Supreme Court Overturns Roe v. Wade

Things that are not part of politics happening presently and how we approach or address it as Anabaptists.
Szdfan

Re: Supreme Court Overturns Roe v. Wade

Post by Szdfan »

temporal1 wrote: ↑Sat Jun 25, 2022 6:33 pm healthcare is about protecting, promoting health, not fast-tracking death. efficiently, and for profit.
Death is also part of healthcare. Hospice care, for example, aims to allow a terminal patient to die with as much comfort and dignity at the end of life.

I thought of you when I saw this:



And this —

https://www.bloomberg.com/news/articles ... iscarriage
Restrictive abortion laws will likely make it more difficult for women to get appropriate miscarriage treatments, doctors say, because the procedures used to treat it can be exactly the same as those used to terminate an otherwise viable pregnancy.

Abortion advocates and doctors’ groups have warned about the havoc that a ban could cause for pregnant patients with a wide range of illnesses and ailments. Now that the high court has delivered its decision against abortion rights, patients are going to feel the effects, doctors said.

“There is a lot of overlap between abortion care and miscarriage management,” said Holli Jakalow, an obstetrician/gynecologist at Columbia University in New York. Some miscarriages develop slowly and doctors may remove fetal tissue early to reduce risk of complications such as bleeding. But now “until there is no absolute heartbeat we are not going to be be able to intervene in some states.”
Cancer care during pregnancy is another area likely to be affected by the Supreme Court ruling. The condition occurs during roughly 1 in 1,000 pregnancies, according to a 2020 review by doctors at the University of California at San Francisco.

Harold Burstein, a breast cancer specialist at the Dana-Farber Cancer Institute in Boston, said that most patients who are pregnant and have cancer can receive the proper treatment while maintaining their pregnancies. But in certain circumstances, the cancer care might cause harm to the pregnancy.
Katherine Van Loon, a specialist in gastrointestinal cancers at UCSF who helped write the 2020 review, said that pelvic radiation for rectal cancer is one such treatment that can’t safely be done on pregnant women because it would damage the fetus.

“It puts us in a situation of withholding necessary treatments to preserve a mother’s health if we can’t terminate a pregnancy that is interfering with our ability to deliver curative therapy,” she said.

Ideally, doctors treating pregnant cancer patients in situations like these would be able to discuss the risks and benefits of all medical options - terminating the pregnancy and starting treatment, or waiting to treat the cancer until later in the pregnancy or until the baby is born - and let the mother choose. But abortion restrictions curtail that choice.
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ABC 123

Re: Supreme Court Overturns Roe v. Wade

Post by ABC 123 »

Dan Z wrote: ↑Sat Jun 25, 2022 11:28 am First and foremost, I'm happy for the decision because I believe it will save the lives of innocent unborn children. I'd love to see the pro-life camp follow up by quickly promoting more robust social support for those who now will carry their babies to term. Although this is a morally correct opinion in my view, it must also be recognized as a socially and economically disruptive one as well - one that will especially put poor women in a bind.

Secondly, as an Anabaptist, I find distasteful the partisan crowing on the right and raging on the left...and my instinct is to steer clear of it and quietly give thanks, like I do whenever Caesar decides for justice.
I see it this way as well.

It is sobering how oblivious it is to celebrate babies being brought to term and into this world by people who did not want them. I am not at all negating the child's right to life, but these are children whose parent(s) would murder them if given the chance.

At the heart of this are moral issues.

There are some unclear medical issues that concern me as well. Like missed miscarriages and ectopic pregnancies. What about events where a mother is very sick and she either undergoes an emergency preterm c section or induction? It happens. Will these still be an option? What of very young girls who are raped and not physically strong enough to carry and birth a child? (Rapists need to be prosecuted more than they are, I think.)

It should be obvious that partial birth abortion and the like are medically unnecessary and morally wrong.

