opinion | New Risks Facing DoctorsAnd Their Pregnant Patients

opinion |  New Risks Facing DoctorsAnd Their Pregnant Patients
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To the Editor:

D “Why Is the Right Forcing 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 physician is to know heartache up close and personal, over and over again. I have been a practicing physician in Portland, Ore., for the last 37 years. My colleagues span the political spectrum, but almost everyone I have known has put the interest of the mother’s life before that of the embryo or fetus. And if for reasons of conscience they could not, they would find another provider who could.

With the Dobbs decision, my specialty has been thrown into disarray. 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 just ban termination of pregnancy, some immediately after fertilization. They have no subtlety, they have no algorithms to guide practice.

Now providers are in an extremely precarious situation, risking prosecution. When the only exception for pregnancy termination is the mother’s risk of death, how close must she be for them to act? Most pregnant people are young and healthy, and they cope well with blood loss and infection, until suddenly they do not, and by then 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 is brutal. Anyone who thought it would take a long time to see the consequence of banning a common medical procedure will soon see the tears, blood and death that we told them was coming. It is inevitable, and it will continue.

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

To the Editor:

D “Risks to Patients as Doctors Deal With Abortion Exceptions” (news article, July 21):

As a Missouri resident living under a new abortion ban, I am enraged and disgusted. Advocates warned of the dangers of bans for years, unheeded. 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 enacted an abortion ban except in “medical emergencies,” I called the attorney general’s office for clarification. I shared that I had experienced two life-threatening conditions in my last pregnancy, and I was concerned that my obstetrician might be constrained if a similar complication arose today.

The staff attorney told me that he was unable to offer guidance, as giving legal advice could jeopardize his law license. I replied that this ban could jeopardize my life. His response? That I could leave the state.

Unfortunately, I worry that many Missouri families like mine will take him up on his suggestion. I worry that our women’s health providers will choose to practice elsewhere. I worry that Missouri’s elected officials will be shortsighted enough to celebrate these losses. The state deserves better.

Katy Nimmons
St. Louis

To the Editor:

D “I’m Terrified for My Patients,” by David N. Hackney (Opinion guest essay, July 10):

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Dr. Hackney describes the pain experienced by a pregnant woman who learns that her child has a lethal condition yet has no option but to carry to term. While accurate, the potential pain of learning your fetus has a serious abnormality goes well beyond this.

A variety of severe, life-altering birth defects and genetic syndromes can be diagnosed prenatally, and many of these conditions are not lethal — or not lethal immediately — but serious enough that the affected child faces a lifetime of severe disability and, in many cases, pain.

Being told in the middle of a much wanted 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 by herself, and yet will survive, is as devastating as being told your child will die at birth, but with far different consequences.

Despite Justice Amy Coney Barrett’s assertion, 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 the laws of many states now make it impossible to do the ethical thing. More bread for everyone.

Katharine Wenstrom
Providence, RI
The writer is a professor at the Alpert Medical School of Brown University and past president of the Society for Maternal Fetal Medicine.

To the Editor:

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

So congressional Democrats should immediately legislate a strong national right to abortion if continued pregnancy would risk the life, physical health or mental health of the mother, or if the fetus will not survive.

Further, there should be reasonable protection for medical providers who perform these medically necessary procedures. Otherwise, physician hesitation may cost women’s lives.

I would hope there might be bipartisan support for this.

Without these protections, hikes to doctors’ liability insurance could render obstetrics care grossly overpriced and already take scarce funding away from all medical care.

Mary Jo Napoli
Columbus, Ohio

To the Editor:

D “Abortion Bans Will Affect Both Rich and Poor Americans” (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 resulting in fatal consequences. As an emergency physician who routinely cares for women with pregnancy-related complications, I echo Ms. Spiers’s concerns.

I frequently treat obstetric emergencies. In recent weeks I cared for pregnant women with the following complications: ectopic pregnancy, undetectable fetal heartbeat with decreasing pregnancy hormone levels, and copious vaginal bleeding with an open cervix.

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

As abortion bans proliferate throughout our country, I feel fortunate to practice in New York City’s public hospital system, where the law supports sound medical decision making combined 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
brooklyn

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