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The unintended consequences of hasty abortion bans

I grew up in a conservative community, and as a juvenile, my political thinking was conservative, too.

Not just because everyone around me thought that way, but because conservatives’ black-and-white worldview seemed to make everything clear and simple: There’s right vs. wrong, good vs. evil, moral or immoral, with nothing in-between. Which appeals to an immature mind not yet ready to deal with the complexities and ambiguities of the real world.

That didn’t last long. It couldn’t, once I got out into the world, and had to be practical.

I was reminded of all that when I read this article in a recent Newsweek issue about the real-world ramifications of abortion laws now being enacted by Republican legislators. Their priority is speedy enactment, and there’s not much thinking behind these laws.

The chief result is confusion:

“Early reports from doctors on the frontlines suggest that confusion over the legality of medical procedures is widespread among OB-GYNs, but it doesn’t end there. Clinicians who may have to perform procedures on pregnant women are wondering about their legal liability, too. The uncertainty extends to pharmacies, classrooms and the social media pages of medical professionals, many of whom worry what they are legally allowed to say or post. Even if some of that confusion eventually subsides, it puts many pregnant women in immediate peril.”

But there’s also fear, which is compromising what should be straightforward medical decisions:

“The post-Roe world … is one of tense discussions and tortured delays that aren’t in the best interest of the patient. It’s a world where anesthesiologists … worry about participating in emergency procedures on pregnant women; where bereaved women who have undergone miscarriages worry, with reason, about their own clinicians accusing them of crimes; where pregnant women sometimes can’t get the medications they need because the pharmacists fear they might be accused of aiding and abetting an illegal abortion. …

“Authors of a recent article in the New England Journal of Medicine put it bluntly. Texas’ new abortion law ‘had a chilling effect on a broad range of health care professionals, adversely affecting patient care and endangering people’s lives,’ they wrote.”

As one doctor put it, “The discussion on abortion is viewed as so black and white. People don’t think about the impact this is going to have on maternal healthcare in general.” He’s talking, of course, about the people who see abortion in black and white terms, meaning Republicans. But, as the Newsweek article pointed out, “in a medical setting, where things move fast, stopping to debate the point, calling in a hospital review board, or consulting legal counsel is not always practical.” Decisions have to be made, and a doctor who fears going to prison isn’t going to risk being second-guessed later, even if the patient dies.

But that’s not all. Women with pregnancy complications, or pre-existing medical conditions that make pregnancy dangerous, are being told to delay abortions until they’re in a state of medical emergency. In addition, “when forced to operate, doctors sometimes opt for procedures that are more dangerous than they would otherwise use” to avoid running afoul of new abortion laws.

These laws also are leading pharmacies to deny medications to women who aren’t pregnant. For example, in some states “new restrictions are … affecting the ability of patients … suffering from rheumatoid arthritis to access [a] drug called methotrexate because doctors sometimes prescribe it for medical abortions.” The new abortion laws also “could interfere with medications for stomach ulcers and cancer treatments.”

A hostile legal environment also threatens to drive doctors and nurses out of some areas, or deter practitioners from locating their practices there. In many cases these will be places that are already underserved. But as a Harvard Medical School professor asked, “Who wants to practice … where you could be arrested?” The new abortion laws also are impacting medical school training, residency programs, and “miscarriage management, counseling and emergency care … even, in some cases, taking biopsies.”

In short, Republicans eager to throw up blanket abortion bans, without thinking about the impact of what they’re doing, have opened a can of worms. Real life, it turns out, is not as simple or black-and-white as they think it is.

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