In the wake of the Supreme Court’s Dobbs decision, which overturned Roe v. Wade and returned the question of abortion to the American electorate, abortion advocates have unleashed a barrage of claims that protecting the lives of children in the womb inherently risks the lives of their pregnant mothers. For example, from Stateline:
“We are already telling pregnant patients who are suffering a miscarriage: ‘You can’t have the best level of care because of the politics around abortion,’” she said.
[Amy] Domeyer-Klenske cited the hypothetical example of a woman whose water broke during the first trimester in her pregnancy. The fetus would likely be unviable, but the woman could develop a life-threatening infection unless a doctor performed an abortion quickly, Domeyer-Klenske said.
But many doctors, fearful of criminal prosecution, might hesitate to act. “Am I going to have to wait until you are in the ICU and septic before I invoke the life is at risk exception?” she asked.
Medicine and the Law
The fallacy used here by abortionists and their allies is that doctors will be handicapped by having to comply with the law applicable to the care of their patients. That’s nonsense. All medical care is encumbered by legal constraints. Even touching another person (let alone poking them with a needle, etc.) without consent is battery, and consent is often a difficult issue in medical practice. Yet millions of doctors deal professionally with these legal boundaries every day. In my own practice, I’m a neurosurgeon who works at a Level 1 trauma center. I’ve performed thousands of brain operations on patients without first obtaining consent from them — they arrive in the ER comatose with life-threatening injuries and we take them to the operating room immediately to try to save their lives. Unconsented touching (let alone cutting) may constitute assault and battery, but the law and standard medical practice recognize that physicians need to take action to save lives, even in situations where consent cannot be readily obtained.
The vast majority of abortions committed in the U.S. are elective and are done without even the pretense to protect the health of the mother. Situations in which a mother’s life is genuinely in danger and for which removal of the child is the necessary medical treatment are quite rare. Neonatologist Dr. Kendra Kolb has an excellent discussion of whether abortion can be medically necessary:
It is often said that abortion is sometimes medically necessary to protect the life or health of the mother. This is simply not true.
As a neonatologist, I am regularly consulted to advise mothers with high-risk pregnancies, and I routinely care for their babies. I have also personally gone through two very difficult pregnancies each requiring hospitalization. So I have great empathy and respect for all women who are pregnant, especially those with difficult or high-risk pregnancies.
What women deserve to know, however, is that even in the most high-risk pregnancies, there is no medical reason why the life of the child must be directly and intentionally ended with an abortion procedure.
In situations where the mother’s life is truly in jeopardy, her pregnancy must end, and the baby must be delivered. These situations occur in cases of mothers who develop dangerously high blood pressure, have decompensating heart disease, life threatening diabetes, cancer, or a number of other very serious medical conditions. Some babies do need to be delivered before they are able to survive outside of the womb, which occurs around 22 to 24 weeks of life. Those situations are considered a preterm delivery, not an abortion.
These babies deserve to be treated with respect and compassion, and parents should be given the opportunity to honor their child’s life… A mother’s life is always of paramount importance, but abortion is never medically necessary to protect her life or health.
A Crucial Distinction
Dr. Kolb’s distinction between abortions and pre-term deliveries is crucial to understanding the indications for delivery of the child when the mother’s life is genuinely in danger (which again is quite rare). An abortion — that is, a procedure intended to deliberately kill a child in the womb — is never medically necessary, any more than an execution or a suicide is medically necessary. Killing a human being is never a medical procedure.
There are situations in which a pre-term child needs to be delivered or removed from the mother because her life is genuinely in danger and delivery/removal is the best option — ectopic pregnancies, eclampsia, and severe heart disease are among the rare circumstances in which premature delivery is medically necessary. These are deliveries, not abortions, because the purpose of the procedure is to save the mother’s life by separating the child from the mother, but the purpose is not to kill the baby. If the baby’s life can be saved, then all reasonable measures are taken to do so. There are circumstances in which saving the baby’s life is not possible (e.g., if the child is less than 21 weeks of gestation). In this rare situation, the mother’s life is saved although, tragically, the child’s life is unavoidably lost.
Legal Consultation on the Spot
Even before Roe v. Wade was overturned, there were myriad laws regulating abortion. If anything, the laws will be clearer and easier to comply with now that the Dobbs decision has returned the authority to legislate such matters to the legislatures whose job it is to write laws. In rare cases of genuine legal ambiguity, legal consultation can be obtained immediately (all hospitals have risk-management teams on emergency call to address such issues) and can be resolved on the spot, with no significant peril to the mother. In decision-making involving pregnant women’s lives, on one hand, and the legal constraints on medical practice (constraints by which all physicians operate), on the other, obstetricians may plead incompetence or negligence. But by their incompetence or negligence, they have done their patients an extreme disservice.
Obstetricians who find legal medical practice too stressful should relinquish their medical licenses. Compliance with the law in difficult emergency situations is inherent to medical practice, and doctors treating pregnant women and their babies can claim no rational exemption to the requirement that all physicians practice legally in the best interest of their patients (both mothers and babies).