Did Republicans in the state Legislature just plunge a dagger into the uteruses of Georgia women of reproductive age?
Or did they unknowingly give Georgia women a progressive reform package for abortion safety in the name of preventing fetal pain?
Could House Bill 954 place Georgia in compliance with the recommendations of the Johns Hopkins University Bloomberg School of Public Health, the American College of Obstetrics and others?
My experience in taking care of the vast majority of bleeding complications of late-term abortions in Atlanta since 1983 tells me that the bill tweaks Georgia abortion rights into the mainstream of medical opinion.
Maximizing maternal safety now overrides the right to choose with regard to late-term abortion, something pro-choice advocates, in an effort to thwart attempts to whittle away abortion rights entirely, refuse to concede.
To see personally which of the above questions is correct, one must examine the facts about abortion. As an aggregate, complications of all types (medical, psychological or surgical) due to abortions are significantly greater than deaths.
Unfortunately, only deaths are reliably recorded and thus represent the landmark for study.
During 1988-97, the death rate for all legally induced abortions in the United States was a mere 0.7 per 100,000 abortions, considerably safer than going to term with a live birth. However, abortions are not all equal. That risk rose dramatically by 38 percent for each additional week of gestation. An abortion done in the 13-15 week of gestation had a relative risk of mortality of 14.7. That doubled to 29.5 (one per 29,000 abortions) for 16-20 weeks of gestation and skyrocketed to 76.6 (one per 11,000 abortions) at or after 21 weeks. For the record, abortion at or after 21 weeks represents on average 1.4 percent of all abortions done per year.
This data from the Maternal and Child Health Integrated Project at the Bloomberg School of Public Health led it to conclude in the April 2004 Obstetrics & Gynecology that, “among women who choose to terminate their pregnancies, increased access to surgical and nonsurgical abortion services may increase the proportion of abortions performed at lower-risk, early gestational ages and help further decrease deaths.”
What about futile pregnancies? Can all that genetic screening be done before the 20th week of gestation?
The American Academy of Family Physicians says yes. In a January 2009 American Family Physician article, the authors note that the American College of Obstetrics and Gynecology 2007 recommendations for genetic screening “include offering all women screening and invasive diagnostic testing before 20 weeks’ gestation.”
The authors of that article, from the University of Texas Medical Branch in Austin, conclude, “Minimizing the risk of the screening and maximizing safety (are) also crucial. With the advent of first-trimester options, patients will need to choose early and be comfortable with their choice.”
So, does a law that limits a woman’s choice for non-medically indicated abortions to the first 20 weeks of gestation — when it is by far safest — significantly infringe on her right to choose?
Is 150 days enough time for a victim of rape or incest to decide to carry the fetus to term? Will exemptions for futile pregnancy and endangerment of the mother’s health answer the need of the rare medically necessary abortion at or after 21 weeks gestation? You decide.
Finally, should pro-life and pro-choice legislators, in an extraordinary instance of unity, agree that the safety of pregnant women is paramount and stand behind Gov. Nathan Deal when he signs the bill into law?
Dr. Kenneth Braunstein is a hematologist in Atlanta who specializes in coagulation disorders.
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