OPINION: Listen to doctors on the far-reaching implications of Ga. abortion law

Gov. Brian Kemp signed HB 481, the "heartbeat bill," on May 7, 2019. The bill outlaws most abortions once a doctor can detect a fetus' heartbeat - usually around six weeks of pregnancy.  The restrictive abortion law went into effect in July after the U.S. Supreme Court overturned Roe v. Wade, the landmark ruling that granted the constitutional right to abortion. Bob Andres / bandres@ajc.com

Credit: Bob Andres

Credit: Bob Andres

Gov. Brian Kemp signed HB 481, the "heartbeat bill," on May 7, 2019. The bill outlaws most abortions once a doctor can detect a fetus' heartbeat - usually around six weeks of pregnancy. The restrictive abortion law went into effect in July after the U.S. Supreme Court overturned Roe v. Wade, the landmark ruling that granted the constitutional right to abortion. Bob Andres / bandres@ajc.com

The issue of abortion doesn’t seem to have much sway over Georgia voters heading into the final days before the midterm elections even though surveys indicate that most Georgia residents are opposed to the six-week abortion ban signed by Gov. Brian Kemp in 2018.

In an AJC poll conducted in September, only 5% of Georgians listed abortion as their top issue in the election. Just months earlier, in a July AJC poll, almost 55% of voters said they disagreed with the new abortion law.

Why do few people seem to care about the passage of legislation to which they are opposed?

Tricia Wingerter, a Republican-leaning independent voter from Pennsylvania told a reporter for the 19th News, an independent, nonprofit newsroom covering gender, politics and policy, that abortion was not a big election issue for her because she doesn’t think news reports about people being denied access to abortion are credible.

No one trusts the media, but then, no one trusts politicians either.

Most Americans (70%) across genders and political parties said they don’t trust politicians to make abortion policy, according to the 19th News poll whose findings were published in September.

If we don’t trust the media and we don’t trust politicians, then who should we trust to understand the impact of abortion legislation?

Most people trust doctors, at least a little bit, and depending on the source, anywhere from 69 to 78% of medical professionals are concerned about the health implications for pregnant people in areas where abortion access is restricted or banned.

But many health care professionals aren’t talking about it publicly or they are only talking about it anonymously.

CNN recently interviewed doctors at public and private medical centers in five states whose employers asked them not to speak publicly about abortion. If they wanted to share stories with reporters about the impact of the Supreme Court overturning Roe v. Wade, they were asked to not disclose their work affiliations.

Doctors, particularly obstetricians and gynecologists, spend years learning and examining the complexities of reproductive health. Their acquired expertise allows them to manage and plan care for scenarios that a pregnant person may encounter — the kind of scenarios that patients and lawmakers could never predict.

Feeling hamstrung by abortion legislation and muzzled by employers, some doctors are understandably frustrated.

Dr. Aliza Machefsky, a professor in the department of gynecology and obstetrics at Emory University, wants voters and lawmakers to understand the impact the Georgia legislation will have on patient care now and in the future.

“One of the things that is difficult for someone outside of the profession to understand about the new legislation is that it wants to take something that has a lot of gray and make it into something that is very black and white,” Machefsky said.

Georgia’s legislation allows for certain exceptions -- rape, incest or emergencies -- but pregnancy outcomes don’t fit into the boxes that lawmakers want them to, she said.

“Previously if you had an obstetric issue that greatly compromised the pregnancy when it was previable, there were a couple of medical avenues that you would discuss with the patient,” said Machefsky. The new state law has created unknowns about what steps doctors can take, she said.

If a pregnant person’s water breaks at 19 weeks, what are the risks of continuing that pregnancy?

If a pregnant person is deathly ill, a doctor might induce labor, but how ill does the person have to be? How high of a temperature must the person have? How much blood must the person lose to be considered ill enough?

“Those are the gray areas that a lot of people don’t realize were previously judgement calls made between the patient and the physician and that now are not possible,” Machefsky said. “It takes away your clinical judgement.”

Machefsky said there is also a lot of discussion in the medical community about the impact of abortion legislation on the future of medicine as it pertains to residency training or family planning.

“There will be a generation of OB-GYNs who aren’t trained in providing abortion care, so one day it may come to be that someone has a medical indication that is allowed for in abortion legislation and nobody is trained to do it,” she said.

Georgia voters may not trust politicians to create abortion policy but they need to hear what doctors have to say about the far-reaching implications of those policies, and doctors need to have the freedom to share what they know with the public.

Read more on the Real Life blog (www.ajc.com/opinion/real-life-blog/) and find Nedra on Facebook (www.facebook.com/AJCRealLifeColumn) and Twitter (@nrhoneajc) or email her at nedra.rhone@ajc.com.