I just can't rejoice. There is so much hurt in this world and it is complicated.
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mike

Re: Supreme Court Overturns Roe v. Wade

Post by mike »

Szdfan wrote: ↑Sat Jun 25, 2022 9:55 pm
Ideally, doctors treating pregnant cancer patients in situations like these would be able to discuss the risks and benefits of all medical options - terminating the pregnancy and starting treatment, or waiting to treat the cancer until later in the pregnancy or until the baby is born - and let the mother choose. But abortion restrictions curtail that choice.
Are there any restrictions on abortion that you would support?
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Szdfan

Re: Supreme Court Overturns Roe v. Wade

Post by Szdfan »

ABC 123 wrote: ↑Sat Jun 25, 2022 10:06 pm
Dan Z wrote: ↑Sat Jun 25, 2022 11:28 am First and foremost, I'm happy for the decision because I believe it will save the lives of innocent unborn children. I'd love to see the pro-life camp follow up by quickly promoting more robust social support for those who now will carry their babies to term. Although this is a morally correct opinion in my view, it must also be recognized as a socially and economically disruptive one as well - one that will especially put poor women in a bind.

Secondly, as an Anabaptist, I find distasteful the partisan crowing on the right and raging on the left...and my instinct is to steer clear of it and quietly give thanks, like I do whenever Caesar decides for justice.
I see it this way as well.

It is sobering how oblivious it is to celebrate babies being brought to term and into this world by people who did not want them. I am not at all negating the child's right to life, but these are children whose parent(s) would murder them if given the chance.

At the heart of this are moral issues.

There are some unclear medical issues that concern me as well. Like missed miscarriages and ectopic pregnancies. What about events where a mother is very sick and she either undergoes an emergency preterm c section or induction? It happens. Will these still be an option? What of very young girls who are raped and not physically strong enough to carry and birth a child? (Rapists need to be prosecuted more than they are, I think.)

It should be obvious that partial birth abortion and the like are medically unnecessary and morally wrong.

I just can't rejoice. There is so much hurt in this world and it is complicated.
I think this names some of my fears and concerns as the Supreme Court takes a sledgehammer to morally complicated and ambiguous issues.

My wife has a cousin who is a family doctor here in rural Colorado and delivers most of the babies in her community. She also performs D&Cs in the case of miscarriages, which would be outlawed under most abortion bans. She’s a Christian and fairly conservative, but believes this procedure is necessary. The thought that states will force women to carry fetuses that are dead or non-viable is horrifying and lacks compassion.

(I’m going to point out that late-term abortions are rare (1% of abortions) and most of them are medically necessary. Most of the time, a partial birth abortion will happen when the mother’s life is in danger or if lethal fetal abnormalities are detected. What makes these abortions especially tragic is that in many cases the mother wants the child.)

This article also makes some of my fears and concerns:

https://www.newyorker.com/magazine/2022 ... -worse/amp
Pregnancy is more than thirty times more dangerous than abortion. One study estimates that a nationwide ban would lead to a twenty-one-per-cent rise in pregnancy-related deaths. Some of the women who will die from abortion bans are pregnant right now. Their deaths will come not from back-alley procedures but from a silent denial of care: interventions delayed, desires disregarded. They will die of infections, of preëclampsia, of hemorrhage, as they are forced to submit their bodies to pregnancies that they never wanted to carry, and it will not be hard for the anti-abortion movement to accept these deaths as a tragic, even noble, consequence of womanhood itself.

