(Washington, D.C., May 3, 2022) – Global Liver Institute (GLI), a premier patient-led liver health nonprofit operating globally, is deeply concerned by the draft opinion published by POLITICO indicating the Supreme Court of the United States may overturn Roe v. Wade. A decision of this magnitude would severely impact patients affected by liver disease in two critical ways.

First, Roe v. Wade is based on a long line of constitutional precedence against government interference with intensely personal decisions and health. At Global Liver Institute, we believe in women’s autonomy, and that a woman’s right to choose is fundamental to the sustainability of her and her family’s health. On top of this is the concerning reality that women in the U.S. are actually more likely to die as a result of pregnancy or childbirth complications than they were two decades ago, and Black women are nearly four times more likely to die than white women.1 These numbers are not improving, and among 11 developed countries, the United States has the highest maternal mortality rate.2

Second, liver health can directly impact a pregnancy whether it is because of a liver condition, surgeries and procedures, and/or medications. Each could impair a woman’s ability to conceive or safely carry a pregnancy to term. Many liver diseases affect infants, girls, adolescents, and women of child bearing age, particularly autoimmune diseases like primary biliary cholangitis (PBC). Pregnancy can also unexpectedly induce a variety of liver diseases that could threaten the life of the pregnant woman, including acute fatty liver of pregnancy (AFLP) and intrahepatic cholestasis of pregnancy (IHCP).3 Even more concerning, some liver diseases can flare up during pregnancy, such as autoimmune hepatitis (AIH) and Wilson’s disease, and diseases not related to the pregnancy, such as viral hepatitis, could also affect the pregnant woman at any time during gestation. 4

The leak of the draft Supreme Court decision may be yesterday’s triggering event, but the erosion of women’s autonomy and disdain for women’s health, especially at the state level, has been expanding perniciously for years. This expansion will continue unless we stop being distracted by tactics around viability, exceptions, and the ability of random neighbors to become bounty hunters. In a civil society it should not be the federal government’s, the state legislature’s, or another person’s decision as to whether and how an adult woman chooses to build a family. We need to collectively commit to putting the education and meaningful support for healthy women throughout the lifecycle and healthy families in place so that a choice can be freely and equitably exercised.

1 https://www.mhtf.org/2016/01/11/black-mamas-matter-building-a-human-rights-movement-for-maternal-health-in-the-u-s/

2 https://www.ajmc.com/view/us-ranks-worst-in-maternal-care-mortality-compared-with-10-other-developed-nations

3 https://my.clevelandclinic.org/departments/digestive/medical-professionals/hepatology/liver-disease-in-pregnancy#definition-causes-tab

4  https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/hep.31559