Dr. Daniel Grossman had two words to describe his reaction to the leaked Supreme Court majority opinion set to overturn Roe v. Wade: infuriating and sad.

Director of the UCSF research program Advancing New Standards in Reproductive Health (ANSIRH) and a professor of medicine and OB-GYN at UCSF’s Bixby Center for Global Reproductive Health, Grossman said he expected the court and its 6-3 conservative majority to chip away at abortion rights. But the scope of the majority draft opinion, which said “Roe was egregiously wrong from the start,” stunned him.

“Even though we were anticipating a decision like this, it’s still really just shocking to see it in black and white,” Grossman said. It seems as if “this draft is a most extreme version of the arguments that are used to try to undermine Casey and Roe,” the landmark 1992 and 1973 Supreme Court decisions protecting abortion rights, “so it’s really shocking that the court would essentially throw 50 years of precedents out the window.”

In several states, mostly in the South and Southwest, access to abortion had already become difficult. Clinics have closed, and new laws in states such as Texas, Florida, Oklahoma and Arizona have banned abortion after six or 15 weeks.

Grossman, 54, said the end of Roe will make things dramatically worse.

“If a state completely bans abortion, it’s very different from having a 15-week or even a six-week ban,” he said. “People thought with a ban at six weeks that the vast majority wouldn’t be able to access care in the state. But with tremendous effort on the part of the clinics and abortion funds in the states, and [because] people getting pregnant were scared about this, abortion declined 50% instead of 85%.”

It’s really tragic to see people having health complications and potentially dying … because of bad policy.

He cautioned: ”If [a state] goes to a total ban, then people won’t be able to get access at all. If it becomes a crime to provide an abortion, it has a much broader, chilling effect on health care, such as treatment for miscarriage and ectopic pregnancy. Clinicians will be worried they might be overstepping a law that makes no sense from a medical perspective, but results in serving jail time.”

Grossman’s medical career has focused broadly on reproductive health. As a young doctor, he worked in Indonesia, Latin America and sub-Saharan Africa, studying the effects of lack of access to safe abortion. He said he saw how unsafe surgical procedures, common in some developing nations, can result in serious consequences, including perforated uteruses and death.

“It’s really tragic to see people having health complications and potentially dying,” he added, “not from a condition we don’t know how to treat, but because of bad policy that prevents them from getting the care they need.”

Now he’s worried, he said, that with the demise of Roe v. Wade, it can happen here.

But it isn’t only potentially severe medical outcomes that scare him. He said overturning Roe will likely cause economic harm, in addition to increased medical risks, mostly to women of color and the poor.

“They’re the ones who will disproportionately suffer the consequences of these bans,” he said. “They will be less likely to be able to travel, and it may be harder for them to access safe and effective medications. And [it’s] also more likely [that they will] continue a pregnancy to term, and we know there is a crisis in maternal mortality in the United States, particularly with Black and Indigenous people.”

Grossman, who lives in San Francisco, credited his liberal Jewish upbringing in Indianapolis with playing a role in his career choice.

His mother was active in the National Council of Jewish Women, and his architect father was a leader in their local synagogue. Both strongly supported the civil rights movement and taught that lesson to their son.

“One of my formative memories of growing up as a Jew was the importance of social justice,” he said. “Being a Jew spurred us to be active.”

A Yale graduate who earned his MD at Stanford University, Grossman initially was interested in global health and infectious disease. But after practicing medicine in the developing world for a time, he saw how some of the most pressing health problems affecting those communities were those related to women’s health.

“That started my interest in OB-GYN,” he said, “and as I saw more related to reproductive health, and saw how people were suffering consequences of unsafe abortion, I became interested in the intersection of medicine, public health and public policy. As a Jew who was raised on tikkun olam [repairing or healing the world], I had a real desire to help people and make a difference in the world.”

In addition to his medical practice and teaching duties, Grossman was a member of the California Future of Abortion Council, which late last year made 45 policy legislative and policy recommendations to prepare California for a post-Roe world. Among the recommendations were increasing funding for abortion access (especially underserved communities) and strengthening legal protections for the procedure.

There’s much more that citizens can do, according to Grossman.

“The first thing I anticipate and hope we will do is demonstrate our outrage,” he said. “Not just physicians who provide abortion care, but everyone involved in health care should recognize just how harmful this decision is. We should all be outraged and demonstrate that by showing up to protests and making it clear that we think this is so harmful.”