I’m an Ohio emergency care resident. My ability to provide abortions has saved lives.

I’m an emergency care medical resident working at a busy one-level urban trauma center in Ohio. My days are never short of surprises. But as the U.S. Supreme Court prepares to hear oral arguments in a case that could roll back reproductive rights by decades, one day’s surprises keep replaying in my mind. Two patients I saw in the course of one shift remind me how imperative it is that we trust our medical providers to give patients the care they need — without restricting their access to life-saving treatment like an abortion.

Before I opened the door, I could already tell the patient in room 11 was in excruciating pain. I find her in tears, doubled over in a fetal position. Her triage notes tell me she’s here for abdominal pain and vaginal bleeding. The notes also indicate a positive pregnancy test. I can see the fear in her face as I explain that we need to perform an ultrasound in order to rule out an ectopic pregnancy. An hour later, ultrasound results confirm my suspicions — but the pregnancy has begun to rupture before I can deliver the news. I rush back in to find the patient keeling off her chair, pale and hypotensive. Other nurses rush to my aid as we try to stabilize her. She will need an immediate laparoscopic surgery to survive.

Next door, the patient in room 10 also requires an ultrasound. And it must be a full moon because her results also indicate an ectopic pregnancy. Our OB/GYN recommends giving her an abortion pill here in the emergency department and then discharging her home with close follow-up. As I step inside the room to ask if the patient has any questions, I again recognize that same fear etched across her face. Quietly she asks:

“Am I going to get in trouble?”

Ever since the Supreme Court overturned Roe v. Wade in June of 2022, it’s been harrowing to see the same fear on my patient’s faces when they realize that giving them appropriate medical care could mean performing an abortion.

Here in Ohio, I’ve taken some comfort in knowing that the Emergency Medical Treatment and Labor Act (EMTALA) allows me to continue providing appropriate medical care for my patient with reproductive-related complaints. Following Roe’s demise, the U.S. Department of Health and Human Services issued guidance that under EMTALA, physicians have to continue performing abortions in emergency departments when medically necessary, especially if the patient needs immediate stabilization and regardless of whether the state has deemed the procedure illegal.

Now, another Supreme Court case — Idaho v. United States — is putting that EMTALA provision on the line. Make no mistake: This will be most impactful abortion policy case since the Dobbs ruling in 2022 overturned Roe. It could set a dangerous precedent for how personal beliefs can infiltrate legislation and unravel democracy. Without the protection of EMTALA, my two patients in rooms 10 and 11 could have been criminally prosecuted for receiving the medical care they needed to survive — and I could have been charged for providing it to them.

As an emergency physician, it’s my duty to take care of anyone at any time. The emergency department has become society’s safety net, especially when it comes to reproductive health. But where I once celebrated Ohio’s success in protecting abortion and reproductive rights, I now have deep concerns about the trajectory of health care and democracy in the United States. In an era where MAGA extremism is capitalizing on political apathy and using it to erode our democracy, it’s more important than ever for Ohio voters to show up and cast informed ballots — our safety depends on it.

Polly Wiltz is a second-year emergency medicine resident at University Hospitals in Cleveland, Ohio.