Politics must stay out of Florida’s abortion decisions
To hold the hands of a young mother and tell her that the fetus she is carrying is not viable and continuing the pregnancy endangers her life is the hardest and one of the most important things I do as an obstetrician-gynecologist. That moment, that mother and her family need all their options to make the best decision for her health and for their future family. Those options must include abortion care.
The 20-week abortion ban currently under consideration by the Florida Legislature would rob such women and their families of this critical option. The bill would make it a felony to perform an abortion in Florida after 20 weeks of pregnancy, forcing physicians to choose between ignoring the needs of their patients and going to jail. As an obstetrician-gynecologist, I find it unconscionable that state lawmakers, almost none of whom have any medical training, are able to make decisions that have such a huge impact on the health and well-being of my patients.
As I think back over the last three decades of providing pregnancy care, I remember clearly so many of the complex conversations I have had with my patients as they struggle to decide what is best for them and their families. There are so many reasons why a woman might find herself needing an abortion after 20 weeks.
In many cases the patient has experienced a delay in realizing she is pregnant, generally because of long-standing irregularities of the menstrual cycle. Sometimes women seek abortion care after 20 weeks because it took them time to gather the necessary funds to cover the cost of care. This has been especially true during the pandemic when so many people, especially women, have lost their jobs.
In my practice I frequently see fetal diagnoses later in pregnancy that present health issues. Sometimes these diagnoses are not compatible with life. And they are sometimes not detected until after 20 weeks. In a typical pregnancy, there is an early ultrasound done to confirm the gestational age, usually in the first trimester. Then there is a more detailed anatomy ultrasound done around the 20th week of pregnancy, and it is at this 20-week ultrasound where some fetal diagnoses are first detected. There can then be a further delay if an amniocentesis is performed to evaluate for genetic issues. Once the problem is diagnosed, the patient and physician sit down and talk about options. In some cases, women decide to proceed with an abortion rather than taking on the risks of carrying the pregnancy to term. This is especially true when there is no chance the pregnancy could survive after delivery.
I remember a patient with a pregnancy diagnosis of trisomy 18, a condition in which the baby rarely survives beyond the first year of life. She was 21 weeks pregnant when the diagnosis was confirmed. The bill currently under consideration would have forced her to stay pregnant, essentially to risk her life for a baby that would be born only to suffer and die very young. She made the decision to have an abortion because she didn’t want her baby to suffer and because she wanted to maximize the chances of having a healthy pregnancy in the future.
As a physician I implore Florida’s politicians to stay out of these complex, life-altering health care decisions. We must trust our medical expertise. But above all, we must trust each individual woman to know what is best for her family, her body and her life.
As I think back over the last three decades of providing pregnancy care, I remember clearly so many of the complex conversations I have had with my patients as they struggle to decide what is best for them and their families.