Further, some proposals, such as mandates that physicians use outdated protocols for medical abortions, are contrary to medical evidence, Dr. Stanwood said.
H.R. 36 is one proposal that’s not evidence based, according to Dr. Hal C. Lawrence, executive vice president and CEO of the American Congress of Obstetricians and Gynecologists. There’s no evidence, despite a fair amount of literature, to indicate that a fetus can feel pain at that time, he said.
Dr. Lisa Hollier
And the actual number of abortions performed after 20 weeks is very low – less than 1% nationally. These typically involve serious medical complications where the termination of the pregnancy is necessary to save the mother’s life, Dr. Lawrence said. “I don’t think we want to take that therapeutic option away from physicians.”
ACOG has been campaigning against the idea of “legislative interference” for the past few years and enlisting physicians from other specialties in the effort. The American Medical Association, for one, has been vocal about its opposition to “governmental intrusions” into the patient-physician relationship and has called on lawmakers to stay out of decisions about what constitutes medically necessary treatment.
“The ability of physicians to provide appropriate treatment options and have open, honest, confidential communications with their patients is an essential value that must be protected,” said Dr. Robert M. Wah, an ob.gyn. and AMA president.
Dr. Lisa M. Hollier, an ob.gyn. in Houston, said she feels the impact of that intrusion firsthand when she’s with a patient.
“My patients come to me, trusting that I will be completely honest with them, open with them, and counsel them fairly regardless of my personal beliefs on a particular topic,” Dr. Hollier said. “When we have legislatures intruding into that very personal moment between a woman and me, it brings in a third party, and she no longer has the complete confidence that I can tell her everything.”
Texas, in particular, has been a battleground when it comes to abortion access. A 2013 Texas law that requires the state’s abortion clinics to adhere to construction, equipment, and staffing standards similar to those of ambulatory surgery centers is currently being challenged in federal appeals court.
The stakes are high in this case, Dr. Hollier said, because if the law is upheld, many facilities won’t be able to meet the new standards, forcing women to travel longer and spend money on lodging, child care, and missed time at work.
Courtesy of Christian Medical & Dental Associations
Dr. Gene Rudd
“Functionally, what it does is really limit the patient’s opportunity to get access to the full range of reproductive health services,” she said.
But not all physicians see the increasing regulation of abortion services as a problem. Dr. Gene Rudd, an ob.gyn. and senior vice president of the Christian Medical & Dental Associations, said it’s part of the necessary regulation of medical practice, in the same way that the government ensures that only competent surgeons can perform an appendectomy, he said.
“The claim that there’s interference is a smoke screen,” he said.
What makes the abortion situation unusual and different, he said, is that lawmakers and physicians aren’t dealing with an appendix, but an “early life,” Dr. Rudd said. The issue of how early in that life the government should offer legal protections is a societal issue, he added, and lawmakers have every right to define it, with input from experts on all sides.
Dr. Rudd, who supports H.R. 36, said he expects that the abortion battle will continue in state houses and courthouses around the country until there is some cultural consensus around the issue.
“I think it’s going to be an ongoing issue,” he said.
mschneider@frontlinemedcom.com
On Twitter @maryellenny