Supreme Court Ruling Will Upend Reproductive Rights for College Students and Complicate Medical Training

College students will lose access to abortion across more than a dozen states with Friday’s U.S. Supreme Court decision overturning Roe v. Wade, the landmark 1973 ruling that established a constitutional right to the procedure.

The 6-3 decision, while not unexpected after a draft opinion was leaked last month, provoked intense reactions across higher education as the ramifications for college students, campus health centers, and medical schools became clear.

The ruling paves the way for roughly half of all states to outlaw abortion, which has been a constitutional right since Roe v. Wade and a 1992 case, Planned Parenthood v. Casey, that upheld it. College students were among the throngs of people who turned out to both protest and celebrate the decision outside the U.S. Supreme Court on Friday.

The ruling is expected to lead to near-total bans on abortion in about half of U.S. states. The impact will be felt most acutely in 13 with so-called trigger laws that will take effect in the coming weeks. About four million students, as of 2019, attended college in those states: Arkansas, Idaho, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, Utah, and Wyoming.

David J. Skorton, president of the Association of American Medical Colleges, issued a statementsaying he was “deeply concerned” about the ruling’s impact on women’s health. “Laws and policies that restrict or otherwise interfere with the patient-physician relationship put a patient at risk by limiting access to quality, evidence-based care,” he said.

The association is studying the implications for medical training, saying it’s crucial that all physicians have “comprehensive training in the full spectrum of reproductive health care.” All medical schools currently require students to complete a clerkship in obstetrics and gynecology, and OB-GYN residencies must provide training or access to training on performing abortions. Residents who object can opt out of participating in induced abortions.

“We strongly oppose this decision and will continue working with our medical schools and teaching hospitals to ensure that physicians are able to provide all patients with safe, effective, and accessible health care when they need it,” Dr. Skorton wrote.

College leaders across the country issued similar reassurances on Friday that they’d do all they could to protect women’s health in spite of the ruling. Michael V. Drake, president of the University of California system, said the university “will continue to provide the full range of health care options possible in California, including reproductive health services, and to steadfastly advocate for the needs of our patients, students, staff, and the communities we serve.” He said the university will continue to offer comprehensive education and training to the next generation of health-care providers.

The decision will make it even harder for colleges that have been struggling to retain women who are pregnant or who have small children. Studies have shown that these students are already much more likely to drop out, and further restrictions on abortion could tip the balance toward staying home when an unwanted pregnancy occurs.

Wealthier women who can afford to travel out of state will have more options than low-income women and those who can’t travel because of family and job responsibilities. In a study that is awaiting publication, researchers at Tulane and Stanford Universities wrote about the “motherhood penalty.” They found that child-care responsibilities are more likely to disrupt the college plans of low-income women than their wealthier female peers or men of all socioeconomic groups.

“It’s one thing if you’re rich and your parents can fly you out of state, but if you’re a working-class kid and your parents spent everything they could to get you to college, what’s going to happen to you?” said Carole Joffe, a professor of obstetrics, gynecology, and reproductive sciences at the University of California at San Francisco. “In the end, a lot of lives will be derailed.”

The ruling also has implications for college admissions, with some students and parents saying they won’t consider attending in states with total bans on abortion.

Some scholars have reactedwith similar pledges to boycott conferences and presentations in states that criminalize abortion. Colleges may find it harder to recruit top faculty and staff members to states with aggressive anti-abortion laws, some educators worry.

Anticipating the ruling, the University of Michigan is among the institutions that created task forces working to maintain access to abortion and related medical care for students, faculty, and staff, across its campuses.

Southern New Hampshire University took it a step further.

Most, however, have been waiting for Friday’s ruling to make plans, said Terry Hartle, senior vice president for government relations and public affairs for the American Council on Education.

In states with trigger laws, colleges will need to provide more accommodations for pregnant students and parents, he said. Even with such accommodations, they should expect more students who are overwhelmed by the demands of college and parenting to drop out. It’s also likely that they’ll see a surge in activism on some campuses, Hartle said. “A lot of students will be very unhappy that something they believed to be a fundamental right is being taken away from them.”

This article is being updated.