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Family physician Travis Walker discusses his article “A physician father on the Dobbs decision and reproductive rights.” Travis reflects on the glaring double standard facing his daughter compared to his sons in the wake of the Supreme Court’s 2022 ruling. He explores the unique medical risks inherent in every pregnancy and challenges the notion that childbirth is ever truly “low-risk.” The conversation highlights the struggle to reconcile professional medical ethics, which value patient autonomy and informed consent, with a legal landscape that restricts those very principles for women. Travis argues that true liberty requires personalized medical advice without state coercion and emphasizes his commitment to raising all his children to understand responsibility, equity, and respect. Listen to a heartfelt examination of how biology and policy collide to shape the freedoms of the next generation.
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Transcript
Kevin Pho: Hi, welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome Travis Walker. He is a family physician, and today’s KevinMD article is “A physician father under Dobbs decision and reproductive rights.” Travis, welcome to the show.
Travis Walker: Hi. Thank you for having me. I am glad to be here.
Kevin Pho: All right, so before talking about your article and why you decided to write it, just bring everyone to the same page. Talk briefly about the Dobbs decision so we could give us some context.
Travis Walker: So obviously the Dobbs decision was the Supreme Court decision that overturned Roe versus Wade and pushed those decisions regarding abortion to the states. As we can see, there is a lot of varying enforcement or actions taken on that from state to state.
Kevin Pho: All right, so tell us about what prompted you to write this article and have it shared on KevinMD.
Travis Walker: In my practice I have come to realize that guidelines and evidence are the basis of what we try to practice. But a lot of those decisions are really based in individuals’ fear, memory, and their own sense of responsibility. As a father, I recognize that in myself.
Looking at my kids and having two older boys and one younger girl, I see that they are going to be faced with very different decisions. This is not just because biology kind of forces that they have different anatomy, but their decisions and consequences are also going to be very different. I think wrestling with that as a father and then also seeing what I see as a physician has made it so that I kind of had to write about it and get my own thoughts on the page to process it.
Kevin Pho: So when the Dobbs decision came down, this was back in 2022. Just talk to me about some of the emotions and feelings that you had after that decision.
Travis Walker: I think I reflected on my own adolescence and going through decisions and probably poor decisions sometimes that I made. Seeing my boys and having them first realizing that they will be men means these are things that we need to recognize. But then having a daughter brings it full circle to realize that if she were to act or behave the same way, to have the same rights and liberties as anybody else, she may not have that opportunity to have fewer consequences.
I think in time, that knowledge that depending on where she chooses to live or where she chooses to raise a family, she would be presented with very different choices and options. My goal was really to try and be as equitable as possible for both of them and to be as equitable as possible as I can for my patients. Then realizing that equity is not there since this decision.
Kevin Pho: Did you have these types of conversations with your sons and daughter and what were those conversations like?
Travis Walker: Yeah, they are still fairly young. My oldest is 10 years old. OK. So trying to frame those conversations around other areas involves saying things like: “This is how your decision affects other people in the context of what he may do with friends or school.” But the day that comes where we have to have sexual health discussions with all three of them is probably not as far away as I would like it to be.
It is definitely something that we are continuing to build toward. For my patients, it is the same thing. I frame these discussions by saying: “Here are your options and here is what is available to you based on where we are.” They know that some of those options may not be available elsewhere.
Kevin Pho: Can you tell us a story about one of your patients or those conversations that you had with your patients about how the Dobbs decision affected their choices? Tell us a story about something that may have happened.
Travis Walker: Yeah. So when I started my career, it was still Roe v. Wade. I was a practicing family physician, but I also practiced obstetrics. So I was still delivering babies and providing prenatal care and postpartum care.
I had a number of patients that had to come in from out of state or even just from rural areas of our state because their choice was not to have a baby. Some of it was due to youth. Some of it was due to mistakes. In egregious cases, it wasn’t their choice when they had sex.
So we would have that discussion. Since Dobbs, I have had patients that have come from out of state and come from states where this is not an option. Nevada doesn’t have a ton of resources when it comes to this. There are still legal protections for it, but we are not in a place where everybody is treated equally. So many people have to travel long distances to try and get the care that they feel is right for them.
Kevin Pho: And when they come from long distances and see you in your clinic, what is that interaction like? Tell me how you feel as a physician when they come from out of state into Nevada because their state is affected by the Dobbs decision.
Travis Walker: It is difficult. Many times I don’t have a relationship with them yet. Part of my ethos is that I sit with them. We talk about why they have come to this decision. But we are really talking about evidence indicating the risks that come with continuing to carry the child or not continuing to carry the child depending on where they are at in their pregnancy.
Really sitting down with them involves trying to understand what their drive is for that decision. Making sure that they fully understand what that decision entails is important, not just medically and physically, but also the consequences that could come emotionally from either decision that they decide to make.
Kevin Pho: It must be so difficult, especially if you don’t have a relationship with these patients who come from out of state. The emotional aspect of that must be challenging.
