Virginians Could Cement Abortion in Their Constitution, so Why Not Track Abortion Outcomes?

As a physician, I don’t make any decisions without assessing my patients, reviewing the data, and ensuring I’ve considered every course of action to find the best one. Before recommending treatment, I want to know not simply whether it will work, but what complications might occur, and how vulnerable my patient might be if something goes wrong.

Virginia voters should expect the same rigor from our policymakers.

Yet this November, voters have been asked to decide whether to establish a “constitutional right to reproductive freedom”—in other words, a right to abortion—even though the commonwealth itself does not require abortionists to report one remarkably basic category of information: abortion complications.

I am one of more than 150 medical professionals in the commonwealth urging voters to reject Question 1. I oppose the amendment for several reasons, but you do not need to share my views on abortion to see a problem here.

Virginia’s own reporting rules make it remarkably difficult to answer a straightforward public-health question: What complications are occurring after induced abortions happen in our state?

You might think that this question could be answered by Virginia’s required Report of Induced Termination of Pregnancy, which includes information including a patient’s age, race, pregnancy history, how far along her pregnancy was, and the type of abortion procedure she underwent. Surprisingly, complications are not among the required fields.

This is more consequential today than it was even just a couple of years ago, due to the way access to abortion in the commonwealth has changed. The booming use of abortion drugs means women are, distressingly, increasingly inducing their own abortions through telehealth rather than in-person clinical visits.

The Guttmacher Institute found that Virginia recorded one of the country’s largest increases in induced abortions in 2024—approximately 6,600 more than the year before. This should make our patients even more concerned about the need for high-quality data detailing complications.

The current prescribing information for abortion drug mifepristone carries a black-box warning concerning serious and sometimes fatal infection or bleeding, while the FDA notes that the drug should not be given when an ectopic pregnancy is confirmed or suspected.

These are exactly the kinds of outcomes that policymakers should want to understand and be transparent about with voters, especially before making alterations to a public health system that places few limits on access to induced abortion.

What’s more, state reporting matters because it can sometimes be the only place where complications are recorded. The reality is that a woman suffering from complications related to abortion drugs often arrives at an emergency department—not the office of the prescribing physician. The FDA reports that 2.9-4.6% of women who ingest abortion drugs end up in the emergency room.

Without a public record of these outcomes in Virginia, the commonwealth’s policymakers are on the verge of making decisions about women’s healthcare with a profoundly incomplete picture of how induced abortion is affecting women’s lives.

This problem is not unique to abortion. We know that reporting can be incomplete and data can be messy across the board in medicine. But that is why it is our duty as physicians to work continually to obtain better information, and we expect our lawmakers and public health officials not to stand in our way. 

Question 1 aims to do considerably more than guarantee that abortion remains legal in Virginia. It would establish so-called reproductive freedom as a “fundamental right” in the state constitution, and it would remove key safeguards requiring that multiple licensed physicians sign off on (often high-risk) abortions that take place later in pregnancy.

I know abortion is an issue on which Americans have differing views, but asking our government to report factual medical outcomes should never be a political game. Even those who support abortion should wonder whether our lawmakers have done their due diligence before making these changes effectively permanent.

Constitutions are different from laws. A legislature can adjust a statute as medicine advances, new evidence emerges, or unforeseen consequences become apparent; a constitutional right is deliberately much harder to alter.

Virginians are therefore being asked to make a very high-stakes decision about medical law even as the Commonwealth’s own reporting system does not routinely collect a basic measure that physicians use to evaluate whether we are providing good medical care.

Supporters of Question 1 claim that it will “protect women’s health,” but if that’s the case, better data should strengthen their position.

What I can report with certainty is that this proposal will remove vital protections for my patients.

Before Virginia fundamentally alters its constitution, voters deserve the clearest possible picture of how induced abortions are impacting our women. Surely we can all agree that women, patients like those my colleagues and I serve, are owed the highest levels of safety when they come to us seeking help and care.

We publish a variety of perspectives. Nothing written here is to be construed as representing the views of The Daily Signal.

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