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Doctor Says Bill A 'Bad Move For Women's Health'

"This bill has no nuance for this extraordinarily complicated issue. ..."

George Leach lives in Avondale Estates.

Neighbors,

I'd like to address House Bill 954, which is a bill that just passed the House and is now pending a vote for the state Senate.  As a local Emergency Medicine physician, I believe this bill would be a bad move for women's health in our state.

In brief, this bill prevents abortions after 20 weeks unless the mother is critically ill.  If an abortion is needed after 20 weeks, the fetus is required to be delivered by inducing labor or C-section.  Inducing labor this early in a pregnancy is often unsuccessful; therefore C-section would be most commonly used.

My objection to this bill transcends the entire pro-life or pro-choice debate.  What’s at stake here is that this bill overly simplifies a situation that is highly variable when considering each pregnant mother individually.  The law broadly dictates physician practice in a way that is not malleable enough to fit the needs for the diverse population of pregnant mothers that we treat.  I believe if you lean more pro-life, this bill is encouraging tightly rigid and unsafe medicine.  If you lean more pro-choice, then your objections to this bill are more directly tangible.  As many of us are, we’re not black or white, pro-choice or pro-life, but we fall somewhere within the greyscale in between.  I believe this bill isn’t the best way for any of us.

As a woman, you could be in the position where you have a pregnancy at 20 weeks and at that time discover that your baby will not live due to an anomaly.  This bill will force you in this position to continue to carry the baby to term (39-40 weeks) even if the end outcome is its certain death, a length of time as great as 20 weeks.  This would add a great deal of additional emotional distress onto an already horrible situation.  This even includes situations such as anencephaly, which is a condition where the fetus doesn't have a brain.

In the other situation, that where a mother's life is at risk, after 20 weeks the fetus must be delivered by induction of labor or C-section.  With induction of labor having a high failure rate at this time, C-sections will be what are most common.  C-sections increase the mother's health risk of a bad outcome in future pregnancies because it weakens the uterus, making it prone to splitting open during future labor.  Obviously, this complication is not overly common, but it does happen, and is why vaginal deliveries are ideally done during pregnancies.  Doing a C-section for the sake of a fetus at 20 weeks only harms the mother since it’s impossible to survive at this age.

What happens if your physician takes a stand and acts in good conscience counter to this law?  They face a prison sentence ranging from 1 to 10 years.

My examples are thankfully not overly common ones, but they do happen often enough.  I've seen them many times, and many of you may know a friend or family member that would have been adversely affected by this, had this bill been law in the past.  This bill has no nuance for this extraordinarily complicated issue, which is why as a husband and hopefully a future father, that I will strongly protest this bill.  I hope you do the same.

Thank you,

George Leach

Julia Ewen March 21, 2012 at 06:45 PM
Thank you, thank you, Dr George Leach, for your cogent analysis of the medical consquences of this bill. The Senate substitute bill reported out this morning (3/21/2012) also removes any right to privacy regarding medical records and gives DAs access to any and all records the DAs want. The burden of proof is now on the doctors and the facility to show that they did everything they could to save the fetus/baby but they don't have to prove that they tried to save the mother. Indeed they had to prove that they had to intervene to save the mother from death or permanent impairment. Mental distress is disallowed completely. The legal risks from saving women even during a planned and full term labor emergency are so great that I worry that obstetricians will move their practices out of Georgia. Not only would we have to go to Nebraska (the nearest state) for late term abortions, we might have to go there for normal deliveries to be sure we'd survive an emergency during ours! This needs to go back to the drawing board.

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