A sexual assault survivor chooses sterilization so that if she is ever attacked again, she won’t be forced to give birth to a rapist’s baby. An obstetrician delays inducing a miscarriage until a woman with severe pregnancy complications seems “sick enough.” A lupus patient must stop taking medication that controls her illness because it can also cause miscarriages.
Abortion restrictions in a number of states and the Supreme Court’s decision to overturn Roe vs. Wade are having profound repercussions in reproductive medicine as well as in other areas of medical care.
“For physicians and patients alike, this is a frightening and fraught time, with new, unprecedented concerns about data privacy, access to contraception, and even when to begin lifesaving care,” said Dr. Jack Resneck, president of the American Medical Association.
In the past week, an Ohio abortion clinic received calls from two women with ectopic pregnancies — when an embryo grows outside the uterus and can’t be saved — who said their doctors wouldn’t treat them. Ectopic pregnancies often become life-threatening emergencies and abortion clinics aren’t set up to treat them.
It’s just one example of “the horrible downstream effects of criminalizing abortion care,’’ said Dr. Catherine Romanos, who works at the Dayton clinic.
Dr. Jessian Munoz, an OB-GYN in San Antonio, Texas, who treats high-risk pregnancies, said medical decisions used to be clear cut.
“It was like, the mom’s life is in danger, we must evacuate the uterus by whatever means that may be,” he said. “Whether it’s surgical or medical — that’s the treatment.”
Now, he said, doctors whose patients develop pregnancy complications are struggling to determine whether a woman is “sick enough” to justify an abortion.
With the fall of Roe vs. Wade, “the art of medicine is lost and actually has been replaced by fear,” Munoz said.
Munoz said he faced an awful predicament with a recent patient who had started to miscarry and developed a dangerous womb infection. The fetus still had signs of a heartbeat, so an immediate abortion — the usual standard of care — would have been illegal under Texas law.
“We physically watched her get sicker and sicker and sicker” until the fetal heartbeat stopped the next day, “and then we could intervene,” he said. The patient developed complications, required surgery, lost multiple liters of blood and had to be put on a breathing machine “all because we were essentially 24 hours behind.”
In a study published this month in the American Journal of Obstetrics and Gynecology, doctors at two Texas hospitals cited the cases of 28 women less than 23 weeks pregnant who were treated for dangerous pregnancies.
The doctors noted that all of the women had recommended abortions delayed by nine days because fetal heart activity was detected. Of those, nearly 60% developed severe complications — nearly double the number of complications experienced by patients in other states who had immediate therapeutic abortions. Of eight live births among the Texas cases, seven died within hours. The eighth, born at 24 weeks, had severe complications including brain bleeding, a heart defect, lung disease and intestinal and liver problems.
Becky Schwarz, of Tysons Corner, Virginia, found herself unexpectedly thrust into the abortion controversy even though she has no plans to become pregnant.
The 27-year-old has lupus, an autoimmune disease that can cause the body to attack tissue surrounding joints and organs, leading to inflammation and often debilitating symptoms. For Schwarz, these include bone and joint pain, and difficulty standing for long periods of time.
She recently received a notice from her doctor saying she’d have to stop taking a medication that relieves her symptoms — at least while the office reviewed its policies for methotrexate in light of the Supreme Court ruling. That’s because the drug can cause miscarriages and theoretically could be used in an attempt to induce an abortion.
“For me to have to be essentially babysat by some policy, rather than being trusted about how I handle my own body … has made me angry,” she said.
The Arthritis Foundation and American College of Rheumatology have both issued statements of concern about patients’ access to the drug. Steven Schultz of the Arthritis Foundation said the group is working to determine how widespread the problem is. Patients having trouble getting the medication can contact the group’s helpline, he said.
I mean, what is there to say? This is all a feature and not a bug. The collateral damage to literally everyone else is of no concern to the forced birth fanatics. It’s time for doctors and other medical professionals who don’t want the state meddling in their ability to treat patients to vote and organize like it. Passing some federal laws if the next election allows for a continued Democratic majority in the House and enough anti-filibuster Senators to actually do something will help, but the chaos will continue until there’s also some action taken to mitigate the damage of 20 years’ worth of Federalist Society judges legislating from the bench. We’ve got a lot of work to do, and it’s going to be bad until we can get it done.