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OB-GYN: Ind. abortion ban is 'bad medicine,' 'encroach[es] on women's rights'

In an opinion piece in the Washington Post's "PostEverything," Katherine McHugh, an OB-GYN in Indianapolis, writes about the harmful ramifications of a new Indiana law (HB 1337) that "punishes doctors if they perform abortions for women because of their fetus's race or sex, or after a diagnosis of disability."

McHugh explains that when physicians "identif[y] a fetal anomaly that can lead to significant, lifelong disability or even ... death" they "have two responsibilities": to "be supportive of the [woman] or family" and "help them understand that they have options, one of which is the termination of the pregnancy." However, "that's no longer the case here in Indiana," McHugh writes. According to McHugh, "Indiana's state government is intruding on the doctor-patient relationship at one of its most vulnerable, sensitive times. Which means that not only does the new law encroach on women's rights to control their own reproduction, it is also bad medicine."

"As a mother as well as a doctor, I am acutely aware of the intensity and fear of the unknown inherent in pregnancy and childbirth," McHugh continues, adding, "Indiana now expects women who live here to experience them without trusting their doctors' knowledge and with strict limits on how doctors may treat patients -- limits driven not by science or research, but by politics."

Reflecting on her experience aiding families who have lost infants with fatal fetal anomalies, McHugh writes that the Indiana law "dismiss[es] and diminish[es]" the pain experienced by such families, stating, "[T]he law doesn't save babies, it just forces a horrific fate onto both mother and [fetus]." She adds, "It includes an exception only for termination of [fetuses] who would die within three months of being born, as if three months is enough time to justify forcing women to take on the risks of carrying a pregnancy to term and delivering a baby, only to watch it die."

McHugh also discusses how the law's ban on "termination of a pregnancy for reasons of gender" will affect a woman who knows her pregnancy carries a risk of having a sex-linked disability. As an example, she cites cases of Duchenne muscular dystrophy, which "occurs almost exclusively in boys," "carries a life expectancy of less than 25 years" and "can't be detected with any existing prenatal test." A woman who previously had a child with Duchenne and is pregnant with a male fetus "will have a 50 percent chance of their newborn also having the disease," McHugh writes, but under the new law, such a woman "won't be able to do anything about it, except hope that [she and her partner] won't have to watch both sons die."

Noting that the law is forcing McHugh and her colleagues to question if they should even offer prenatal screening, McHugh states, "Preventing women with these fetal diagnoses from choosing abortion forces them to see their children die a slow, painful, premature death."

McHugh adds that while "[n]ot all prenatally diagnosed disabilities are fatal ... what is important is that [families] have the right to choose." She explains, "Families who choose to continue abnormal pregnancies and raise children with disabilities face incredible hardships." McHugh writes each woman pregnant before this law could "make a different choice." However, under the Indiana law, those women "who will now be forced to deliver babies they might not otherwise have had -- the babies 'saved' by this law -- Indiana sets aside no additional funding or services ... Rather than protecting life, the state has only prolonged suffering."

McHugh continues, "Some women may still be able to find a physician who can provide them with the abortion care that they need, but through what channels?" She explains, "Instead of mourning a much-loved [pregnancy], a woman in Indiana will either have to lie to her provider and say she never wanted to be pregnant, ... or her provider will have to agree to terminate her pregnancy without asking why, which is terrible care." Moreover, although some women can afford to travel out of state, that would take them "away from their support systems, at great expense and additional stress," McHugh writes. "All of these options are inhumane treatment of a grieving [woman]," she asserts.

"The relationship between a pregnant woman and her doctor requires both trust and privacy," McHugh notes, adding, "There is no room for legislators in the exam room, and there is no space for politics in medical decisions." According to McHugh, it is "impossible" for her to "provide advice based on scientific evidence and clinical experience so that patients may make educated decisions for themselves" if she is "legally required to withhold appropriate treatment for a medical condition."

McHugh concludes, "[T]his law forces me to ignore my medical training and stand idly by while my patients suffer. This is not the care I want to provide, nor is it what my patients deserve" (McHugh, "PostEverything," Washington Post, 4/1).