opinion | New risks for physicians and their pregnant patients

About the publisher:

On “Why Does the Law Make Women Who Miscarry Suffer?” by Michelle Goldberg (Column, July 19):

They don’t tell you that in med school, but being an OB/GYN means knowing heartbreak up close and personal, over and over again. I have been a practicing physician in Portland, Oregon for 37 years. My colleagues span the political spectrum, but nearly everyone I know has put the interest of the mother’s life ahead of that of the embryo or fetus. And if they couldn’t do it for reasons of conscience, they would look for another provider who could.

The Dobbs decision messed up my specialty. 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 only ban abortion, some immediately after fertilization. They have no subtlety, they have no algorithms to guide the practice.

Now the providers are in an extremely precarious situation and risk prosecution. If the only exception to terminating a pregnancy is the risk of death for the mother, how close does she have to be to act? Most pregnant women are young and healthy, and they cope just fine with blood loss and infection until they suddenly don’t, and by then it may be too late to save them.

America will now see what happens when politicians use women’s nurturing for political gain. It’s brutal. Anyone who thought it would be a long time before they saw the consequences of banning a common medical procedure will soon see the tears, blood and death we told them was coming. It’s inevitable and it will continue.

Marguerite P. Cohen
Portland, Ore.
The author is a Fellow of the American College of Obstetricians and Gynecologists.

About the publisher:

On “Risks to Patients When Doctors Handle Abortion Exceptions” (News article, July 21):

As a Missouri resident living under a new abortion ban, I am angry and disgusted. For years, proponents have been warning of the dangers of bans, unheeded. Even now, when doctors describe how pregnant women will die from lack of care because of this ban, our leaders shrug.

Days after Missouri enacted a ban on abortion except in “medical emergencies,” I called the Attorney General’s office to clarify. I shared that I had experienced two life-threatening conditions in my last pregnancy and I was concerned that my obstetrician might be limited if a similar complication were to arise today.

The prosecutor told me that he could not offer advice because giving legal advice could jeopardize his license to practice law. I replied that this ban could endanger my life. His answer? That I could leave the state.

Unfortunately, I am concerned that many Missouri families like mine will respond to his suggestion. I worry that our women’s healthcare providers will choose to practice elsewhere. I worry that Missouri’s elected officials will be short-sighted enough to celebrate these losses. The state deserves better.

Katy Nimmons
st louis

About the publisher:

On “I Fear for My Patients” by David N. Hackney (Opinion Opinion Guest Post, July 10):

dr Hackney describes the pain of a pregnant woman who learns her child is terminally ill but has no choice but to carry it to term. While this is true, the potential pain of learning that your fetus has a serious abnormality goes far beyond that.

A variety of serious, life-altering birth defects and genetic syndromes can be diagnosed before birth, and many of these conditions are Not fatal – or not immediately fatal – but serious enough to leave the affected child with lifelong disability and, in many cases, pain.

To learn in the middle of a long-awaited pregnancy that your child will have severe neurological or physical disabilities, that they will never be able to walk or speak or even turn around and still survive is as devastating as the news your child will die in childbirth, but with very different consequences.

Despite Judge Amy Coney Barrett’s claim, these children are unlikely to be adopted. It is unethical to diagnose a disease and not offer the patient reasonable and safe therapeutic options, but the laws of many states now make it impossible to be ethical. More pain for everyone.

Catherine Wenstrom
Providence, R.I
The author is a professor at Brown University Alpert Medical School and past president of the Society for Maternal Fetal Medicine.

About the publisher:

dr David Hackney joins so many doctors in pointing out the serious life and health risks pregnant women now face. President Biden and Congress cannot restore comprehensive abortion rights in any way that will survive future elections.

Therefore, congressional Democrats should immediately enact a strong national abortion law if continuing the pregnancy would endanger the life, physical or mental health of the mother, or if the fetus will not survive.

In addition, there should be adequate protection for medical providers performing these medically necessary procedures. Otherwise, medical hesitation can cost women their lives.

I would hope that there might be bipartisan support for this.

Without this protection, increases in medical liability insurance could grossly overprice obstetric care and deprive already scarce funding for all medical care.

Maria Jo Napoli
Columbus, Ohio

About the publisher:

On “Abortion Bans Will Affect Both Rich and Poor Americans” (opinion guest post, July 7):

Elizabeth Spiers describes the impact of abortion restrictions as “a crisis for all American women,” with delays in therapeutic abortion having dire consequences. As an emergency physician who routinely attends to women with pregnancy complications, I share Ms. Spiers’ concerns.

I regularly treat obstetric emergencies. In the last few weeks I have been caring for pregnant women with the following complications: ectopic pregnancy, undetectable fetal heartbeat with falling pregnancy hormone levels and heavy vaginal bleeding with a dilated cervix.

My patients were not asked about their political affiliation or religious beliefs. I didn’t need to know if her pregnancies were planned or desired. My focus was on providing timely care to three vulnerable patients with pain and bleeding who asked our medical team for compassionate treatment and emotional support. All three patients had therapeutic abortions.

As abortion bans increase across our country, I feel fortunate to practice in the New York City public hospital system, where the law supports sound medical decision-making combined with a woman’s choice. No time for complacency. The lives and well-being of millions of women will depend on it.

Bonny J Baron
Brooklyn

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