In the meantime, abortion bans will hurt, disable, and endanger many people who want to carry their pregnancies to term but who encounter medical difficulties. Physicians in prohibition states have already begun declining to treat women who are in the midst of miscarriages, for fear that the treatment could be classified as abortion. One woman in Texas was told that she had to drive fifteen hours to New Mexico to have her ectopic pregnancy—which is nonviable, by definition, and always dangerous to the mother—removed. Misoprostol, one of the abortion pills, is routinely prescribed for miscarriage management, because it causes the uterus to expel any remaining tissue. Pharmacists in Texas, fearing legal liability, have already refused to prescribe it. If a miscarriage is not managed to a safe completion, women risk—among other things, and taking the emotional damage for granted—uterine perforation, organ failure, infection, infertility, and death.
I’m also afraid of the criminalization of miscarriages. In some states, women who miscarry will face criminal investigations and prosecution if they are unable to prove whether they have had a miscarriage.
Both abortion and miscarriage currently occur more than a million times each year in America, and the two events are often clinically indistinguishable. Because of this, prohibition states will have a profoundly invasive interest in differentiating between them. Some have already laid the groundwork for establishing government databases of pregnant women likely to seek abortions. Last year, Arkansas passed a law called the Every Mom Matters Act, which requires women considering abortion to call a state hotline and requires abortion providers to register all patients in a database with a unique I.D. Since then, six other states have implemented or proposed similar laws. The hotlines are provided by crisis pregnancy centers: typically Christian organizations, many of which masquerade as abortion clinics, provide no health care, and passionately counsel women against abortion.
The data that crisis pregnancy centers are capable of collecting—names, locations, family details, sexual and medical histories, non-diagnostic ultrasound images—can now be deployed against those who seek their help.
Fetal-personhood laws have passed in Georgia and Alabama, and they are no longer likely to be found unconstitutional. Such laws justify a full-scale criminalization of pregnancy, whereby women can be arrested, detained, and otherwise placed under state intervention for taking actions perceived to be potentially harmful to a fetus. This approach has been steadily tested, on low-income minorities in particular, for the past four decades. National Advocates for Pregnant Women—the organization that has provided legal defense for most of the cases mentioned in this article—has documented almost eighteen hundred cases, from 1973 to 2020, of prosecutions or forced interventions related to pregnancy; this is likely a substantial undercount. Even in states such as California, where the law explicitly prohibits charging women with murder after a pregnancy loss, conservative prosecutors are doing so anyway.
I dislike abortion. I want less abortion. I understand the religious objections and even though I am critical of the pro-life movement, I don’t completely disagree with them. But I also think this is a set of morally and ethically complicated issues that require a certain amount of ambiguity. I think the pro-life movement’s absolutist framing is completely inadequate to deal with these issues.

I’m deeply skeptical and cynical about the rhetoric that conservative Christians are going to provide compassion and care to single mothers and their babies now that Roe is gone. Part of my cynicism comes from the fact that nothing prevented Christian conservatives from doing these things already (and yes, I know that crisis pregnancy centers provide support, but that support is limited. What about free childcare that would enable the mother to earn a living to support herself and her children? What about healthcare? What about decent affordable housing? What mental health and spiritual support? How active are these pro-life Christians in the lives of these single mothers and children five or ten years down the road?)

And yes, I certainly know people who put their money where their mouth is — some of my cousins have fostered and adopted children and I find that work deeply admirable — but I also feel they are outliers. It’s incredibly easy to advocate for someone who requires nothing from you (fetuses are pretty undemanding for people who aren’t pregnant) — it is a lot harder when that advocacy costs you something. Raising children who are traumatized, have behavioral disorders, struggle with fetal alcohol syndrome or neonatal abstinence syndrome are not for the faint of heart. There are reasons why there are over 400,000 children in the US foster care system.

As Ken points out, states with more abortion restrictions have higher infant mortality rates than states with less abortion restrictions. A lot of this has to do with politics and ideology — more conservative states offer less of the kind of critical services needed for prenatal care and healthy births. The cynical part of me believes that the pro-life movement does not care a lot about fetuses after they are born — the ideological concern about creeping Communism seems greater than concern for marginal, low-income women.

I think the Dodd ruling is a disaster. I think women will die or be harmed because they will not receive medically necessary treatment that otherwise would be available. I think there is a strong potential that some states will become incredibly intrusive in the lives of women. Some states will ban shipping abortion pills by mail. Are they going to go through the mail looking for these pills? Some states are going to ban travel to other states for abortions. Are they going to restrict interstate travel for their own citizens? Will states imprison women they believe had an abortion (which again, is clinically indistinguishable from a miscarriage)? Are states going to subpoena ovulation apps to turn over data so that they can monitor whether women are pregnant?

