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Melissa Harris-Perry: Dr. Ghazaleh Moayedi is an OB-GYN and prior to the Supreme Court overturning Roe v. Wade, she was an abortion care provider in Texas. Now there's a near total ban on abortions in the state, and the law also targets doctors, providing an abortion in Texas is now a felony. Dr. Ghazaleh Moayedi joins us now. Dr. Moayedi, thank you for being here.

Dr. Ghazaleh Moayedi: Thank you for having me, Melissa.

Melissa Harris-Perry: I know that you still describe yourself as an abortion care provider. What does that mean now in Texas?

Dr. Ghazaleh Moayedi: Yes, it's very different, but in some ways, the work has not changed. I can't actually directly take care of my community here right now, but I'm still teaching medical students and residents across the state, teaching community members about abortion care. What I've seen since the fall of Roe is that learners, medical students, residents are even more eager and hungry to learn the skills, to be able to take care of their patients, and to save their lives when they need to.

Melissa Harris-Perry: There is, I guess, a very, very narrow carve out in this near total ban for question of life-saving care in dire circumstances. Help me to understand and help our listeners to understand, is it extremely rare to have these kinds of circumstances? What would count as these circumstances? What are we even talking about here?

Dr. Ghazaleh Moayedi: Unfortunately, it's not rare. The reality is that as an OB-GYN or anyone, frankly, that takes care of pregnant people, we know that there are weekly almost, situations that arise where someone their back of water breaks, but prior to what we would call viability in the second trimester. They start bleeding or they develop preeclampsia high blood pressure. Any number of things that, if the pregnancy is not ended, will cause harm to the pregnant person and will not result in a live birth.

These situations have always existed, and they arise in any hospital in this country once every other week, it's not new. What has happened is that our ability to take care of people in a timely fashion, to prevent injury, to prevent a host of complications varies from city to city, hospital to hospital, and day by day who's working, who is making the decision, when is it an emergency enough? That is, it's terrifying for every single pregnant person in states with laws like this.

Melissa Harris-Perry: Talk to me about the felony criminal component for the physician. I want to understand the extent of this. You cannot perform a first-trimester abortion unless you can indicate that there is this kind of clear and present danger to the life of a pregnant person. What if you traveled to provide an abortion? Is that acceptable or allowable under this law if the person that you provided to is a resident of Texas, but you're not providing it in Texas, how far does the reach of Texas go on this law?

Dr. Ghazaleh Moayedi: That is one of the scary parts that remains to be seen, it's not clear. I think any reasonable mind looking at the law, and of course, I'm not a lawyer, but still any one of us looking at these laws would say, of course not, the state doesn't have reach outside of Texas. This is a Texas-based law, but the reality is that it is intentionally vague. The attorney general of Texas and several politicians in Texas have indicated that these laws do reach past our state borders, that they intend to come after us.

In fact, several politicians have already started the harassment of abortion funds for funding people to leave out of state. It's not clear, this is completely unprecedented, so we don't know, it's a very tricky space to be practicing in where you're not sure if what you're doing is potentially illegal, and either you do it and hope that you don't get arrested or you proactively sue to clarify, which is exactly what I'm doing in conjunction with, I think, all of the abortion funds in Texas.

Melissa Harris-Perry: Has there been an uptick in negative health outcomes for women since this near total ban? I'm wondering if there's even research happening about this yet since it's all relatively new.

Dr. Ghazaleh Moayedi: I think what the sheer numbers that will remain to be seen, it's a very difficult thing to track for a number of reasons. We actually don't have a mechanism to track how systems of oppression negatively impact maternal health. What I mean is that when a state looks at maternal morbidity and mortality, they don't check off abortion ban denied life-saving care. Systemic racism led to poor outcomes. Those aren't the categories that they look at, they look at categories that, to some effect, blame the person themselves for what has happened to them. They had a heart issue, they had bleeding, they had preeclampsia, and they don't look at the systems that create this.

