Doubts, fear, tied hands: How US doctors are being affected by anti-abortion laws

By Paula Escalada Medrano

Austin, Texas, Jun 21 (EFE).- Fear, unease and a feeling of helplessness have predominated over the past year among doctors specializing in obstretrics and gynecology in many places in the United States due to the passage of laws that have restricted access to abortion, a situation that is significantly affecting healthcare professionals who attend to women.

After the US Supreme Court on June 24, 2022, overturned the right to abortion on the federal level, a number of states have passed a plethora of laws prohibiting the procedure and threatening OBGYN physicians with harsh penalties such as lengthy prison terms and revocation of their medical licenses.

“As a doctor,” she said, “my hands are tied,” adding that when she’s interacting with a patient she may not say what is the “best” medical treatment but rather must ask herself what the lawmakers believe is best, Amna Dermish, an obstetric gynecologist, told EFE.

She works for Planned Parenthood, the biggest US provider of reproductive medical services, and over the past few months she has noted two consequences resulting from the anti-abortion shift: “the deterioration of women’s health” and a radical change in her own daily work.

In providing a tour of the Planned Parenthood clinic in Austin, Texas, where she spoke with EFE, Dermish stopped in front of a door to one of the rooms where, formerly, abortions were performed, saying that now they use it as a storeroom, while they wait to find another use for it.

Today, the most the clinic can do is to provide women with orientation information about how to travel outside of Texas to obtain an abortion. After the Dobbs vs. Jackson Women’s Health Organization, which overturned the 1973 Roe vs. Wade ruling that established the right to abortion, Dermish’s ability to provide direct medical attention “disappeared completely,” she said, tearing up several times during her chat with EFE.

Dermish’s life changed greatly even before the high court’s decision because Texas, headed by conservative Republican Gov. Greg Abbott, was one of the states that pioneered reversing the right to abortion.

Months before the Supreme Court ruling, on Sept. 1, 2021, a state law dubbed the Texas Heartbeat Act went into effect prohibiting abortion if cardiac activity can be detected in the fetus, something that occurs at the sixth week of gestation, when many women don’t even know yet that they might be experiencing an unwanted pregnancy.

The state law, which several lawsuits unsuccessfully tried to overturn, provided the example that many states used to create their own anti-abortion regulations.

Among other things, the Texas statute authorizes any citizen to report people who help a woman obtain an abortion, meaning that doctors are vulnerable to private lawsuits and could face prison time.

According to Dr. Kristyn Brandi, the spokesperson for the American College of Obstetricians and Gynecologists, the most difficult thing over the past months has been to understand exactly what it is that they can do because “the rules can change any day” and it is very confusing and chaotic to provide medical attention.

She practices in New Jersey, a state that has protected the right to abortion, but even there she is getting questions from patients about whether the medical attention they need is legal because they see contradictory things on the news and become very confused.

Physicians, she told EFE, have had to “hire lawyers” who are available 24 hours a day if the doctors need legal advice.

Imagine if there’s an emergency, she said, adding that it’s very distressing to have to stop everything and call an attorney to learn if what they need to do for the patient is legal.

For Dr. Dermish, the toughest thing about this situation is having to look a patient in the eye and tell her that she cannot do anything for her.

The moment that an ultrasound is performed and she sees cardiac activity and knows that she’s going to have to tell the patients that she cannot treat them is devastating and she still can’t get over it, she said.

In Texas there are no exceptions to the abortion ban except when the life of the mother is deemed to be at risk. But the problem comes at the point where that risk must be evaluated.

In a report prepared with the testimony of doctors, the Advancing New Standards in Reproductive Health organization complains that many health care workers cannot correctly attend to their patients in situations such as when the placenta ruptures prematurely.

One of the statements on that subject in the report is from a doctor whose patient’s water broke between her 16th and 18th week of pregnancy – when the fetus is not yet viable outside the womb – and the doctor had to send the woman home, where she developed a serious infection and had to be placed in an intensive care unit.