The most recent kerfuffle surrounding abortion rights illustrates the dangers of trying to legislate complex medical issues. And is particularly distressing.
Virginia House Delegate Kathy Tran introduced a bill to remove unnecessary and burdensome requirements surrounding abortion services in her state. This video, now shown over and over and over again, shows her responding to a question referencing the bill’s impact on abortions done specifically in the 3rd trimester. Now remember, 3rd trimester abortions are extremely rare. In fact, my ob/gyn friends who have worked in large and busy group practices within a huge medical system for over 30years have only heard about 1 occurrence. And when these abortions are done, they are typically surrounded by heart-breaking circumstances. This is not a routine or lightly considered procedure.
The question posed to her was pure political posturing and guaranteed to inflame emotions. I can say that with confidence because the questioner stated that a physician need to ‘simply (emphasis mine) be willing to certify that continuation of pregnancy would impair the mental health of the mother’.
there is nothing simple about a 3rd trimester abortion
But that word implies a belief among many in the anti-abortion community that any minor psychological distress would be an acceptable reason for a 3rd trimester abortion- which is nonsense. The question then veered into whether Tran’s legislation would allow a fetus, even up to the time of the mother going into labor, to be aborted. Which is also nonsense.
Poor Delegate Tran walked right into the trap. Her attempt to answer the question- as posed- gave it credibility, as if it was perfectly reasonable question. And worse, her answer was so terrible, it invited backlash which was immediate and hyperbolic.
And this backlash did not only come from those who sincerely feel that due to the sanctity of life abortion should never under any circumstance be legal, nor from those who cynically use this topic to cause division in our society or those with more sinister desire to control women.
Even more moderate voices (PBS NewsHour, Shields and Brooks segment that aired feb 1, 2019) expressed outrage, as they interpreted the legislation as allowing infanticide (a word I kept hearing over and over in reports). Which is not what was being proposed.
This whole think made me so sad… and angry.
And further underscores why complicated medical decisions which require nuanced discussion should not be legislated, especially in today’s charged and polarized environment. There’s always someone trying to score political points, and with an assist from a lazy national media- understanding the true realities are impossible.
The self-righteous outrage overlooked the poignant human issues that face those considering a 3rd trimester abortion. In the majority of the time, the cause is the reality that a developing fetus has severe congenital anomalies incompatible with life.
While Governor Ralph Northam (so far he’s still governor- but that’s another issue), a pediatric neurologist, tried to offer a better explanation in his radio interview, he didn’t necessarily help either.
a more appropriate response
Neither Tan nor Northam said clearly and outright that the question was a nonsensical hypothetical. No medical provider would perform a 3rd trimester abortion for anything less than a devastating psychological/medical issue with the mother or the developing fetus; and no medical provider would perform an abortion once a woman was in labor. Once in labor, the fetus is delivered.
When the mother of a fetus with severe anomalies, incompatible with life beyond mere minutes/hours/perhaps days, goes into labor, the governor did accurately describe what would occur: the fetus would be delivered, gently wrapped in a blanket and either the infant resuscitated to try to extend life or allowed to die a peaceful and natural death surrounded by family.
Contrary to how Shields and Brooks and others have portrayed it, this is perfectly ethical and acceptable care. Hopefully the decision regarding resuscitation would have been made prior to delivery- during discussions between the mother/family, the obstetrician, and the pediatric/neonatal specialist so that a care plan would have been in place. There’s even a subspecialty within palliative medicine- neonatal palliative care- with expertise in helping families with these unimaginably difficult and heart-breaking realities. And if anyone from the media, which only served to fan the flames further, would have done their job and explored this topic, they would have found that everyone involved works very hard to create a sacred space around the neonate and family- one that truly honors the sanctity of life during a time of great sadness.
That’s what we all want from our medical care. And it’s way too important an issue to trivialize and denigrate by political posturing.
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