Healthcare and Women’s Lives at Stake in Virginia

The quick summary – all you need to know in one paragraph: The Dobbs Decision and the abortion bans that followed have had a significant, negative effect on women’s healthcare. State bans have increased the risk of maternal and infant mortality. They disproportionately impact Black and Latino women, Medicaid beneficiaries, single mothers, and those with limited education. They prompted an alarming exodus of medical professionals and created maternity care deserts in one-third of US counties. Women’s reproductive care should not vary with each new state election or administration. For Virginia women to have consistent, comprehensive healthcare, it is vital to ensure that their fundamental right to reproductive care is enshrined in the Virginia constitution.

Vote Yes on HJR 1 this November!

Read on for the history, background and details of HJR 1

Come Nov. 3, 2026, Virginians will be voting on three constitutional amendments, including HJR 1 that will enshrine a woman’s right to reproductive freedom in our state constitution. To understand the implications of HJR 1 for Virginia voters, it’s essential to consider the impact of the US Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization on healthcare. Ever since the Court overturned Roe v. Wade in 2022, women in the US have faced serious, even lethal, obstacles to obtaining safe, legal reproductive care. In 1973, the Supreme Court in Roe held that women had a constitutional right to obtain abortions, up to the end of the second trimester of pregnancy. For nearly 50 years, the US recognized Roe as settled law.

In 2022, however, the Court nullified the Roe decision in Dobbs, leaving abortion regulation to the states. The Dobbs ruling has led several states to impose bans or severe restrictions on abortion. By the end of 2025, 13 states had enacted strict abortion bans, although a few allowed limited exceptions.

Of the remaining states, 6 impose bans after 12 weeks, 4 impose bans after 22 weeks, and 18 other states impose restrictions at or near viability. 9 states have no gestational limits. So, the US has a patchwork of state laws affecting women’s reproductive rights.

Disturbing Patterns since the Dobbs Decision

Impact on women’s health and mortality. Women living in states that ban abortion are almost twice as likely to die during pregnancy, childbirth or postbirth than those in states where abortion is legal. For example, in the year following Dobbs, maternal mortality in Texas, a state with a complete ban, rose by 56%! Latina mothers in Texas face a mortality risk almost 3 times higher than Latina mothers in California, where abortion is legal. Black women living in banned states are more than 3 times as likely to die as white mothers in those states; see also People in states with abortion bans are twice as likely to die during pregnancy.

The US already has the highest maternal mortality rate of any high income country. In those states where abortion is banned, infant mortality has increased – by as much as 9% in Texas and Kentucky, for example.

Before abortion bans, if a fetal abnormality was discovered, women could terminate the pregnancy. In states with bans, that option no longer exists. Women are forced to carry the “doomed pregnancies” to term. Therefore, more babies are born with severe defects that are incompatible with life, resulting in a higher rate of infant deaths. These traumatic losses have an impact on the mental and physical health of the mothers and families.

Equally troubling, abortion bans have a disproportionate impact on the most vulnerable in society. The greatest impacts fall on Black and Hispanic women, Medicaid beneficiaries, unmarried women, and those without college degrees. Johns Hopkins ; AJPH.

Impact on the Medical Profession States wth abortion bans have forced medical schools, teaching hospitals and clinics to eliminate abortion-related topics and training from their curriculum. One doctor described this situation as “leaving students… unprepared not just for a career as an OB-GYN, but also for common emergency room situations, like a pregnancy complication requiring an emergency abortion to save a patient’s life.” America’s Doctor Shortage Is Getting Worse.

Recent data shows a marked decrease in applicants to medical schools in states with abortion bans. Surveys of medical students and residency applicants indicate that most see abortion training, along with acess to abortion for themselves or a partner, as a significant factor in where to apply.

As Dr. Stella Dantas, President of the American College of Obstetricians and Gynecologists said, “Abortion is reproductive health care, and OB-GYNs…provide reproductive health care. Abortion is the same procedure that’s used in miscarriage management and ectopic pregnancy management. It is used in situations where the pregnancy’s highly desired and it cannot go on for the health of the mom. So, you do need that training.”How strict abortion bans threaten health care for all women

Many doctors in states with bans, including Texas, North Carolina, Ohio, Tennessee and Florida decided to leave those states, at least in part, due to the bans. Idaho lost over one-third of its OB-GYNs since enacting its 2022 ban. States with the harshest abortion restrictions have a dire shortage of doctors. More than one-third of American counties are now deemed “maternity care deserts,” – areas that lack “a single doctor, nurse, mid-wife, or medical center that specializes in maternity care….” This shortage is particularly acute in rural areas.

