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“As an OBGYN who has been in Pittsburgh since 2005 when I started medical school at Pitt, I have seen a tremendous shift in how we deliver and access healthcare. Our large healthcare entities are more and more focused on efficiency, the bottom line, and seeing as many patients as possible, and this has had a devastating impact on the quality of care that patients in our communities receive. The institutionalized racism, misogyny, and classism that is embedded in these healthcare systems are being identified and named, yet in most cases, that is where the progress ends. We see many organizations doing performative justice work, not transformative justice work. The legal and political landscape has also had a massive impact on how we provide healthcare. This impact is most obvious for me in the reproductive healthcare space. As an abortion provider and the CEO of Allegheny Reproductive Health Center, an independent abortion clinic in Pittsburgh, we are constantly providing abortion care in an ever changing landscape. Our patients come to us from Western and Central Pennsylvania, and the surrounding states including West Virginia and Ohio. Since losing the federal protections of Roe v Wade in the June 24th, 2022 Dobbs decision, we are seeing more and more patients from all over the country, especially from southern states. With the upcoming Pennsylvania midterm elections in November 2022, and possibility of a constitutional amendment banning abortion being on the ballot in Spring 2023, Pennsylvania may be the next state to lose abortion access in this country. We also are seeing rising rates of pregnancy related morbidity and mortality for people of color, especially black women. This is not an accident. The institutionalized and interpersonal racism and bias that people of color experience with healthcare providers is not improving ... it is worsening. With the pressures of the pandemic and changes within our hospital institutions, racism in healthcare delivery is leading to more and more people being harmed. This is completely unacceptable and completely modifiable. Healthcare systems, especially our hospitals, must immediately change policies and protocols that systematically target people of color and implement more than just virtual training on implicit and explicit bias. Leadership in these institutions, which is dominated by privileged white people, must step aside to bring in diverse perspectives and experiences ... Only then will we begin to see real change. As healthcare providers, we must provide care in a way that shifts the power into the hands of the patient ... our client. When we take the power and control out of our hands, legislators' hands, and the courts' hands, patients have better outcomes and can trust the systems that they live within. As healthcare providers, we need to not only provide the care but also fiercely advocate for our clients. We need to be a voice for them and put aside our own personal biases and opinions. When we do that, we will be the healthcare providers that our patients need and deserve” - Sheila Ramgopal, MD, MA, FACOG (they/them/theirs) Chief Executive Officer Allegheny Reproductive Health Center
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