, all because providers are unsure what care is “safe” from a legal standpoint. This is unacceptable.

As internists, we bring a unique lens to the reproductive health crisis. Far too often, conversations around reproductive care are left to our obstetrics and gynecology colleagues. Their expertise is vital, but reproductive health is not exclusive to one specialty.

Internists counsel patients on contraception, manage chronic conditions during pregnancy, and often serve as a patient’s only regular medical contact. We are on the front lines, especially in rural and underserved areas where specialists are scarce. But our ability to provide quality care is now under direct threat from policies that are driven not by evidence but by ideology.

The ripple effects of these policies are far-reaching. Research consistently shows that access to comprehensive reproductive care, including abortion, improves maternal and infant health outcomes. Conversely, restrictions are linked to higher maternal mortality, especially among Black, Indigenous, and low-income populations.

That is why the Reproductive Health Coalition is calling for a national reset in how we talk about reproductive health. This is not a “culture war” issue. This is health care. It is about dignity, privacy, and the sacred trust between a patient and their clinical team.

It is also about clarity and courage for health care providers. Our coalition has helped draft Shield Laws for states that continue to provide abortion services, and we have created legal guidance to help clinicians understand their protections. No provider should have to choose between doing the right thing medically and risking their career or freedom.

We urge policymakers, clinicians, and voters alike to consider this: women’s health is not optional. Reproductive care is not a fringe issue. It is a core part of health care that affects half the population and impacts all of us.

The time for neutrality has passed. Silence only enables injustice.

We must reshape the conversation. We must lead with compassion, evidence, and integrity. And we must remind the country that access to reproductive care, abortion included, is about more than rights. It is about survival.

Christine Petrin and Susan Thompson Hingle are internal medicine physicians.