This commentary is by Paul Manganiello, M.D., a resident of Norwich who is emeritus professor of obstetrics and gynecology at Geisel School of Medicine at Dartmouth and co-medical director of the Good Neighbor Clinic in White River Junction.
Recently, there have been a number of commentaries appearing in VTDigger as we approach the upcoming midterm elections concerning the passage of Prop 5/Amendment 22.
In some of these commentaries, several statements have been made, based on misinformation either unintentionally, or, sadly, purposely made to mislead, such as “Prop 5 will make Vermont a mecca for abortions,” “abortions will be performed right up until the time of birth,” “the verbiage in the amendment is confusing,” and “it’s not needed because abortion is already legal in the state.”
And, to a certain extent Prop 5, as stated, will not change access to abortion for women in Vermont. What has been correctly, and factually, been pointed out by other recent commentators is that most abortions are performed prior to viability (of the fetus), while those rare abortions performed in the third trimester are performed for either the health of the mother or because of a nonviable condition in the fetus. That is reality; that is the truth.
What we see elsewhere in our country, however, is not only an assault on a woman’s right to have an abortion, now that Roe v. Wade has been overturned, but what is becoming increasingly clear is also an assault on a woman’s choice of contraception.
This is being carried out by a group of individuals pushing their extreme religious belief that human personhood begins at conception. This is not a medical fact. These individuals are misstating reproductive scientists, wrongly alleging that the mechanism of actions for hormonal contraption and intrauterine devices are as an abortifacient, abortion-producing methods, claiming that, “hormonal contraception and IUDs interfere with the implantation of the fertilized egg.”
Ironically, they feel these contraceptives should be banned, which might then necessitate a woman needing to resort to an abortion of an undesired pregnancy.
As demonstrated by our recent tragic national response to the Covid pandemic, many Americans appear to be “illiterate” when it comes to basic statistics as they relate to assessing health outcomes, benefits and harms (risks) surrounding medical treatments, the upside and downsides.
Before the Covid vaccines were developed, the only preventive treatments were masking, keeping your distance, and handwashing. People were being hospitalized and dying at frightening rates.
Once the vaccines were developed and tested, people had another option: Take the vaccine or not. We then had a “natural” experiment. Those who refused to take the vaccine continued to be hospitalized and or die at rates that were far greater than those who were adequately vaccinated. Rarely, some individuals had reactions to the vaccine, or were not protected by the vaccine. But statistically, more of the people who took the vaccine lived to talk about it.
This happens with all medications, even aspirin; if you don’t take aspirin, you will continue to have your pain; if you decided to take aspirin, you will probably feel better than if you don’t. Rarely you might have a medical condition that might adversely interact with aspirin. There will always be risks/harms with all the potential benefits of medical treatments.
If these individuals were serious about reducing the need for abortion, rather than seeking to ban or restrict the use of these contraceptives, you would think that they would make access less restrictive and fund research to improve contraceptive methods.
These same individuals also mislead the public, wrongly stating that hormonal contraception is dangerous to a woman’s health. Now, it’s true that some women have health conditions that would prevent them from using hormonal contraception, or have undesirable side effects after initiating the medication — again as with any medication. No class of drugs, however, has been studied as extensively as hormonal contraception, and for healthy women who desire contraception, they are extremely safe and very effective at preventing a pregnancy.
When you compare women who are taking hormonal medications for contraception and examine their rates of side effects and adverse events, overall, women who are pregnant face worse outcomes during their pregnancy and subsequent delivery.
We don’t need our version of the Iranian “morality police” who are killing women because they refuse to wear a headscarf, or women in Afghanistan who are assaulted for leaving their home unaccompanied by a male companion. However, we are literally killing women in this country, when you examine the mortality rates for women in the U.S. who do not have access to reproductive health care.
We all have a right to our own personal beliefs. You can choose not to have an abortion. You don’t have a right to impose your religious belief on others. I believe in a God who gave each of us the gift of “free will.” I do not believe in a punitive God; I do believe in a God who will ultimately love us for whatever reproduction choices we make.
