The post-Roe crisis for pregnant women

Every day brings new evidence of the disaster wrought by the United States Supreme Court’s politico-religious end to women’s medical autonomy in the overturning of Roe v. Wade, especially in hardline states like Arkansas with near-absolute abortion bans.

One problem is the difficulty that currently exists in knowing where future doctors can train to become obstetricians and whether this training will be complete if public institutions are unable to provide courses on abortion. Abortion is a necessity for some problem pregnancies, including spontaneous miscarriages.

There are heartbreaking (and life-threatening) stories of women facing medical emergencies in states where doctors fear acting out of legal responsibility.

There is even a debate about what “abortion” means. As The New York Times reports, anti-abortion forces try to invent euphemisms and excuses for necessary abortions or offer workarounds that don’t exist in states like Arkansas.

Major medical societies and medical billing codes define abortion as any procedure that terminates a pregnancy – whether that pregnancy is wanted or not, whether a woman seeks the procedure to cleanse her uterus after a miscarriage or due of a serious fetal diagnosis, or to terminate an unintended pregnancy.

“An abortion is an abortion is an abortion,” said Dr. Louise King, an obstetrician-gynecologist and bioethicist at Harvard Medical School.

Lawmakers and anti-abortion groups disagree, saying it’s only an abortion if the woman or her doctor chooses to terminate the pregnancy. This usually means that terminating a pregnancy in a dire medical situation is acceptable, while terminating an unwanted pregnancy is not.

This is, of course, sophisticated. Vague laws force doctors to make decisions contrary to what might be best for a patient.

Louisiana anti-abortion politicians faced outrage in August when a hospital denied an abortion to a woman carrying a fetus doctors said was born without a skull. One of the state’s three bans allowed abortion to terminate “medically futile” pregnancies. But the condition of the fetus, acrania, was not specifically on a list of exceptions allowed by law.

Anti-abortion politicians tried to claim that the abortion this woman got in New York to end her pregnancy was a “medical procedure” and not an abortion. In the case of the abortion of a 10-year-old rape victim in Ohio, another anti-abortionist said the rape and pregnancy would impact her life and therefore constitute an exception to the ban on abortion. the state.

You have to look hard for any margin of protection for women in Arkansas’ near-total ban.

Abortion is permitted to remove a dead fetus or terminate an ectopic pregnancy. Otherwise, abortion is permitted only “to preserve the life of a pregnant woman whose life is endangered by a physical disorder, physical illness or physical injury, including a life-threatening physical condition caused by or resulting from the pregnancy itself”.

Only to “preserve life”. How many angels can dance on the head of this pin? The New York Times article commented:

Most laws allow exceptions to save the life of the pregnant woman. But uncertainty about what constitutes life-threatening has led to what the president of the American Medical Association called “chaos” as medical professionals try to decide which conditions fall under those exceptions. Women are denied abortions for miscarriages and to end pregnancies that have little or no chance of survival, or left to get sicker before they can have an abortion that is considered life-saving.

Arkansas, as Attorney General Leslie Rutledge proudly proclaims, is the most “pro-life” state in the country. This means it has a law so ruthless that women will die or be seriously injured or forced to travel great distances at great expense to end a dangerous pregnancy, including one with a fetus unlikely to survive.

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