A Guest Post by Dr. Leah Torres
It is every pregnant person’s nightmare: months into a very wanted pregnancy, a doctor comes in and says, “There is something we need to discuss.”
“Is there something wrong?” they think. “Is my baby ok? What is it?! For the love of all that is holy tell me!”
And the news comes: the baby will not survive after being born.
Not one person shouting about how vile and evil the new proposed third trimester abortion laws are has clearly ever taken care of a patient in need of that procedure. These patients are faced with one of the most tragic and heart-wrenching decisions of their lives, one where their entire future has changed in a moment’s notice. No matter what these “experts” say – and remember these are mostly anti-choice activists who have never in their lives attended medical school – the patients needing them are not monsters. No, the monsters are those who are opposed to pregnant people doing what is best for themselves and for their families.
Of course, this is a rare occurrence, but it does happen. What those of us who provide present-day, evidence-based abortion care can tell you is that the patient who comes in perfectly healthy and with a healthy fetus doesn’t ask for an abortion after viability. If they do, it is because they did not know how far along they were. When that does happen, and a patient learns they are too late to obtain a legal abortion, the doctor tells the patient an abortion cannot be done and discusses prenatal care and after-delivery plan. They do not whimsically approve the termination anyway, regardless of what the “pro-life” talking heads argue, both because they know the law and because their medical ethics are at stake.
I have had patients like this. It’s a hard reality to tell them that they cannot have an abortion because they are too far along, even though they believed they were earlier in their pregnancy and that termination was still an option. I cared for just such a patient after doing her ultrasound for her termination appointment, informing my shocked patient that she was actually 30 weeks pregnant and could not have an abortion. And once she learned that abortion wasn’t an option anymore, she kept seeing me for prenatal care, and I delivered her healthy baby. She and her partner were so grateful that they came to me again for prenatal care during her next pregnancy, even though I was a two-hour drive away. I delivered that second child, too.
But a patient with a non-viable pregnancy is an entirely different situation. Imagine if instead her ultrasound at 30 weeks showed a fetus with a condition called “anencephaly.” This condition means the fetus has an underdeveloped brain and an incomplete skull, and is not compatible with life. The fetus can continue to grow in utero, but once born, the neonate will survive only hours, perhaps a day or two. There is no brain to regulate breathing or other physiologic functions like heart rate, electrolyte metabolism, vital functions that are crucial when transitioning from uterine life to extra-uterine life.
Now that same patient is faced with a choice: continue to feel her baby move and grow inside her, knowing there will never be a first day of school, a moving-to-college day, a walking-down-the-aisle day, and give birth knowing she and her partner will watch it gasp and have tubes inserted in all sorts of places as it slowly loses its life, or have an abortion that would require stopping the fetus’ heart and delivering a still born baby. Does that sound like something anyone wants to face? Does that sound like a decision that the government should interfere with and make cookie cutter laws to apply to?
This scenario doesn’t even take into account how sick the pregnant person can get, and how termination may be needed to save their life, but that happens, too. There are so many ways that pregnancy can cause harm – even permanent, life threatening harm – to the person carrying to term. How can I as a medical professional justify putting a pregnant person’s life at risk for a fetus that will never be able to live?
So, no, the monsters are not the physicians who provide multi-disciplinary expert care in these rare cases, nor are they the patients who are faced with this decision and choose what they feel is the most humane and appropriate option for themselves and their families. The monsters are those who would interfere with this decision-making process, shaming them for not doing what a talking head who wants to earn votes from the masses would do. The monsters are those who make mothers feel bad for doing what’s best for their children. The monsters need to step down and allow health care providers to do what they do best: provide evidence-based, compassionate health care.