While what the first author says seems compelling about abortions done at later gestations, or as she points out “up to and including nine months,” it is not informed and draws on speculation by the author. Just because she can’t imagine a situation that would necessitate this type of care doesn’t mean it would be a nefarious situation.
She draws conclusions of frightening scenarios that are not based on actual practice. She hasn’t asked anyone what this would look like in real life. As a practicing OB-GYN for 25 years across 5 states, I have never seen or heard of an abortion done at nine months gestation. It doesn’t mean it doesn’t happen, it’s just that it is extremely rare and hence a complicated medical situation.
While the author can only speculate about what type of medical scenario might lead to such a decision, what I can envision would be a serious situation in which many trained providers would be involved in helping the patient and her family make an informed decision about a very serious situation.
From what the author writes, it seems that a medical provider would jump on board and provide this type of care wantonly. Why would she believe that a medical provider would be involved in such a situation? Where is her information coming from? Real life or her imagination?
As a trained provider, what I can say is happening is that I have a gravely ill patient, with a baby that perhaps has very little chance to survive because of the lethality of the situation or even being the cause of a lethal situation. The point is not that someone would take advantage of this law to end a pregnancy, it is that it would be in place for those exceedingly rare situations where terminating the pregnancy would save the women’s life.
So, where the author sees the risk of someone wantonly ending a pregnancy, I see it as possibly lifesaving for a very rare situation.
If anyone cares to investigate, I can think of a few rare situations such as twin-twin transfusion where one twin can cause the other twin to die and in rare cases cause a syndrome that could be lethal to the mother (mirror syndrome), twin gestation if a triploid fetus in one twin that can cause severe pre-eclampsia and death in the mother. These are just a few that I can name, that I have never seen, but are known to exist in the real world, not just someone’s imagination.
With regard to the letter writer’s comments, it is fear-mongering at its best to think that the United States is full of physicians who can’t wait to open an “Abortions R Us” for the sole purpose of carrying out unethical and medically inappropriate abortions at the time of birth.
There is one other thing that I would like to address from the Aug. 19 commentary. The author states, “I remind you that with every right comes responsibility. You and your partner are responsible for ensuring you do not get pregnant.” I would like to remind the author that there is not one single form of contraception that does not fail. None. Including sterilizations. Therefore, even with the very best intentions to avoid pregnancy, people still do get pregnant. What the author offers in her commentary is speculation and opinion, which should not guide our actions on Prop 5/Article 22.
Renee Johannensen, MD, Fellow American Board of Obstetrics and Gynecology
Licensed OB-GYN in Vermont, New Hampshire, New York and Alabama