Overturning Roe Already Threatens Women's Health, To Surprise Of Nobody
A 'man-midwife' examines a woman as her disgruntled husband is led away by a servant. 1773, public domain.

It only took an hour and 20 minutes for last Friday's Supreme Court decision overturning Roe v. Wade to start making one doctor in Wisconsin worried about going to jail for providing good medical care. The doctor sent a group text to colleagues asking what to do to help a woman whose fetus was anencephalic — it was missing parts of its brain and skull, and wouldn't survive being born, if the pregnancy even made it to full term. Wisconsin's "trigger law" criminalizing abortion (five year sentence and $10,000 fine, 15 years and $50K if fetus is past 16 weeks) had gone into effect automatically with the Supreme Court ruling, so the doctor cancelled the appointment the woman had for later that day. But what next?

Welcome to the wonderful new world brought to you by the "culture of life."

Dr. Jane van Dis, an OBGYN professor at the University of Rochester, tweeted this week that she'd heard from a colleague in Missouri (where abortion is now a felony carrying a sentence of five to 15 years) who said that, out of fear of prosecution, "We are now observing patients with ectopic pregnancy and hemoperitoneum until they have a documented falling hemoglobin or unstable vital signs.”

You see, these laws may allow emergency abortions when the life of the mother is endangered, but if the procedure occurs while a woman is still relatively healthy, providers might go to prison. As in other countries where abortion is only allowed to save a pregnant person's life, the laws will definitely cause deaths as doctors try to decide whether their patients are endangered enough to make an abortion legal.

As NPR reports, the danger to women's health is often very much the point of many abortion laws, which are written broadly to prevent as many abortions as possible, leaving clinicians facing an "impossible choice between upholding their ethical obligations and following the law," as an amicus brief from the American Medical Association and the American College of Obstetricians and Gynecologists put it.

Dr. Lisa Harris, an OBGYN and professor at the University of Michigan, was part of a university task force on the challenges the profession will face in a post-Roe world; the study was cited in the dissent to Dobbs v. Jackson. Harris noted that Michigan's old abortion ban law — currently on hold due to a court order prior to the Dobbs ruling — makes abortion a felony except when it "shall have been necessary to preserve the life of such woman."

"How imminent must death be?" Harris asks. "There are many conditions that people have that when they become pregnant, they're OK in early pregnancy, but as pregnancy progresses, it puts enormous stress on all of the body's organ systems – the heart, the lungs, the kidneys. So they may be fine right now – there's no life-threatening emergency now – but three or four or five months from now, they may have life-threatening consequences."

So, she asks, does the language in these laws allow for abortion early in pregnancy if a life-threatening complication could arise later?

Dr. Louise King, an OBGYN at Boston's Brigham and Women's Hospital (she's also an attorney and medical ethicist, if that's Type A enough for you), says the laws will almost inevitably mean doctors will have to simply "watch somebody get sicker and sicker and sicker until some point – and where is that point? – where it's OK to intervene and we won't be exposed to criminal liability."

Again, this is not at all an abstract issue. In Ireland, four years before abortion was finally legalized in 2018, a hospital in Galway chose not to perform an abortion for a woman who was miscarrying, even though doctors agreed the 17-week-old fetus couldn't survive. But it still had a heartbeat, so the hospital delayed, and the woman, Savita Halappanavar, 31, died. She asked again and again over a three-day period for an abortion, but no dice: "Life" was the only criterion, even though the fetus could not survive.

Mind you, these laws are all designed to delay abortion care — as then-congressman Joe Walsh (R-Illinois) said in 2014, legislators no longer want to allow abortions to protect a pregnant person's health because honestly, women are never endangered by pregnancy anyway:

There’s no such exception as life of the mother. And as far as health of the mother, same thing, with advances in science and technology, "health" of the mother has become a tool for abortions anytime under any reason.

So legislatures will save all the babies by making sure women really are on death's door before they can get an abortion. And if some go through that door, then maybe Jesus will smile upon them, unless they're heathens.

Sure, state legislatures could define things more clearly. But that might allow more abortions. The dilemmas faced by providers and patients

"could be resolved by a legislature trying to engage in more specificity, which they will not do," predicts Kim Mutcherson, co-dean of Rutgers Law School whose scholarship focuses on bioethics and reproductive justice. In places where abortion is illegal, legislators will broadly "want to make it as difficult as possible, and one of the ways that you do that is [by] creating a standard where people don't know with specificity whether what they're doing is right or wrong."

Instead, she says, "You have to wait until somebody gets in trouble. You have to wait until there's a case. You have to wait until somebody gets arrested. And then you start to understand, 'OK, this is what the parameters are.'"

Clarity through the court system is likely to take months, if not years.

And then there are the laws written so badly that they criminalize treatment of ectopic pregnancies, in which a fertilized egg implants outside the uterus. If not removed, the embryo will kill the pregnant person long before it can become viable. That was the case with Missouri's "trigger" law until it was hurriedly amended in March to remove the specific ban on treatment for ectopic pregnancies.

Under the first version of the bill, violations would have been a class A felony in some cases, punishable with 10 to 30 years in prison or a life sentence. That included if the abortion was performed on a woman with an ectopic pregnancy.

But please do not worry your little heads about this at all, because Yr Wonkette got a nice email blast from a PR firm for the antiabortion group "Susan B. Anthony Pro-Life America" to assure us that NONE of these issues are real! The chirpy missive informs us that

Contrary to what many pro-abortion politicians may be stating, Dobbs will not affect lifesaving medical care for high-risk pregnancies. Many outspoken critics of the recent ruling are claiming that women experiencing ectopic pregnancies, for example, must choose either death or prison, which is completely false.

You see, the anti-abortion "American Association of Pro-Life Obstetricians and Gynecologists" says that ectopic pregnancies really are emergencies, so surely no hospitals will ever delay treatment. Why no, the email doesn't mention the Missouri law at all, or any other state laws that are so badly written that, if followed to the letter, would result in prosecution of doctors treating ectopic pregnancy.

Incidentally, just this week, Dr. Donna Harrison, the CEO of the American Association of Pro-Life Obstetricians and Gynecologists insisted on NPR's 1A talk show that there really are no medically necessary abortions. She explained that the only purpose of abortion is to kill a living human being, and after she said "killing babies" a few more times, they thanked her and cut her mic. Maybe someday NPR will screen its guests, the end. Good luck with your health emergencies everyone!

[NPR / WaPo / Kansas City Star / NYT]

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Doktor Zoom

Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.


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