Abortion makes many people uncomfortable. I understand. When I was an obstetrician-gynecologist, I remember telling my supervising doctor that I would learn abortion skills, but probably wouldn’t provide them when I graduated, because it made me “feel a little uncomfortable.”

My supervising doctor replied, “Do you think women have a right to this procedure?” I thought, “Well, yes, of course.”

S expired decision in Dobbs v. Jackson Women’s Health Organization, The Supreme Court has expressed its desire to place a heavy brick on the rock of the statue of Lady Justice, which adorns the Supreme Court building. The goal of law, like medicine, must always be to strike a balance between benefit and harm. The judges are definitely on the side of the damage.

Balancing the scales will require a concerted and sustained effort. Most Americans fall into the “murky environment” of the abortion debate and may be reluctant to tread in saturated water. Again, this hesitation is understandable. Abortion is an awkward topic for many people. However, people who have been passive on this issue can no longer be so. If this is you, it’s not too late. Let your legislators know where you are on this issue. Have difficult conversations with family and friends about why you support bodily autonomy. Donate to organizations performing this work.

Therefore: when I was a young doctor, unsure of my desire to perform abortions, my supervisor and I talked about how I might have an ethical and moral obligation to fulfill my role to ensure that the procedure is accessible. Because it’s not about me, my comfort, you or anyone but the caregiver. So, almost 20 years later, in addition to prenatal care and the birth of complex pregnancies, I now also provide abortions and teach new doctors how to do them.

I do this because people are entitled to this procedure, but also because this medical saying resonates with me: “Can I never see in the patient anything but a being in pain.” This does not mean that every decision to have an abortion should be painful (although some are), but rather a reminder to set the needs of the patient in the first place.

I have this somewhat stellar idea that if the anti-abortion crusaders can spend a few days in my office, they will begin to understand. While this dream may seem naive, it is a fact that many patients who identify as pro-life sat in my office after the unexpected news of their pregnancy and told me that they had a new understanding of these nuanced problems. They can now see the harm in the laws they have previously supported.

I have written before about how the provision of medical care that both respects childbirth and protects the right of a person not to conceive is not a contradiction. The well-established medical ethical principles of charity, innocence, justice and autonomy force me to provide full-spectrum reproductive care. If the expired opinion for Dobbs standing, this will prevent me from providing the full range of obstetric care and will break a 50-year precedent that preserves the right to terminate a pregnancy. The case disputes 2018 Mississippi Gestational Age Actwhich prohibits abortions after 15 weeks with few exceptions. The petitioners also asked the Court to set aside a precedent establishing a constitutional right to prevent abortion, the final results of Rowe vs. Wade and Planned parenting in Southeast Pennsylvania against Casey. States will now be the main legislators of abortion and can force people to give birth against their will. More than 20 states they already have abortion bans designed to take effect quickly if the court passes these laws as constitutional, with the most restrictive abortion ban almost completely.

This is terrible news for anyone who values ​​bodily autonomy, the separation of church and state, and government intervention in science and medicine. Although we cannot remove individual values ​​and morals from this debate if we accept the premise that medicine is an applied science, it is worth exploring the science behind why abortion restrictions are harmful.

Numerous studies confirmed that restrictions on abortion do more harm than good that abortion is safeand that the oft-cited concern that abortion is detrimental to mental health not true. The most famous of these studies is the decade Deviation studywhose main finding is that abortion does not harm health and well-being, but in fact refusing an abortion leads to poorer financial, health and family outcomes.

Most people do not realize that carrying a pregnancy to term is 14 times more dangerous than early legal abortion. Although we must work to reduce maternal mortality, especially among colored women, the fact is that being pregnant (or being forced to seek a dangerous or illegal abortion) will always be more risky than a safe abortion.

The harm of abortion restrictions is the reason why mass medical societies oppose them. Examples include American College of Obstetrics and Gynecologyon Maternal Fetal Medicine Societyon American Academy of Pediatricson American Psychiatric Association and on American Academy of Family Physicians. IN American Medical Association expressed opposition to the most restrictive laws. These are not radical marginal organizations, but groups made up of doctors who live in your community and take care of you every day.

Technology has continued to advance since initial abortion decisions in 1973 and 1992. New techniques in medical and surgical abortions continue to reduce the already low complication rate. Home pregnancy tests are becoming more sensitive, allowing people to recognize pregnancies without visiting a doctor. Diagnostic techniques in ultrasound and genetics have expanded exponentially, allowing the detection of complications that would not have been known until after birth in 1973.

As we face the onset of state legislation against abortion, we must be prepared with an idea of ​​how best to balance the scales in order to offer the greatest benefit with the least harm. In my opinion, as a doctor who has dedicated her career to helping pregnant women and babies have the best results, the best way to do this is to remove all restrictions on abortion. This is not an extreme position.

While some people may conclude that it is appropriate to limit abortions after a certain point in pregnancy and to limit the reasons for termination of pregnancy, pregnancy is one of the most complex biological processes – and thus the ways in which it can confused, are innumerable and complex. The decisions a person makes with their doctor require nuanced consideration of individual values ​​and circumstances, rather than a general approach that may be legitimate; this was part of the dispute in Rowe vs. Wade.

Even the concept of “viability” on which SCOTUS bases previous solutions is vague and dynamic as a consequence of the evolving nature of medicine. The probability of each fetus surviving outside the uterus as a newborn is an assessment based on many factors. In addition, as technology advances, forecasts will change. Viability is a poor legal standard. If Judge Samuel Alito did the right thing in the past opinion, it was to abandon vitality as a benchmark.

Dogmatic laws presuppose security, which rarely exists in the realities of clinical medicine. They fail to take into account the range of predictions that characterize many conditions, as well as how the complexity of psychosocial circumstances, mental health, and differences in access to care affect a person’s health outcomes. Legislators cannot legitimize every circumstance or exception that must exist in order to prevent sometimes significant harm and / or suffering. Biology constantly surprises us.

Once abortion restrictions are removed, we need to remove other barriers to care. Like the others described, not only laws restrict choice. It doesn’t help that abortion is legal if you can’t afford it, you can’t get a break, you don’t have transportation, or countless other systemic restrictions. IN Hyde’s fixwhich prohibits federally funded insurance such as Medicaid from covering abortions must sink without bubbles. Unnecessary FDA restrictions on mifepristone, a common and safe abortion, should also be lifted. We need to support and encourage the many excellent organizations that help people gain access to care and remove barriers. Finally, because reproductive choice is a matter of choice, we need support systems for people who decide to stay pregnant and / or parents. None of the above requires a decision of the Supreme Court. Many of them could and should be enacted by Congress or enforced by executive order.

In addition to its scale, Lady Justice holds a double-edged sword. She wears a blindfold. It seems that our Supreme Court will not use this sword responsibly in relation to abortion, and the bandages that some of the judges wear regarding the autonomy of the body must be removed. The work of preserving abortion rights belongs to everyone – not just people who can get pregnant. My patients deserve to make decisions about their bodies without ideological interference. And you too.

https://www.scientificamerican.com/article/what-the-supreme-court-should-know-about-abortion-care/

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