Three weeks before the Supreme Court overturned Roe v. Wade, Dr. Caitlin Bernard, an Indianapolis obstetrician-gynecologist, donned her white lab coat, put her infant daughter right into a front-pack baby carrier and joined a number of colleagues who marched to the State Capitol, hoping to deliver a letter to Gov. Eric Holcomb.
Signed by a whole bunch of health professionals, the letter implored Mr. Holcomb, a Republican, to not convene a special legislative session to further restrict abortions. It contained a pointed political message: “Abortion bans should not popular in our state.”
Dr. Bernard, who catapulted into the national highlight for providing an abortion to a 10-year-old rape victim last month, delivers babies and provides contraceptive care, pap smears and other routine obstetric and gynecological care. She can be one in all a small variety of doctors in her state with specific training in complex reproductive care, including second-trimester abortions.
But a few of her riskiest work takes place outside her hospital, advocating publicly for abortion access.
Her outspokenness has extracted a price. Dr. Bernard, 37, has been criticized across right-wing media, faced harassment and is the topic of an investigation by the Indiana attorney general. She’s landed at the middle of a post-Roe clash that the medical community has been dreading — one through which doctors themselves are the main target of political and legal attacks.
“Physicians who provide abortion have been harassed, they’ve been murdered,” Dr. Bernard said on Tuesday in an interview with The Latest York Times. “And for too long, I believe, due to that, they’ve needed to be silent to guard their families, and it’s created an concept that we’re doing something incorrect or something illegal. And we’re not. And I feel compelled to say that.”
Threats against abortion providers are hardly latest. However the overturning of Roe has created a daunting latest legal landscape for doctors.
In Indiana, Todd Rokita, the attorney general, is investigating whether Dr. Bernard, an assistant professor of clinical obstetrics & gynecology on the Indiana University School of Medicine, reported the Ohio girl’s abortion to Indiana state officials, as required. Records show she did.
Read More on Abortion Issues in America
In a press release to The Times on Tuesday, the attorney general said he would “see this duty through to the very end,” and accused Dr. Bernard of using “a 10-year-old rape victim’s personal trauma” to “push her ideological stance.”
Dr. Bernard, in turn, says Mr. Rokita is just one other politician engaging in “state intimidation for their very own political ends.” She has filed a tort claim against him, step one toward a possible lawsuit for defamation.
Medical professionals who work in reproductive health are watching the events in Indiana closely, said Dr. Kristin Lyerly, an obstetrician-gynecologist in Wisconsin who coordinates reproductive health care advocacy within the upper Midwest for the American College of Obstetricians and Gynecologists. Before Roe was overturned, she said, she was providing abortions at one in all 4 clinics in Wisconsin. Abortion is now banned there under an 1849 law that makes it a criminal offense.
“Those of us who provide abortion care have been attempting to do it discreetly and thoroughly for a few years knowing that that is obligatory health take care of our patients,” Dr. Lyerly said. “Now, we feel like we really want to inform the story and be very frank about what we’re seeing and experiencing and what our patients are coping with, while walking that very effective line of protecting patient privacy.”
Abortions are only a small a part of Dr. Bernard’s practice. She handles complex abortion cases — those where the lifetime of the mother is at risk — on the university’s medical center. She provides abortions — each surgical and drugs — several days a month at Planned Parenthood clinics in Indiana and Kentucky.
The work has long included stressful elements that go well beyond delivering sensitive medical care: In 2020, she said, the F.B.I. informed Planned Parenthood it was investigating a kidnapping threat against her daughter.
Her patients describe her as kind and caring; Rebecca Evans, a nurse midwife who sought care from Dr. Bernard after she suffered a miscarriage, called Dr. Bernard a “full scope” clinician, who “does all of those various things, and he or she’s really captivated with all of it.”
Dr. Bernard’s advocacy, she says, is in furtherance of her goal of providing patients the most effective medical care possible. By limiting abortion options, and requiring her to make sure statements — resembling informing patients that fetuses feel pain during an abortion when the science on that issue continues to be unclear — the state is forcing her to practice medicine in a way that’s unsafe and never medically accurate, she says.
She is the plaintiff in a 2019 lawsuit filed by the American Civil Liberties Union that sought unsuccessfully to overturn Indiana’s ban on nearly all second-trimester abortions. She testifies steadily within the State Legislature. After Roe was overturned, she organized a protest. (She also sports a tattoo on her left foot, showing a wire coat hanger — an emblem of a dangerous at-home abortions before the procedure was legal — over the words “Trust women.”)
