A Week in Review: SOTU, Stacey Abrams and Reproductive Justice

 

A guest post by Dr. Savita Ginde

We are in an era where stories, both fake and true, are coming out every day and presented with such confidence that it is difficult to separate truth from fact. Even when it feels as if reproductive health is under attack from every direction, we continue to witness some shining moments, like Stacey Abrams’ State of the Union rebuttal and the stay granted by the U.S. Supreme Court. But before we can celebrate these feats, it is necessary to understand why they were needed in the first place.

Last week, on Tuesday night, President Trump spoke to the country during his State of the Union. Most of his talking points were benign, even heartening at times, as he addressed our need for unity and a plan to rid the U.S. of HIV. However, during his speech, right after proposing a much-needed national paid family leave plan, he transitioned into an attack on a recently passed New York law and a similar Virginia bill that would remove some restrictions on second and third-term abortions, claiming that these pieces of legislation would “allow a baby to be ripped from the mother’s womb moments before birth.” Misstatements made by Virginia delegate Tran and Virginia’s Governor fueled this rhetoric even further, and facts have now been misconstrued rather than corrected. True Supporters of reproductive rights and justice do not promote or support infanticide. Period. 

To say that “a baby [is] ripped from the mother’s womb” is an utter misrepresentation that evokes negative emotions and shuts down true dialogue. This statement was quite frankly a disservice to the American people. After providing his statements and opinion about these laws, President Trump turned and made a very deliberate nod to VP Mike Pence. I interpreted this nod as President Trump showing his support of the deep religious convictions of Mr. Pence. I respect Mr. Pence’s belief; but not everyone has the same beliefs. I don’t want his religious beliefs placed on me, nor are his beliefs reflective of what population health data shows. We have bypassed our common ground of compassion and respect for each other and have devolved into using dehumanizing rhetoric.

In reality, the laws that Trump was referring to intend to protect patients’ health and remove the unnecessary barriers surrounding abortion care. Second and third-term abortions, such as the ones in question, rarely happen. Pregnancies terminated after 24 weeks are few and far between and occur when a mother’s life is in danger or the fetus is not viable. 

After the SOTU, Georgia’s Stacey Abrams gave a response centered around reproductive justice.  

Far too often, people are led to believe that “reproductive rights” are synonymous with “reproductive justice.” This is not the case. Whereas reproductive rights are centered around advocating on behalf of abortion rights, the reproductive justice framework uses an intersectional lens to dive much deeper into the topic, and includes access to both safe abortion, accurate sexual education, and reliable contraception as some of its foundational components. 

When Stacey Abrams mentioned reproductive justice, it became a reminder that we need to approach the quest for bodily autonomy by looking at the social, political, and economic inequalities that create barriers to accessing safe abortion, sexual education, and reliable contraception. It was also a call to action to support the individuals and groups that are already doing this work. If the highs and lows of last week indicate anything, it is how much we need to better understand, engage in and support the reproductive justice movement. 

The Real “Monsters” in the Debate Over Third Trimester Abortions are Those Opposing Them

A Guest Post by Dr. Leah Torres

It is every pregnant person’s nightmare: months into a very wanted pregnancy, a doctor comes in and says, “There is something we need to discuss.”

“Is there something wrong?” they think. “Is my baby ok? What is it?! For the love of all that is holy tell me!”

And the news comes: the baby will not survive after being born.

Not one person shouting about how vile and evil the new proposed third trimester abortion laws are has clearly ever taken care of a patient in need of that procedure. These patients are faced with one of the most tragic and heart-wrenching decisions of their lives, one where their entire future has changed in a moment’s notice. No matter what these “experts” say – and remember these are mostly anti-choice activists who have never in their lives attended medical school – the patients needing them are not monsters. No, the monsters are those who are opposed to pregnant people doing what is best for themselves and for their families.

Of course, this is a rare occurrence, but it does happen. What those of us who provide present-day, evidence-based abortion care can tell you is that the patient who comes in perfectly healthy and with a healthy fetus doesn’t ask for an abortion after viability. If they do, it is because they did not know how far along they were. When that does happen, and a patient learns they are too late to obtain a legal abortion, the doctor tells the patient an abortion cannot be done and discusses prenatal care and after-delivery plan. They do not whimsically approve the termination anyway, regardless of what the “pro-life” talking heads argue, both because they know the law and because their medical ethics are at stake.

I have had patients like this. It’s a hard reality to tell them that they cannot have an abortion because they are too far along, even though they believed they were earlier in their pregnancy and that termination was still an option. I cared for just such a patient after doing her ultrasound for her termination appointment, informing my shocked patient that she was actually 30 weeks pregnant and could not have an abortion. And once she learned that abortion wasn’t an option anymore, she kept seeing me for prenatal care, and I delivered her healthy baby. She and her partner were so grateful that they came to me again for prenatal care during her next pregnancy, even though I was a two-hour drive away. I delivered that second child, too.

But a patient with a non-viable pregnancy is an entirely different situation. Imagine if instead her ultrasound at 30 weeks showed a fetus with a condition called “anencephaly.” This condition means the fetus has an underdeveloped brain and an incomplete skull, and is not compatible with life. The fetus can continue to grow in utero, but once born, the neonate will survive only hours, perhaps a day or two. There is no brain to regulate breathing or other physiologic functions like heart rate, electrolyte metabolism, vital functions that are crucial when transitioning from uterine life to extra-uterine life.

Now that same patient is faced with a choice: continue to feel her baby move and grow inside her, knowing there will never be a first day of school, a moving-to-college day, a walking-down-the-aisle day, and give birth knowing she and her partner will watch it gasp and have tubes inserted in all sorts of places as it slowly loses its life, or have an abortion that would require stopping the fetus’ heart and delivering a still born baby. Does that sound like something anyone wants to face? Does that sound like a decision that the government should interfere with and make cookie cutter laws to apply to?

This scenario doesn’t even take into account how sick the pregnant person can get, and how termination may be needed to save their life, but that happens, too. There are so many ways that pregnancy can cause harm – even permanent, life threatening harm – to the person carrying to term. How can I as a medical professional justify putting a pregnant person’s life at risk for a fetus that will never be able to live?

So, no, the monsters are not the physicians who provide multi-disciplinary expert care in these rare cases, nor are they the patients who are faced with this decision and choose what they feel is the most humane and appropriate option for themselves and their families. The monsters are those who would interfere with this decision-making process, shaming them for not doing what a talking head who wants to earn votes from the masses would do. The monsters are those who make mothers feel bad for doing what’s best for their children. The monsters need to step down and allow health care providers to do what they do best: provide evidence-based, compassionate health care.