Lawmakers must respect patient autonomy and the expert judgment of their care teams about reproductive choices, clinicians say in a new paper published in the American Journal of Respiratory and Clinical Care Medicine. Furthermore, health care professionals must hold lawmakers accountable for respecting patient-doctor care decisions.

The article outlines pregnancy risks for people with pulmonary arterial hypertension and stresses the importance of access to contraception and medically necessary abortion. The authors were convened by the Pulmonary Hypertension Association as part of its advocacy efforts. PHA supports medical care driven by clinical judgment and the patient-clinician relationship, including legal, safe and affordable access to contraception and abortion.

“As PAH community representatives, we recognize the vital importance of access to comprehensive reproductive health care for our patients,” the authors state. “We stand with the American Thoracic Society, American College of Obstetrics and Gynecology and the PHA in their support for safe and legal contraception and abortion services as necessary parts of health care.”

Pregnancy can be significantly dangerous to people with PAH and fetuses. People with PAH have higher than normal pulmonary artery pressure, and pregnancy can increase that pressure to levels that could cause heart failure and death.

“Recognizing these life-threatening risks, major medical groups unanimously agree that patients with PAH who are pregnant receive care at specialty centers,” the doctors write. PH Care Center professionals counsel patients on pregnancy risks and work with patients to make shared care decisions.

“Forcing pregnant patients to receive PAH care outside of a specialized PH center simply for access to standard reproductive care is unsafe, discriminatory and unethical,” the paper states. “When lawmakers take away constitutional rights and interfere in reproductive health care through restrictive policies, they undermine the patient-provider relationship and violate the long-established medical ethical principles of beneficence, nonmaleficence, justice and autonomy.”