By using a sledgehammer to these complicated issues, the Supreme Court is enabling an authoritarian element in conservatism. People often complain about intrusive big government, I can’t think of anything more intrusive than the government in your bedroom and your medical decisions.
Last edited by Szdfan on Sun Jun 26, 2022 12:10 am, edited 1 time in total.
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Szdfan

Re: Supreme Court Overturns Roe v. Wade

Post by Szdfan »

mike wrote: ↑Sat Jun 25, 2022 10:54 pm
Szdfan wrote: ↑Sat Jun 25, 2022 9:55 pm
Ideally, doctors treating pregnant cancer patients in situations like these would be able to discuss the risks and benefits of all medical options - terminating the pregnancy and starting treatment, or waiting to treat the cancer until later in the pregnancy or until the baby is born - and let the mother choose. But abortion restrictions curtail that choice.
Are there any restrictions on abortion that you would support?
Yes. I don’t support elective late-term abortions. I put medically necessary abortions, abortions to treat miscarriages or abortions for nonviable fetuses (like ectopic pregnancies) into a different category.
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Szdfan

Re: Supreme Court Overturns Roe v. Wade

Post by Szdfan »

Szdfan wrote: ↑Sun Jun 26, 2022 12:07 am
mike wrote: ↑Sat Jun 25, 2022 10:54 pm
Szdfan wrote: ↑Sat Jun 25, 2022 9:55 pm
Are there any restrictions on abortion that you would support?
Yes. I don’t support elective late-term abortions. I put medically necessary abortions, abortions to treat miscarriages or abortions for nonviable fetuses (like ectopic pregnancies) into a different category.
I should add that my support for abortion is not without conflict and discomfort. I would put myself into the “safe, legal and rare” camp that sees abortion as necessary evil or an unfortunate necessity. I support the use of contraception and sexual education because I think it also helps prevent abortions (by preventing pregnancy) and that “abstinence only” is not an effective or realistic strategy.

I think there are significant issues with the contemporary ethos towards sexuality — as a culture we’re oversexed and not particularly happy — but I find post-sexual liberation culture to be a lot more honest about what people desire and who they are than the stereotypical image of the 1950s suburban family. I would rather live with the sexual messiness of today than with the authoritarian attempt to control other people’s sexuality and sexual identity by stuffing all that sexual liberation back into the box.

That’s probably more than you wanted to know, but I think a lot about the conflict over abortion isn’t really about babies but rather about deeper culture war issues.
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RZehr

Re: Supreme Court Overturns Roe v. Wade

Post by RZehr »

I’d rather it be stuffed back in the box, over todays LGBTQ rainbow Pride perversions.
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Robert
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Re: Supreme Court Overturns Roe v. Wade

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Szdfan wrote: ↑Sun Jun 26, 2022 12:07 am
Yes. I don’t support elective late-term abortions. I put medically necessary abortions, abortions to treat miscarriages or abortions for nonviable fetuses (like ectopic pregnancies) into a different category.
I would not call a D & C an abortion. If the fetus is already dead, I do not see it as one. Maybe terminology needs to change, because this is a necessary medical procedure, not killing an unborn.

I am sure since we can sort it out here, legislators in the various states can also. Do you know for a fact that these procedures are outlawed for a miscarriage or are you just assuming?
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Only an Anz
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Re: Supreme Court Overturns Roe v. Wade

Post by Only an Anz »

Szdfan wrote: ↑Sat Jun 25, 2022 8:36 pm
Only an Anz wrote: ↑Sat Jun 25, 2022 5:16 pm
Szdfan wrote: ↑Sat Jun 25, 2022 1:11 pm
Yes. I read news accounts of an influx of patients in clinics in Oklahoma and Kansas.

There also was an increase of ordering abortion pills by mail.
Oklahoma? I highly doubt that.
https://apnews.com/article/abortion-hea ... 2f14b09b80
OKLAHOMA CITY (AP) — Two abortion providers in Oklahoma said Tuesday that they’re still seeing a massive influx of women from Texas who want to terminate their pregnancies after Texas last year passed the most restrictive anti-abortion law in the U.S. in decades.