The OB-GYN shortage doesn’t just affect women who have pregnancy complications or seek an abortion. OB-GYNs are a vital part of health care for all women. They conduct pelvic exams, take pap smears, provide birth control, administer mammograms and provide routine and specialized pregnancy care.

Many OB-GYNs in states with bans find it very difficult to provide the best possible care to their patients. They are hampered by restrictions on patient counseling and referrals. Doctors report that they find the abortion ban laws with limited exceptions for saving a mother’s life vague and hard to understand. Many hesitate or decline to act until a patient is near death, which may be too late.

Doctors also fear legal liability and criminal prosecution. Stress and exhaustion cause some providers to move to another state or to leave the reproductive healthcare field.

Environment of fear for patients and caregivers Miscarriages are common. About 1 in 5 pregnancies result in a miscarriage, although some studies indicate that the percentage is even higher. Some states view pregnancy loss with suspicion. Prosecutions in connection with pregnancy loss have increased since the Dobbs decision. In the year following Dobbs, at least 210 pregnancy-related prosecutions occurred. Among the states that have conducted criminal prosecutions are: Alabama, Arkansas, California, Georgia, Ohio, Oklahoma and South Carolina.

Two legislators in Tennessee recently filed a bill proposing that abortion be treated as criminal homicide, subjecting women who have abortions to felony charges and, in certain cases, the death penalty.

In several tragic cases, women who were miscarrying were denied medical care and died from bleeding out or sepsis because their doctors feared criminal prosecution under state law. More than 100 pregnant women “in medical distress who sought help from emergency rooms were turned away or negligently treated” between 2022 and 2024.

Doctors’ fears of criminal prosecution are well-founded. As of February 2025, 12 states with abortion bans had statutes imposing criminal penalties on physicians.

Details on HJR 1 and how it will protect reproductive freedoms

HJR 1 says that the fundamental right to reproductive freedom includes: “the ability to make and carry out decisions relating to one’s own prenatal care, childbirth, postpartum care, contraception, abortion care, miscarriage management, and fertility care.” Consequently, it takes a comprehensive view of women’s reproductive health.

This right cannot be denied, obstructed or limited “unless justified by a compelling state interest.” In other words, the state can’t arbitrarily take away this right or make it harder for women to exercise it. The resolution adds that “a state interest is compelling only if it is for limited purpose of maintaining or improving the health of an individual seeking care, consistent with accepted clinical standards of care and evidence-based medicine….”

HJR 1 is very clear that Virginia can “regulate the provision of abortion care in the third trimester,” but the state cannot “prohibit an abortion (i) that in the professional judgment of a physician is medically indicated to protect the life or physical or mental health of the pregnant individual, or (ii) when in the professional judgment of the physician the fetus is not viable.” This provision requires that third trimester abortions be approved by one doctor, not three doctors as current law requires.

This resolution is equally clear that the state “shall not penalize, prosecute or otherwise take adverse action” when an individual exercises this fundamental right, nor can it take such actions against those who aid or assist others in exercising that right. This provision protects women from criminal penalities for exercising their fundamental right, and protects those who assist them in exercising that right. This provision also prevents third parties, including legislators, from substituting their judgment for that of a woman and her doctor.

HJR 1 was sponsored by House Majority Leader Charniele Herring (D-Alexandria). She notes that “With the passage of HJR 1, Virginia is taking decisive action to protect reproductive freedom in the Commonwealth, and ensure that personal healthcare decisions remain between patient and doctor and free from political interference.”

In the Senate, HJR 1 was co-sponsored by Jennifer Boysko (D-Herndon). Senator Boysko described HJR 1 as a “victory for every woman and girl in the Commonwealth who believes in the right to make personal healthcare decisions without government interference. By protecting reproductive freedom in our constitution, we are standing up for the rights, health and autonomy of Virginians.”

Republican legislators have three criticisms of HJR 1:

• It removes all restrictions on abortions. The second and third paragraphs of the amendment make plain that this is not “abortion on demand”. HJR 1 says very clearly that Virginia can “regulate the provision of abortion care in the third trimester….” It also says that if the state has a “compelling interest,” it can regulate abortion care in the first and second trimesters, as well.
• Sen. Mark Peake (R-Lynchburg) has criticized the term “individual” in HJR 1 for not distinguishing between adults and minors. Democrats and legal experts argue that this is unnecessary since Virginia already requires minors to have parental or guardian consent, unless they petition a judge for authorization.
• Del.Todd Gilbert (R-Shenandoah) argued HJR 1 doesn’t address the “compelling state interest in protecting the unborn at a certain point in the pregnancy.” This argument doesn’t make sense, because HJR 1 affirms the state’s compelling interest in regulating abortion care, as noted above.

Vote Yes on HJR 1 this November!

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