The recent U.S. Supreme Court order to pause the case of a Texas ruling to ban mifepristone– one of the two medications used in medically induced abortions– adds to the chaos around the efforts to throw decisions a woman makes with her doctor into a hyper-charged political environment.
In his recent ruling in Texas, U.S. District Court Judge Matthew Kacsmaryk insisted that the FDA ignored the “intense psychological trauma” women who utilize medical abortion therapy and then “see the remains of their aborted children” supposedly experience.
This falsehood flies in the face of both medical evidence and reality. A judge in Washington state issued a ruling blocking the ban in several states.
In my more than 15 years of practice as a family physician, I have helped hundreds of women plan their families. I have delivered their babies, cared for their children, helped them research their options when they have difficulty conceiving, consoled them when they’ve lost a pregnancy, and yes, given women the most up-to-date and accurate information when their pregnancy was unplanned so they could make the decision that was right for them.
For them, the experience is emotional. But I have often seen how a woman– when equipped with all of the information she needs and want about the decision they face– is able to come to peace with the outcome.
The judges, lawyers, and politicians who say they know what’s best for a woman and her family have never been in the room with my patients and me when we are discussing their medical care. The decisions playing out in the courts and state legislatures that limit how doctors care for their patients are based on false information, threaten a woman’s ability to get safe and necessary care, and put the entire family at risk.
As a physician who practices patient-centered, evidence-based medicine, I need to set the record straight.
The two-pill combination of mifepristone and misoprostol used for medically-induced abortion care is only approved for use up to the 10th week of pregnancy.
Anti-abortion groups routinely portray fetuses in very early pregnancy as fully formed human beings; and that is simply not true. At 10 weeks of pregnancy, fetuses are the size of a prune and are just starting to become more defined. Medically speaking, fetal viability occurs at 24 weeks of pregnancy, months after the fetal heartbeat is first detected.
The claims of psychological trauma after an abortion have also been proven false. In a 2016 study in the British Medical Journal, researchers surveyed over 800 women seeking abortions in 30 abortion clinics across the U.S.
Using validated screening tools for post-traumatic stress disorder, they assessed whether women who received an abortion were more likely to suffer from PTSD than those who ultimately did not receive an abortion. The study clearly showed no difference in PTSD between women who received an abortion and women who didn’t.
The real trauma is coming from the continued decisions being made by courts and state legislatures to restrict a woman’s agency over her health decisions. Data from the Guttmacher Institute shows that as of 2016, two-thirds of all abortions in the United States, medical or surgical, occurred at eight weeks or sooner.
This is critical to note, as the Guttmacher Institute, a leading expert on reproductive healthcare and access, issued a statement that the Texas decision will severely impact all states across the US, but 10 states most critically. These 10 states are not defined to any one geographic region and will affect women everywhere.
In states where access to abortion was already being restricted, the strategy that anti-abortion activists have taken is to portray women as the victims. They instead criminalize physicians and other healthcare workers who are providing scientifically sound, evidence-based medical care that is near universally accepted as the best and most appropriate care that a pregnant woman should have based on their unique needs.
In Idaho, which criminalizes abortion at every stage, evidence of these extreme measures are showing clear and devastating effects. In less than one month, two critical access hospitals in Idaho have announced they will cease to offer obstetrical services and cited the anti-abortion climate in the state as a key factor in their inability to recruit and retain key staff and personnel necessary to maintain a safe environment to deliver babies.
The impact of these closures, and the more than 200 across the country that have closed since 2011, have created what are known as maternity care deserts, defined by the March of Dimes as “any county in the United States without a hospital or birth center offering obstetric care and without any obstetric providers.”
In the past decade-plus, four of the five states which have suffered the greatest loss of access to obstetrical services are states where abortion services have become increasingly restricted.
The consequences are deadly. A 2019 study shows the risk of dying during pregnancy and for up to a year after having a baby due to pregnancy-related causes was significantly higher for women living in maternity deserts.
To be sure, anti-abortion activists say they are acting to save and protect the unborn child. But what about the children that are already born?
According to the National Center for Health Statistics, babies at the greatest risk for dying before the age of one are babies born to adolescent mothers, babies born to mothers past their prime childbearing years, and babies born too soon after a prior delivery.
Without full spectrum family planning services, including abortion, there will be more babies born into these high-risk groups. The trauma of a mother seeing their infant die is undeniable.
The risk to mothers who lack access to full reproductive and maternity care puts their already-born children at high risk of psychological trauma as well. I’ve counseled many heartbroken children through both the severe illness and the death of a parent. These experiences change children forever.
The ideological divide regarding abortion in the United States put the people that matter – women and their children – at serious risk. As a physician who has long cared for families, I cannot ever forget the importance of these families.
Policymakers, judges, activists, and decision-makers in the judicial system at the local and federal levels must honor their importance as well.
