Casualties in the Abortion War

The Christian Right's war on abortion is having the effect of reducing women's choices even though abortion is legal because fewer and fewer doctors learn how to or are willing to perform the procedure - especially dialations and extractions (intact D&Es), labeled "partial-birth abortions" by opponents, even though they are needed for women whose fetuses have died.

  Ms. Magazine carries the story:

I was 19 weeks pregnant, strong, fit and happy, imagining our fourth child, the newest member of our family. He would have dark hair and bright eyes. He’d be intelligent and strong — really strong, judging by his early kicks. And now this. Not alive? ... My doctor turned around and faced me. She told me that because dilation and evacuation is rarely offered in my community, I could opt instead to chemically induce labor over several days and then deliver the little body at my local maternity ward. “It’s up to you,” she said.

I also did some research, spoke with friends who were obstetricians and gynecologists, and quickly learned this: Study after study shows D&Es are safer than labor and delivery. Women who had D&Es were far less likely to have bleeding requiring transfusion, infection requiring intravenous antibiotics, organ injuries requiring additional surgery or cervical laceration requiring repair and hospital readmission. A review of 300 second- trimester abortions published in 2002 in the American Journal of Obstetrics & Gynecology found that 29 percent of women who went through labor and delivery had complications, compared with just 4 percent of those who had D&Es.

Sounds like the medically smart choice. Unfortunately, abortion opponents have made sure that women don't always have access to medically smart choices:

We told our doctor we had chosen a dilation and evacuation. “I can’t do these myself,” said my doctor. “I trained at a Catholic hospital.” My doctor recommended a specialist in a neighboring county, but when I called for an appointment, they said they couldn’t see me for almost a week.

On my fourth morning, with the bleeding and cramping increasing, I couldn’t wait any more. I called my doctor and was told that since I wasn’t hemorrhaging, I should not come in. Her partner, on call, pedantically explained that women can safely lose a lot of blood, even during a routine period. ... At last I found one university teaching hospital that, at least over the telephone, was willing to take me. “We do have one doctor who can do a D&E,” they said. “Come in to our emergency room if you want.”

But when I arrived at the university’s emergency room, the source of the tension was clear. After examining me and confirming I was bleeding but not hemorrhaging, the attending obstetrician, obviously pregnant herself, defensively explained that only one of their dozens of obstetricians and gynecologists still does D&Es, and he was simply not available. Not today. Not tomorrow. Not the next day. No, I couldn’t have his name. She walked away from me and called my doctor. “You can’t just dump these patients on us,” she shouted into the phone, her high-pitched voice floating through the heavy curtains surrounding my bed. “You should be dealing with this yourself.”

Women in America shouldn't have to go through this, shivering on exam tables while doctors pass them around like hot potatoes, not wanting or even able to do what is medically advisable because self-righteous moralists have decided that abortion should be a criminal rather than a medical issue. Only about a quarter of all obstetrics and gynecology residency programs do any sort of training in abortions at all, and even then usually only the D&C procedure for fetuses under 13 weeks. Fewer then 7% of all obstetricians in the U.S. are trained for the D&E procedure (for fetuses 13 to 19 weeks) and most of them are over 50.

More than 66,000 women each year in the U.S. undergo an abortion at some point between 13 and 20 weeks, according to the Centers for Disease Control and Prevention. ... Most of those women face increasingly limited access to care. One survey showed that half of the women who got abortions after 15 weeks of gestation said they were delayed because of problems in affording, finding or getting to abortion services. No surprise there; abortion is not readily available in 86 percent of the counties in the U.S. Although there are some new, early diagnostic tests available, the most common prenatal screening for neural tube defects or Down syndrome is done around the 16th week of pregnancy. When problems are found — sometimes life-threatening problems — pregnant women face the same limited options that I did.

Should women's options be so drastically reduced? In the America that the Christian Right wants, this is the best that women should expect and even then only if they are particularly optimistic. For the Chritsian Right, the health and welfare of mothers simply doesn't count.

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