To the editors:
On “Why Does Law Force Women Who Miscarry to Suffer?”, by Michelle Goldberg (column, July 19):
They don’t tell you this in medical school, but to be an OB-GYN doctor, you have to know heartache up close and personal, time and time again. I have been a practicing physician in Portland, Oregon for 37 years. My colleagues span the political spectrum, but almost everyone I know has put the importance of the mother’s life above that of the embryo or fetus. And if for reasons of conscience they couldn’t do that, they would look for another provider who could.
With the Dobbs decision, my specialty has been confused. Miscarriage is one of the most common conditions we treat, as it occurs in about 10 to 20 percent of known pregnancies.
These new laws in anti-choice states simply prohibit termination of pregnancy, some right after conception. They have no subtlety, they have no algorithms to guide the practice.
Now providers are in an extremely precarious situation, with the risk of prosecution. If the only exception for termination of pregnancy is the mother’s risk of death, how close does she have to be to act? Most pregnant people are young and healthy and cope well with blood loss and infections, until they suddenly don’t, by which time it may be too late to save them.
America will now see what happens when politicians exploit the care of women for their political gain. It’s brutal. Anyone who thought it would take a long time to see the ramifications of banning a common medical procedure will soon see the tears, blood, and death we said were coming. It is inevitable and it will continue.
Marguerite P. Cohen
The writer is a fellow of the American College of Obstetricians and Gynecologists.
To the editors:
Re “Risks to Patients as Physicians Handle Abortion Exceptions” (news article, July 21):
As a Missouri resident living under a new abortion ban, I am furious and disgusted. For years, proponents warned of the dangers of a ban, without heeding. Even now, as doctors describe how pregnant women will die from substandard care as a result of this ban, our leaders shrug.
Days after Missouri issued an abortion ban except in “medical emergencies,” I called the attorney general’s office for clarification. I shared that I had two life-threatening conditions during my last pregnancy, and I was concerned that my obstetrician would be restricted if a similar complication occurred today.
The staff attorney told me he was unable to provide guidance as giving legal advice could jeopardize his law license. I replied that this ban could endanger my life. His reaction? That I could leave the state.
Unfortunately, I’m afraid many Missouri families like mine will take him up on his suggestion. I worry that our women’s caregivers are choosing to practice elsewhere. I worry that Missouri’s elected officials will be short-sighted enough to celebrate these losses. The state deserves better.
To the editors:
On “I’m Terrified of My Patients,” by David N. Hackney (opinion guest essay, July 10):
dr. Hackney describes the pain experienced by a pregnant woman who learns that her child has a deadly condition but has no choice but to go to term. While accurate, the potential pain of learning that your fetus has a serious abnormality goes far beyond this.
A variety of serious, life-altering birth defects and genetic syndromes can be diagnosed prenatally, and many of these conditions are not fatal – or not immediately fatal – but severe enough that the affected child has severe disabilities and, in many cases, pain for a lifetime.
Being told in the midst of a coveted pregnancy that your child will have severe neurological or physical disabilities, that she will never walk, or talk or even be able to roll over on her own, and still survive, is just as devastating If told your child dies at birth, but with very different consequences.
Despite Judge Amy Comey Barrett’s claim, these children are unlikely to be adopted. It is unethical to diagnose a medical condition and not provide the patient with reasonable and safe therapeutic options, but many states’ laws now make it impossible to do it ethically. More pain for everyone.
The writer is a professor at Brown University’s Alpert Medical School and past president of the Society for Maternal Fetal Medicine.
To the editors:
dr. David Hackney joins so many doctors who highlight the serious life and health risks pregnant women now face. President Biden and Congress cannot restore comprehensive abortion rights in a way that will survive future elections.
So Democrats in Congress must immediately enact a strong national right to abortion if continued pregnancy would endanger the life, physical or mental health of the mother, or if the fetus will not survive.
There must also be reasonable protection for healthcare providers who perform these medically necessary procedures. Otherwise, the doctor’s hesitation can cost women’s lives.
I hope there is bipartisan support for this.
Without these protections, increases in doctors’ liability insurance could make obstetric care grossly overpriced and remove the already scarce funding for all medical care.
Mary Jo Napoli
To the editors:
On “Abortion Bans Will Affect Americans Rich and Poor” (Opinion Guest Essay, July 7):
Elizabeth Spiers describes the impact of abortion restrictions as “a crisis for all American women,” with delays in therapeutic abortions having fatal consequences. As an emergency room physician who routinely cares for women with pregnancy-related complications, I echo Ms. Spiers’ concerns.
I often deal with obstetric emergencies. For the past few weeks, I nursed pregnant women with the following complications: ectopic pregnancy, undetectable fetal heart rate with declining pregnancy hormone levels, and profuse vaginal bleeding with an open cervix.
My patients were not asked about their political or religious beliefs. I didn’t need to know if their pregnancies were planned or wanted. My focus was on the timely care of three vulnerable patients, with pain and bleeding, who looked to our medical team for loving treatment and emotional support. All three patients had therapeutic abortions.
As abortion bans spread across our country, I feel privileged to work in New York City’s public hospital system, where the law supports good medical decision-making in conjunction with a woman’s choice. No time for complacency, however. The lives and well-being of millions of women will depend on it.
Bonny J. Baron