Why the 20 week Ban is wrong for Ohio and women everywhere

The new abortion regulations, which will take effect in 90 days unless a court halts them, will make it a fourth-degree felony for a physician to perform an abortion after 20 weeks of pregnancy when the fetus is viable. The crime is punishable by up to 18 months in prison. A conviction also would result in the loss of a physician’s medical license. No exceptions for rape, incest or fetal anomalies.

Only 45 out of 21,000 abortions in Ohio last year were performed on women over 20 weeks and we all know the heartbreak those patients faced before they made that decision. Unfortunately, politics gets mixed in with personal beliefs and medical facts and we end up with a situation where signing the 20 week bill looks “reasonable” compared to the heartbeat bill, which would get legally challenged anyway. What the governor and other pro-life people do not realize is that most abortions that happen after 20 week are usually for medical reasons and are not because the pregnancy is inconvenient or unwanted. Some examples include patients who’s membranes rupture prematurely while the fetus still has a heartbeat. These patients have the option to continue the pregnancy. However, without fluid in the second trimester the lungs may not develop and the fetus will die after delivery or the mother will become infected and if not allowed to deliver while the fetus has a heart beat she could die of sepsis. Often anencephaly is not diagnosed until later in pregnancy, these fetuses have a heartbeat but no brain and therefore are unable to live after delivery. Should that mother have to carry the pregnancy to term and then bear the pain of labor and losing her baby after delivery? What about patients whose fetuses are diagnosed with lethal physical or chromosomal abnormalitites that are incompatible with life after delivery? The decision to carry the pregnancy or not should be left to the patient and the doctor who counsels and cares for her. I personally have dealt with 3 patients in the last 2 years who learned at 18 weeks that their babies would be born with devestating physical abnormalities. 2 of them chose to terminate while one of my patients chose to carry her baby to term but delivered 6 weeks early. The baby had a severe brain defect and lived for 30 days and went through multiple surgeries only to die at the end of that time. She is now left with medical bills that are not being covered by insurance and is having to navigate appeals to the government. From a health care perspective who is going to pay for the care of these babies who have anomalies and may live for a few months with extensive life care support? It’s not upto me to judge but I believe those health care dollars would be better spent on prenatal care or other preventive services. Emotionally it is so heartbreaking to see parents watch a child die when we can offer them the option of termination. The 20 week bill talks about a fetus being able to feel pain but what about the baby I mentioned who went through several surgeries before he died? I guarantee he was in pain with every procedure he endured in his short life. Doesn’t that pain count to those who believe abortion should be banned at 20 weeks? Ultimately it should be upto the parents to make the decision of whether to carry a pregnancy or not in this scenario and not one forced upon them by the state of Ohio.

Currently elective abortion is legal in the US as has been determined by the Supreme Court. The question is whether or not the State of Ohio should attempt to put restrictions on that right. In that context, to impose that restriction does not eliminate a women from pursuing an elective abortion, it merely changes the ability to do so based upon financial resources. Someone who is wealthy can travel to another state. Someone who does not have the resources is unable to do so. They then potentially have an undesired birth which has been historically associated with a higher probability of a poorer outcome, and/or less than ideal infant care, and/or less than ideal child rearing. In all instances this adds to society’s costs in higher medical care, social services and, as has been demonstrated, crime. If a women has the right to remain in control of her body and decide that she wishes not to continue a pregnancy to its outcome, then she should not be impeded in that process. Doing so creates a separate set of complications that do not further benefit our society.

The other concern that Ob/Gyns have with this bill is the criminal penalties imposed on us for simply doing what is medically appropriate care. How are my physician colleagues supposed to counsel and care for their patients when we face double jeopardy in the sense that we may do something against the law by providing reasonable medical care but if we follow the law we may end up being charged with medical malpractice. These laws will discourage other physicians from coming to Ohio to practice which will affect access to care. This in turn will lead to higher rates of infant mortality which are already high in Ohio.

#WomensHealth #OhioRegresses

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