For the editor:
Pregnancy doesn’t care if you’re “anti-abortion” or pro-choice.
If you care about someone of childbearing age, the current or impending restrictions on pregnancy care in more than half of our states (hopefully not New York) are alarming.
Regardless of your views on abortion or early life, pregnant women may be terrified of seeking timely help if common symptoms such as pain and bleeding occur. Providers can be paralyzed by the fear that if a heartbeat is detected while the mother’s health is at risk, the best emergency care will be seen as breaking the law.
Miscarriages occur in a third of pregnancies, and anyone who experiences a miscarriage may fear that others will suspect self-directed abortion; they may therefore delay seeking help. Their followers may also be terrified of suspicion falling on them.
Ectopic pregnancies are pregnancies implanted outside the uterus, usually in the fallopian tubes, where it is impossible to develop to viability. If allowed to grow, the tubes can burst, leading to severe, life-threatening bleeding or infertility if the woman survives. Delaying care due to the presence of a heartbeat, when the fertility, health and life of the mother are threatened, is professional misconduct.
Placental abruption, the separation of the placenta from the uterus, is catastrophic for both mother and fetus, but a heartbeat may be detectable. Doctors may be reluctant to intervene and will instead choose to wait for the heartbeat to stop, which may be too late to save the mother.
Uterine rupture is also catastrophic and can occur after multiple caesarean sections or closely spaced pregnancies when the uterine wall becomes too thin to remain intact. A heartbeat may be detectable and intervention may be delayed until the heartbeat stops. Again, it may be too late to save the mother. Suppliers terrified of being accused of breaking the law are committing professional misconduct instead.
The pregnancy-related mortality rate is more than 10 times higher than that of a safe and legal abortion. People should be able to choose when to accept that risk. The risk of adverse pregnancy outcomes is highest among those who lack insurance, have a medical history, and/or live in poverty.
Reproductive health care should not be under religious or legislative control, and no one should ever be threatened or feel terrified for making a medical decision.
Dorothy Federman, MD