No, We Aren’t ‘Murderers’ – We Are Your Doctors

The far right is now on its second month of claiming that unless new laws are put into place, abortion providers will willfully and eagerly murder newborn infants while the patient silently and complicitly watches. The utter mistrust and suspicion that anti-choice politicians have towards medical professionals who offer legal abortion care (and, frankly, to the people who seek it out) is no longer shocking. What is surprising, however, is how much the public is falling for this mistaken concept that the doctor providing abortions is somehow a completely different entity from the doctor checking your paps, inserting your IUDs and yes, even delivering your baby into the world.

One of the hardest parts of being an abortion provider is the isolation in our medical profession that is  thrust upon us by anti-choice factions. They’ve forced medical schools to outsource full-scale Ob/Gyn care that includes learning miscarriage management and abortions at all levels of gestation. They’ve made medical students opt in, rather than opt out, of learning these completely legal and necessary medical procedures, and travel off campus and further if they want to get enough training to be proficient. And they’ve removed elective abortions from hospitals and private family medical clinics and corralled them into abortion clinics and reproductive health clinics alone, as if they were an infectious disease that must be contained.

Providing an abortion is just one part of what an Ob/Gyn, or even many family doctors can and should be able to do, and an important part of the medical services spectrum that allows one doctor to see a patient through every level of that person’s medical needs at any given point in their life. Yet the right has siloed abortion into one “shameful” medical concept and annexed it from the full continuum of care, as if there are “abortion doctors” and “real doctors” rather than them being one and the same.

That same doctor that gives one pregnant person an ultrasound to see if she is early enough to use medication abortion for a termination is likely to be found a day later with another patient checking her dilation to see if she’s  in labor. Yet the right is adamant that the first one is a monster, and the second a trusted part of the medical team, despite the fact that each is the same person in a different setting.

No, we aren’t committing infanticide, or murder, or doing harm. We took oaths to protect our patients, and there are already laws to be certain that we uphold them. We are all  physicians and we are all governed by the same boards and bodies,  yet anti-choice activists have convinced you that we are different simply because of the clinic in which we provide our care.

Of course there are bad abortion providers out there, that is inescapable. There are also bad cardiologists, bad oncologists, bad surgeons and more. Yet in those specialties a rogue doctor is treated as an anomaly, and isn’t seen as tarnishing an entire profession. Yet because an abortion doctor’s specialty is relieving a patient of a pregnancy they do not want to continue, every rare instance of poor care or doctor violation is seen as the rule, not the exception.

Abortion providers, like all doctors, do what they need to do to best meet the needs of their patients. Just as you would trust a doctor to provide the best end of life care that a patient and their family requests, you can trust us as well to put the needs of the pregnant patient first and do what they want and is necessary as they deal with an unwanted pregnancy, or a pregnancy that is medically compromised.

As a doctor, I am no more likely to harm or dispose of a viable, full term fetus than any other doctor would be to murder an elderly patient simply because they are bedridden or too frail to walk. But just as most doctors will honor end of life decisions and work with a family to offer hospice when there is no hope for recovery, I too work with my own patients to make the best medical decisions for themselves and their families, too.

No one is murdering Grandma, and no one is committing infanticide, despite what anti-choice activists say. But those same activists who want to end abortion – not just later abortion, but all abortion at any point and for any reason – want to also take away your right to make end of life decisions, too. Today they are arguing to force resuscitation on fetuses on the very edge of viability against the wishes of a parent. Tomorrow, they will be focused on keeping bodies with no brain activity on life support against the wishes of the family, too. We already saw this in Texas when the state kept a brain-dead pregnant woman on life support to try to get her fetus to viability, despite her family asking them to stop. When you are legislating “life” as “conception to natural death” a family’s wishes could easily be against the law.

I am not a murder, or a monster. I am a doctor. I once delivered your babies and still do your paps, IUD’s, physical exams and STI checks, and yes, I terminate pregnancies, too. Trust me to do my  job and look out for your medical best interests at every point in your life.

After all, I trust you to make the best decisions for yourself, too.

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

Torres profile picA 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.