It is very difficult to track because we look at these on an individual basis rather than the structure that creates this harm and inequity. When we're looking at something like a maternal death in a state like Texas, we don't even have a report for the last year, two years, three years. I think we're still waiting on a report from nine years ago on the causes of our maternal deaths. It will be many, many years before we even know who has potentially died from these laws. Then on top of that, how will we know? There's never going to be a physician or a hospital that comes forward and says, "Yes, this patient we were trusted to care for died because we denied care." It's never going to happen.

Melissa Harris-Perry: That's an insurance issue, right?

Dr. Ghazaleh Moayedi: Yes. The malpractice company would not let them be risk management, it would never happen. These cases will almost exclusively rely on the pregnant person who is about to die, realizing that they have been denied care because of an abortion ban. Them communicating that to someone they love, then them dying, it's just horrible to think about. Then that person that they entrusted with that knowledge coming forward and telling the story, the reality is that that is not going to happen as often as we think it should be, and as often as the actual cases are happening across the country in my state too.

Melissa Harris-Perry: Doctor, take a quick pause with me. We're going to be right back with more in The Takeaway. We're back, and I'm continuing my conversation with Dr. Moayedi, OB-GYN an abortion care provider in Texas. Dr. Moayedi, I said, I feel like we've been on a bit of a journey. You've been so generous with your time to repeatedly come back and talk with our listeners. Tell us a little bit about what the emotional, maybe just weighing the life choices that you and your family and your practice, your staff have been through in these recent months.

Dr. Ghazaleh Moayedi: Yes, we have definitely been on a journey, I appreciate you having me back over and over again. It has definitely been an emotional journey for me, for my family, and for all of my colleagues in the state. Immediately after the decision came out this summer, we spoke, I was extremely down and I'm usually a super positive and joyous person.

Even though we knew what was going to happen, we have known, it was still a moment of introspection and reflection for me and for my family and I'm sure many other people in this state. I considered moving, I still consider when is going to be the time that I do have to leave. At that point my partner and I started making a list. Where could we live? Where can I, I want to practice abortion in abundance.

I have been fighting to provide compassionate care to people. I know how meaningful it is to every single patient I take care of. How life-changing it is, and I want to move into a space where I can provide that care without fear, without stigma. Abortion abundance is what I've been saying. We thought about it and I started making motions and then just, nothing's changed really.

The more I worked on it and continued to do my work in Texas teaching, educating, advocating, working among coalition partners, still this seems like where I'm needed, where my work is meaningful and impactful. Even though it's painful, it's still fulfilling, and I still find joy in the teaching that I am able to do in the impact I'm able to have here. It's definitely been a journey. I don't have an answer, but I'm dreaming of abortion abundance for all of us.

Melissa Harris-Perry: The 2022 midterms proved to be a moment of perhaps more optimism and light for, or as you might say, abundance maybe than might have been initially expected by some. Do you look towards 2024 as a possibility for a restoration of your capacity to practice in the state and with the communities that you're so committed to?

Dr. Ghazaleh Moayedi: I definitely was hoping that this election, this midterm would make a difference. The reality for folks in Texas is we're working, but we're a long way from state political change for a number of reasons. Elections are truly not what's going to liberate us. The courts are not what's going to liberate us. I think that these are areas where we need to focus and continue working, but honestly, what happens in election for the people that I take care of is not as important as in their day-to-day lives, if that makes sense. Of course, it has an impact, but the 2024 election isn't going to change anything for us in Texas, we need bold action, not incremental change.

We need leaders right now that are in power to do something way more meaningful, way more, bold. I don't know what a better word is for that, but just we need more than what we are getting right now, and it is possible and we don't need to wait for another candidate, another election, another whatever. People want this change now, and we need people that are brave enough to do it. Those of us on the ground, we are being brave every day. We need those with less to lose to join us in that.

Melissa Harris-Perry: Dr. Ghazaleh Moayedi is an OB-GYN and an abortion care provider in Texas. Dr. Moayedi, thank you for being here, and Happy Thanksgiving.

Dr. Ghazaleh Moayedi: Thank you, Melissa.

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