Social distancing & Abortion Restrictions
With roll out of social distancing rules across the country some states are facing problems likely created by anti-reproductive choice activists. This problem is driving a wedge across State legislatures. The situation is driving some socially liberal legislators to the point of madness and doctors claim some women to desperation. The question at hand is whether abortion should be considered an essential procedure. States like Oklahoma, Alabama, Iowa, Texas and Ohio have declared surgical abortions as non-essential. Thus Covid-19 related social distancing effectively placed a bans on abortion in these states. Physicians groups and women’s reproductive rights activist are challenging these determinations. Doctors argue that abortion is a time sensitive procedure. Abortion cannot be deferred for a few months so it can done at a more convenient date.
Does Female Representation in State Legislators Impact Laws Passed?
The question on whether abortion is an essential procedure is very much dependent on who is making the determination. Those of us who have ever considered the possibility of carrying a fetus for 9 months are more likely to have a more nuanced answer to this question. Female representation in state legislatures in the US is about 29%. It is thus not surprising that some states would make this determination.
My Early Clinical Experience with a Pregnant Woman
Whenever, I think of the abortion debate I remember one of my earliest experiences in obstetrics & gynecology in medical school.
A classmate and myself, had just finished evaluating this very emaciated thirtyish looking taciturn lady. This woman was basically dragged into our clinic by a concerned neighbor. This “Good Samaritan” believed something was clinically wrong with my patient. Our patient however appeared totally unconcerned or possibly mildly antagonistic to our efforts. Because our patient was not very helpful with answers to our questions her neighbor helped. After a very difficult history by two absolutely inexperienced medical students we started to put our story together.
A thirty something year old woman with progressive unexplained weight-loss and and gradually distending belly. She had no other related symptoms except for possible loss of appetite. I do not remember if we even asked for her last menstrual period. Anyway on account of the weight loss and abdominal distention our primary diagnosis was gynecological tumor possibly ovarian cancer.
Anyone could imagine our surprise when we presented our case and gave our differential diagnosis only to have our professor ask for a fetal stethoscope.
What in God’s name was he going to do with a fetal stethoscope?
Well Prof. Collision listened to the lady’s “distended” or should I say pregnant belly and gave us the opportunity to also listen. The clear rapid lub dub of the fetal heartbeat was as clear as day in this belly that we believed was carrying a cancerous tumor.
So What Must our State Legislators do?
I tell this story because when the ultrasound was done in this very emaciated sickly looking woman it appeared the fetus was very much viable and healthy in spite of the relative weight loss and unhealthy look of the mother.
I learned one fact of Medicine that day, a growing fetus acts in many ways like a tumor or at the very best, a congenial parasite.
On this note I can understand how a pregnant woman who does not wish to keep the pregnancy can consider resorting to desperate measures. Fortunately most of these laws have so far met with legislative roadblocks and will hopefully not ever impact the health of our women.
I would like to end here by referring our very hardworking state legislators in these 5 states to reread the WHO definition of health, “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.
Please allow our people the opportunity to maintain both mental, physical and social wellbeing whilst social distancing. It is very possible that unintended pregnancies could very well be the unintended consequences of social distancing.
Leonard Sowah is a physician in Baltimore, Maryland
