The real targets of our abortion ban

Don’t trust me. Trust women.

I’m a board-certified obstetrician and gynecologist practicing in Little Rock, providing a broad range of care to women with gynecologic and obstetric needs including hysterectomies, tubal ligations, pap smears, STD testing, delivering babies both vaginally and by cesarean, menopausal care and more.

I don’t provide abortion care; not regularly anyway. I have performed a handful of them, but I’m not an abortion provider, not in the sense you’re worried about.

There was that one time that we induced a 21-week pregnant woman because she was becoming critically ill with a condition called HELLP syndrome, and we all knew the fetus would die. I guess that’s an abortion. Legally it is … knowingly causing the death of an unborn child.

There was another time that my patient’s bag of water broke at 15 weeks. She became infected and we ended the pregnancy—another abortion.

I remember delivering a patient in the ICU during the pandemic. While she fought for her life in respiratory distress from the covid infection—under the added stress of carrying a pregnancy—we helped her decide the right time for her to end her pregnancy so she could balance her life with that of her child.

One woman with severe heart failure accidentally became pregnant. She had been on birth control to prevent a pregnancy as it could be life-threatening for her. As it turned out, she was one of those 3 percent for whom the birth control just didn’t work. Since her chances of dying were estimated at 1 in 10, she chose to end her pregnancy so she could be around for her other two children. Abortion.

It’s easy to look at these cases and say, “But these aren’t the people Arkansas’ abortion ban is targeting. There’s an exception for maternal life in an emergency.“And I’m here to say it’s just not that clear. The law isn’t clear, and I know of no physician who is willing to risk a 10-year felony prison sentence to try to help clarify the law. So when it comes to maternal health, we are stuck in limbo.

What do we do about the woman with a placenta percreta who is bleeding and so close to viability? Do we just transfuse her and take a chance? What about congestive heart failure? Pulmonary failure? Sepsis?

Are we just supposed to put Band-Aids on our patients until our legislators (who have zero medical training) say they are sick enough? I acknowledge that many may not even heard of some of these medical problems, and that’s exactly why they should be managed by trained medical experts, not lawmakers.

And what is the cutoff for “life-threatening,” by the way? Our legislators were not kind enough to clarify this when they wrote the law, being purposefully vague in order to take power away from patients. Is it 50 percent, 10 percent, 5 percent? If there were a 1 in 20 chance that I would die in a wreck the next time I was in a car, I’d probably never drive again. For every 2,300 pregnancies in Arkansas, a mother dies. That’s higher than Cuba. Higher than Syria. In my career, I’ve been involved in twice that many deliveries. Where do we draw the line? With your daughter? With your wife?

One of the saddest things about my job is delivering women who have children with what we call “lethal fetal anomalies.” More simply put, this baby will certainly die. These are truly the hardest days of my entire career.

These families so desire a child—some have waited years and spent tens of thousands of dollars to grow their families. No matter the case, the news that their baby has no brain or is afflicted with a rare genetic disorder is devastating. To be in that room while the mom weeps audibly and the fathers cry for maybe the second time in their marriage—it’s overwhelming.

Our team brings the full weight of medicine—genetic counselors, high-risk obstetricians and specialists from several fields— and there’s just nothing we can do. These parents speak with their minister and they pray. And they come back and ask to end the pregnancy. And again you might say, “But Dr. Taylor, this isn’t who is being targeted by the abortion ban.”

But actually, shockingly, it is. In Arkansas, there is no relief for a fatal fetal anomaly. None. No choice. The state of Arkansas does not trust your daughter or your wife to make decisions about her pregnancy when it comes to deformities so profound that they will certainly lead to the death of the newborn.

Our legislators refuse to include an exception because “it’s a slippery slope.” That’s an interesting choice of words considering Arkansas leads the country in dead moms. The slippery slope is that our own moms are more likely to die than moms in Syria. Perhaps we could start with a new base line—one where we trust women.

What about your wife if she is raped and becomes pregnant? Surely the state will let her end that pregnancy. Not in Arkansas. Trust me.

And what about the 14-year-old girl who is raped by her father or brother—surely that doesn’t happen? It does, trust me.

And if she becomes pregnant, the state will force her to carry the pregnancy. Trust me.

Of course, these laws don’t really apply to the legislators. When they need abortions, they find ways. Trust me.

Pregnancy is not punishment. We need to start changing how we think of women at baseline. They are by and large good decision-makers, probably better than men. They are, in fact, the powerhouses of our future. When we lift up women and give them power, entire societies prosper. They are the part of society that can make Arkansas great again. Trust me.

When one of my patients is faced with these impossible decisions, we have long, challenging conversations. We make decisions together, ones that are sensible and ethical. I take enormous pride in empowering women and am humbled by the respect they show me simply by involving me in their private care. And when we are in that office room together, one group of people is notably absent every single time: the Legislature. And it needs to stay that way.

So maybe I am an abortion provider—a doctor who provides the full scope of obstetric and gynecologic health care to his patients based on their needs. Because abortion care is health care. And abortion saves lives.

Don’t just trust me. Trust women!

Make a promise to your daughter. Sign the petition to put the Arkansas Abortion Amendment on the ballot today. Arkansans know best.