Travis Walker: Yeah. With every patient encounter, you get to know them little by little and hopefully have the time and ability to help them understand their own decision. But you must also understand internally yourself what it is that is bringing them here. Making sure that they understand the full ramifications of what is going on is key.
Kevin Pho: So in your article you talk about this maxim saying that there is no such thing as a low-risk pregnancy. Talk to us about how sometimes medical complications can influence that decision and how the Dobbs decision can make those decisions even more difficult, especially if there is a medical complication with the pregnancy.
Travis Walker: Yeah, I mean, I think the thing that is under-recognized is that even the most perfect pregnancy with perfect labs and great ultrasounds can turn on a dime. I think recognizing that there is inherent risk in this, a risk that men don’t carry that women do, is important.
Knowing that when a true complication arises there is a way to protect the mother is vital. We can often identify those with good access to prenatal care early in the pregnancy.
At times it becomes necessary to have that discussion that this is not going to be a healthy pregnancy or this is not going to be a viable pregnancy. We need to be able to discuss that with that patient. Perhaps sometimes what was their dream to have a child and to get pregnant becomes difficult. Maybe it is something that we have to end because we are trying to preserve life or quality of life.
Kevin Pho: Now, of course, this is a very political topic. Do you ever talk to other physicians or colleagues who support the Dobbs decision? Tell us just in general what topics are discussed and what issues are brought up when you have someone that you disagree with in terms of the Dobbs decision.
Travis Walker: Absolutely. You can’t work in women’s health care and not at some point address this. I think ultimately what it comes down to is not necessarily the politics, but understanding the choices that are available to people. It involves being able to explain those options and choices to them in a way that makes sense to them so that they can make the best decisions for themselves.
When I have these conversations with other physicians, I try not to bring out the politics in it. We all have our individual beliefs, but really anchoring it in what the right step and the right choice is that the patient needs to make helps them make the decision that is right for them.
Kevin Pho: So for those patients who may be listening to you on this podcast, when the Dobbs decision came down they may not think that it would affect them at that point, but eventually it may affect them. Do you have any insight or advice to patients who may be listening to you as to how this decision may affect them going forward?
Travis Walker: I think ultimately it comes down to what options are available to you. There are things that each state can do even outside of Dobbs that are legal in some and not in others.
This is one of those issues where there is a very hard line on who it affects. It affects women. Women will have to suffer the consequences of any decision that is made or made for them in this situation that men won’t.
I try and remove my personal beliefs completely. I really focus on helping them understand for their own ethos what makes the most sense. I think ultimately if there are people who feel strongly one way or another, they should take it upon themselves to advocate for what they believe in.
Just the way that we advocate as physicians for our patients to make the right decision for them, whether we disagree with it or not, those are things that I want my patients to know. We are always here to support them. I am always here to support you, but if you have your own beliefs you should definitely fight for them and push for them.
Kevin Pho: Now, what do you see as the path going forward as to the ramifications of the Dobbs decision, say in the next year or so? Are there any issues in your clinic that you foresee happening that you have to anticipate?
Travis Walker: For us, we don’t provide abortion services out of our clinic, but oftentimes we do have patients who are seeking those services.
With it being up to the states, we have been in a very supportive state as far as patient autonomy and supporting those decisions. But I do think that in time those resources can become further constrained. It can make medically appropriate decision-making more and more difficult when we are talking about how we preserve life and quality of life.
It will continue to be what it will be and evolve based on how it is supported until something changes. That will be until either more advocacy takes hold or there are differing opinions in this country about how essential and necessary these services are. We can see how they affect the individual patient and how those choices and consequences vary from state to state based on what those options are.
Kevin Pho: Now for those parents who are listening to you and they have teenage daughters, tell us the types of issues that you would like parents to talk about regarding the ramifications of the Dobbs decision.
Travis Walker: I think it is understanding that at least for me it has come down to understanding that there are differences between how my sons will live their lives and how my daughter will live her life. Do I endorse promiscuity or any of that? Absolutely not. But I also understand that at some point I will have less and less control over their lives.
My goal is to raise them to make the best decisions that they can and to think about others when they make those decisions. I also want them to recognize that they are both complicit in the consequences of those decisions. Hopefully, both my sons and my daughter will have at least equal takeaways or at least equal consequences from those decisions.
Kevin Pho: We are talking to Travis Walker, family physician. Today’s KevinMD article is “A physician father under Dobbs decision and reproductive rights.” Travis, let’s end with some take-home messages that you want to leave with the KevinMD audience.
Travis Walker: Ultimately it is coming down to what is the right course of action for a patient, what is the right course of action for our families, and for ourselves. It involves ultimately recognizing that if we want there to be equality or equity, we must recognize that there are differences that we can have an influence on both as parents and physicians. But ultimately it is about helping everybody make the right decision for themselves.
Kevin Pho: Travis, thank you so much for sharing your perspective and insight and thanks again for coming on the show.
Travis Walker: Thank you very much for having me.