Indiana currently allows abortions as much as 22 weeks. This week, because the Indiana legislature considered a near-total ban on abortion in the course of the legislative session she fought against, Dr. Bernard was not there.
Abortion opponents have been leaving hateful messages on her cellphone, she says. She continues to see patients, but has hired a security detail, and her colleagues have began a GoFundMe account to assist together with her mounting legal bills. An in-person appearance in a tense environment on the Legislature might further inflame the situation.
“The politicization of me, and of the work that I do, has definitely made it difficult for me to proceed to do the advocacy that I even have previously,” she conceded.
Not long after Roe was overturned, the Indianapolis Star learned of her 10-year-old patient, who had traveled from Ohio, where abortion is banned after six weeks, even in cases of rape or incest. Dr. Bernard’s allies say it isn’t any accident that the 10-year-old child was referred to her; there are only a few doctors, they are saying, who could handle such a sensitive case.
Earlier this month, President Biden cited the case when he signed an executive order designed to make sure access to abortion medication. Suddenly, all eyes were on Dr. Bernard.
Dr. Bernard on Tuesday refused to debate any aspect of the case, citing the girl’s privacy. Along with worrying about prosecution, she could face consequences at work. Until Tuesday, her employer, Indiana University School of Medicine, a state-funded institution, and Indiana University Health, a nonprofit health care system, had been publicly silent about her, except to say she had not violated patient privacy laws.
In a press release to The Times, Indiana University’s president, Pam Whitten, and medical school dean, Dr. Jay Hess, said Dr. Bernard stays “a member of the school in good standing.” I.U. Health called her a “valued and revered physician” and a “true advocate for the health and well-being of her patients.”
In a way, Dr. Bernard’s life has prepared her for this moment. She absorbed her activist streak from her parents, who got here of age within the socially liberal Sixties, and lived on a communal farm in upstate Latest York when their children were little.
When she was five, she informed her family that she was going to be a physician, said her sister, Rebeccah Johnson. When she was 15, she and her sister walked past a phalanx of protesters at a Planned Parenthood clinic to get contraception. Later, she witnessed firsthand the complications women can suffer from pregnancy when she and her father, a carpenter, went to Guatemala to assist run health clinics.
Perhaps due to that, she said, she was at all times drawn to obstetrics and gynecology. Early in her profession, Dr. Bernard joined a program called AMPATH, led by Indiana University, which brings American doctors to Kenya, where abortion is basically prohibited.
Nearly a 3rd of the patients she saw were affected by complications from unsafe at-home abortions. “We’d often see women who had been raped, assaulted, and now pregnant,” said Dr. Astrid Christoffersen-Deb, her supervisor.
After completing medical school and residency at Upstate Medical University in Syracuse, N.Y., Dr. Bernard trained at Washington University in St. Louis, where she became accredited in “complex family planning,” a specialty that qualifies her to handle complicated cases including second-trimester abortions.
“Individuals who need abortions within the second trimester are sometimes facing absolutely the worst conceivable situations — they’ve a really wanted pregnancy and their baby shouldn’t be going to survive or goes to have an incredibly difficult life they usually try to spare their child from that end result,” she said, adding, “Politicians, people who find themselves uncomfortable with abortion care, have often never been in those situations.”
In 2017, Dr. Bernard left St. Louis for Indiana, where she has develop into the “go-to” doctor to talk out for reproductive rights, said Dr. Tracey A. Wilkinson, a pediatrician who, together with Dr. Bernard, is involved with Indiana’s chapter of the Reproductive Health Advocacy Project. Dr. Wilkinson spent all day Monday on the Indiana Capitol, and said she felt Dr. Bernard’s absence acutely.
“We don’t go knowing that we’re going to change the way in which the votes occur,” Dr. Wilkinson said. “We go to place within the record that any person stood up and said that this was incorrect. We go in order that our patients hear any person standing up for them.”
On Tuesday, Indiana’s abortion ban advanced out of a Senate committee, drawing critics from across the political spectrum. Abortion rights advocates called the measure an attack on women, while several anti-abortion activists criticized exceptions that will allow for abortion in cases of rape and incest; one suggested that Dr. Bernard’s 10-year-old patient must have been required to present birth.
If the bill passes, Dr. Bernard said, she’s going to likely find herself referring Indiana women to abortion providers out of state. Though she knows it could create further problems for her, she doesn’t intend to be quiet.
“One of the crucial vital things concerning the issue of abortion within the U.S. is that individuals don’t wish to discuss it,” she said. “They fear the stigma, providers fear the stigma that they’re going to be harassed, targeted, because they’ve been. So probably the most vital things is just being honest about it.”
Mitch Smith contributed to this story.