Reproductive Justice Under Siege: The Ethics of Contraception, Sterilization, and Pregnancy Healthcare in Post-Roe America

Abstract: The legal and ethical landscape surrounding contraception, sterilization, and access to medically necessary abortion is rapidly shifting in the wake of the Dobbs decision. Threats to reproductive justice in America emerge from interconnected forces, including deliberate legal maneuvers limiting reproductive freedom and interventions purportedly designed to protect autonomy, which often backfire and restrict reproductive justice. Historically marginalized communities—including Black and Indigenous women, those with disabilities, low-income individuals, incarcerated populations, and other minoritized people—face compounded risks related to reproductive injustices and diminished access to healthcare services.

Historical efforts to prevent injustice—such as prohibitions on sterilization in prisons or mandated waiting periods—can create new barriers. Today, legal forces like Dobbs and the dismantling of EMTALA protections explicitly erode patient care and threaten clinicians’ ability to provide standard care. Importantly, restrictive abortion policies have disproportionately impacted maternal morbidity and mortality among Black women. Minoritized groups remain at risk of forced sterilization, while those seeking voluntary procedures are denied services under the guise of protection.

The stakes are particularly high in the post-Dobbs era, where shifting standards of care for abortion threaten pregnant patients' health. EMTALA-related litigation has placed clinicians in precarious legal situations when a patient’s life is endangered due to pregnancy complications.

This interdisciplinary panel of mid-career professionals—featuring bioethics, law, medicine, and public health experts—will encourage attendees to explore these threats to patient- and community-centered care. We will recommend policy and practice solutions that support a shift from restriction and control toward genuine reproductive justice.

Keywords: Reproductive Justice, Abortion & Contraception, Legal Threats to Reproductive Healthcare