How Physicians Are Responding to the “Partial Birth” Abortion Ban
The notion that the recent Supreme Court’s upholding of the “partial birth” abortion ban is not about “saving babies” but rather about making providers afraid to perform abortions due to the imprecise language, and therefore creates barriers for women while keeping abortion technically legal has been discussed before. Today, the Boston Globe reports on just how providers are responding, and it shouldn’t come as too big of a surprise:
In response to the Supreme Court decision upholding the Partial-Birth Abortion Ban Act, many abortion providers in Boston and around the country have adopted a defensive tactic. To avoid any chance of partially delivering a live fetus, they are injecting fetuses with lethal drugs before procedures.
Because the ban is not technically a “late term” abortion ban as supporters might have you believe, physicians worry that a fetus could accidentally partially emerge while living, and so they might run afoul of the law, which doesn’t specify fetal age and carries a prison sentence.
In Boston, three major Harvard-affiliated hospitals — Massachusetts General, Brigham and Women’s, and Beth Israel Deaconess — have responded to the ban by making the injections the new standard operating procedure for abortions beginning at around 20 weeks’ gestation, said Dr. Michael F. Greene, director of obstetrics at Mass. General. “No physician even wants to be accused of stumbling into accidentally doing one of these procedures,” Greene said.
The report also states that “Medical staff inject either the heart drug digoxin or potassium chloride, a potentially poisonous salt also used in state executions.”
San Francisco’s Darney and colleagues have studied both chemicals, long used in late-term abortions that involve simply inducing labor. Darney said his group concluded that digoxin was safe but offered no advantages in the actual abortion procedures, despite some clinical experience suggesting it made them easier. They found no safety record for potassium chloride, but a few case reports suggested that it could be dangerous if accidentally injected into the woman instead of the fetus.
As a result, some providers are not doing the shots, while others are leaving it up to the woman. At one Oregon clinic, any woman having an abortion after 20 weeks is being required to have the shot, despite the lack of study and because of the ambiguity of the law.
The Globe reports that medical education that would help train new providers is also being affected. In one clinic, “Medical students and nursing students are no longer invited to watch later-term abortions, for fear one might misinterpret the procedure and lodge a criminal complaint.”
I’m troubled by the idea that physicians are performing an unnecessary injection that may pose an additional risk to women for fear of accidentally breaking the law. The physicians aren’t blameless here, choosing to subject women to an injection rather than risk liability. However, in deliberately framing the ban in a vague, non-evidence-based manner, this seems to be precisely the outcome supporters desired. The ban was never going to outrightly prevent women from having abortions – it simply makes it harder and perhaps more dangerous for them to obtain, and you still end up with an abortion either way.
Previous related posts:
–Supreme Court Upholds Abortion Ban
–Physician Commentary on the Partial Birth Abortion Ban Act of 2003
–American College of Obstetricians and Gynecologists Responds to Supreme Court Decision
–More Doctors React to the Supreme Court Abortion Ban