Officials with Trust Women and Planned Parenthood Great Plains, which both operate abortion clinics in Oklahoma City, said some women from Oklahoma are being forced to seek abortion services in other states because of two-week wait times for services in Oklahoma.
https://tulsaworld.com/news/state-and-r ... rce=signup
An Oklahoma abortion provider has released data showing an increase of 2,500% in patients from Texas ZIP codes because of that state’s Senate Bill 8 ban.

According to Planned Parenthood Great Plains, Texas residents are forced to travel hundreds or thousands of miles to access an abortion — if they can find the necessary resources to do so — or to carry pregnancies against their will.
More than half of Planned Parenthood’s Oklahoma centers’ patients since September are from Texas, compared to less than 10% the previous year in that time frame. Planned Parenthood health centers in Oklahoma saw a nearly 2,500% increase in abortion patients with Texas ZIP codes.

Oklahoma, New Mexico, Kansas, Colorado and Missouri Planned Parenthood health centers collectively saw abortion patients increase nearly 800% since the Sept. 1-Dec. 31, 2020, period, according to the press release.

Try again. Those are all from before May of this year.
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Szdfan

Re: Supreme Court Overturns Roe v. Wade

Post by Szdfan »

Robert wrote: ↑Sun Jun 26, 2022 10:24 am
Szdfan wrote: ↑Sun Jun 26, 2022 12:07 am
Yes. I don’t support elective late-term abortions. I put medically necessary abortions, abortions to treat miscarriages or abortions for nonviable fetuses (like ectopic pregnancies) into a different category.
I would not call a D & C an abortion. If the fetus is already dead, I do not see it as one. Maybe terminology needs to change, because this is a necessary medical procedure, not killing an unborn.

I am sure since we can sort it out here, legislators in the various states can also. Do you know for a fact that these procedures are outlawed for a miscarriage or are you just assuming?
I don’t know, but I don’t think anyone else knows either. A D&C in a miscarriage is indistinguishable from a D&C in an abortion. These abortion bans are not clear about distinguishing between care for a miscarriage and care for an abortion. In some states, Doctors face felony charges if they provide care for miscarriages that are identical to abortions. Under the best case scenarios, it could take months to clarify these things, which is not a help for women currently experiencing a miscarriage.

There’s currently a lot of uncertainty about which procedures are still permitted under which circumstances and it’s already getting in the way of critical medical care. Most of these medical exemptions are for “life-saving” care? Well, who determines what is life saving? How close to death does a pregnant woman have to be before doctors can perform an abortion?

Since these abortion bans are driven by politics and not medicine, it’s lawmakers who determine what “life-saving” is and not doctors. The language in these laws are too vague and it’s affecting medical care.

https://abcnews.go.com/amp/Health/docto ... d=84668658
But doctors told ABC News the language of these laws is vague and makes it unclear what qualifies as a mother's life being in danger, what the risk of death is, and how imminent death must be before a provider can act.

"We've taken the Hippocratic oath to do no harm, and these types of laws and this type of language actually do harm," Dr. Melissa Simon, vice chair for research in the department of obstetrics and gynecology at Northwestern University Feinberg School of Medicine in Chicago, told ABC News. "I do not -- nor do my patients want me to -- stop what I'm doing and think about what the judge would do: 'Will the judge sentence me to jail if I were to perform an abortion?'"

A professor of obstetrics and gynecology at the University of Michigan, Harris told ABC News, "None of this is straightforward. It's very nuanced and complex, and it's really hard for a one-size-fits-all rule or law to generate what all patients are going to need."

Doctors ABC News spoke with said laws that only allow exceptions to save the mother's life will put the onus on the provider to prove the pregnant person is in danger of dying. In some states, providers could face charges.

Dr. Leilah Zahedi, a maternal-fetal medicine physician in Chattanooga, Tennessee, and a spokesperson for the Society for Maternal-Fetal Medicine, said the anti-abortion rights laws don't make it clear if a woman's risk of death has to be 100% for the procedure to be performed or not.

"When I see patients, for instance, who have a major cardiac problem, a lot of the time they have a risk of a major cardiac event of up to 15% to 25%, even up to 50%," she told ABC News. "At the moment they're fine. But as they get further into pregnancy, that's going to put their life more and more at risk."

She continued, "So do I have to wait until they're on death's doorstep, or can I intervene at that point to prevent more harm and more damage to them?"
These are not just academic questions. Ireland reformed and repealed its abortion ban after the death of Savita Halappanavar in 2012. Halappanavar was experiencing a miscarriage. Her water broke, but her body did not expel the fetus. Halappanavar discussed abortion with her physician but her request was denied because Irish law banned abortion if a fetal heartbeat was still present. Halsppanavar later developed sepsis and died from a cardiac arrest at age 31.

Doctors in Texas are already dealing with this uncertainty due to the current ban on abortion.

https://www.npr.org/sections/health-sho ... scarriages
As the Supreme Court appears poised to return abortion regulation to the states, recent experience in Texas illustrates that medical care for miscarriages and dangerous ectopic pregnancies would also be threatened if restrictions become more widespread.

One Texas law passed last year lists several medications as abortion-inducing drugs and largely bars their use for abortion after the seventh week of pregnancy. But two of those drugs, misoprostol and mifepristone, are the only drugs recommended in the American College of Obstetricians and Gynecologists guidelines for treating a patient after an early pregnancy loss.

The other miscarriage treatment is a procedure described as surgical uterine evacuation to remove the pregnancy tissue — the same approach as for an abortion.

"The challenge is that the treatment for an abortion and the treatment for a miscarriage are exactly the same," said Dr. Sarah Prager, a professor of obstetrics and gynecology at the University of Washington in Seattle and an expert in early pregnancy loss.
Dr. Lauren Thaxton, an OB-GYN and assistant professor at the Dell Medical School at the University of Texas-Austin, has already heard about local patients who have been miscarrying, and couldn't get a pharmacy to fill their misoprostol prescription.

"The pharmacy has said, 'We don't know whether or not you might be using this medication for the purposes of abortion,'" she said.

Thaxton, who supervises the obstetrics-gynecology residents who have seen these patients, said sometimes the prescribing clinic will intervene, but it takes the patient longer to get the medication. Other times patients don't report the problem and miscarry on their own, she said, but without medication they risk additional bleeding.
These situations can create significant moral distress for patients and providers, said Bryn Esplin, a bioethicist and assistant professor of medical education at the University of North Texas Health Science Center in Fort Worth. "Any law that creates a hesitancy for physicians to uphold the standard of care for a patient has a cascade of harmful effects both for the patient but also for everyone else," said Esplin.

It's an emotional and legal dilemma that potentially faces not just obstetricians and midwives, but also family physicians, emergency physicians, pharmacists, and anyone else who might become involved with pregnancy care. And Ogburn, who noted that he was speaking personally and not for the medical school, worries that fears about the Texas laws have already delayed care.

"I wouldn't say this is true for our practice," he said. "But I have certainly heard discussion among physicians that they're very hesitant to do any kind of intervention until they're absolutely certain that this is not possibly a viable pregnancy — even though the amount of bleeding would warrant intervening because it's a threat to the mother's life."
I think that the pro-life movement and the Supreme Court have created a disaster in healthcare by swinging a sledgehammer at an ethically and morally complicated issue. I think Dodd is a reckless decision that fails to take into account how the justices’ decision dramatically impacts people’s real lives. While some of these questions might eventually get figured out, it’s going be chaos for a long time as doctors deal with a patchwork of contradictory regulations from state to state. Some states may never clarify these exemptions because there’s no requirement in Dodd for the states to provide any exemptions for abortion.

The uncertainty created by the Dodd ruling prevents women from receiving critical care that will kill women who otherwise would have survived.
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