BILLIONhe Fall of Roe v. Wade on June 24th marks the beginning of a strange era of becoming a Maternal-Fetal Medicine doctor. By definition, we care for anyone with a high-risk pregnancy, which can happen because the pregnant woman has a medical condition like diabetes or breast cancer, or because there’s something wrong with the fetus genetically or anatomy, such as birth defects. As high-risk pregnancy doctors, we share the mantra that we hope for the best but prepare for the worst. Fortunately, of the thousands of patients we have cared for over the past 12 years, the majority have achieved our best hope: a relatively normal pregnancy and successful delivery. However, despite our best preparations, some people have suffered the worst: we mourn mothers who have passed away during pregnancy or childbirth and with their patients. me, mourning the loss of their desired pregnancy in the womb. For these reasons — not to mention the fundamental principle in medical ethics that is patient autonomy (the right of patients to make their own decisions about their own body, even if the doctor disagrees or decides goes against medical advice) — partial care goes hand in hand with onions – avoid high risk pregnancy care.
In fact, many high-risk pregnancy providers also offer abortions for the initial desired pregnancies, sometimes to save their patients’ lives, and sometimes because their fetuses may not be healthy. Severe genetic abnormalities or birth defects that are incompatible with life after birth. Other times, we offer abortions because of complications such as life-threatening vaginal bleeding, abnormal cervical dilation, or ruptured sacs during what is known as the “pregnancy period.” .
To understand what preparatory stage is, we must first understand the viability of the fetus. Fetal viability does not begin when the small set of embryonic cells that eventually become the heart begins to beat at 6 or 7 weeks gestation. In medicine, fetal viability is defined as the point at which a pregnancy is viable if born. Although there is no general consensus, currently in the United States, fetal viability is assumed to be around 6 months (23-24 weeks gestation), although some hospitals offer alternative treatments. Aggressive therapy for infants born at 22 weeks and survival was performed. Report as early as 21 weeks. Despite the rapid advances in infant care over the past few decades, babies born before their ability to live – even those at the peak of their ability to live – cannot live. survived after birth.
As doctors of Maternal-Fetal Medicine, we are geographically fortunate: because we live in Rhode Island, which has codified the legal right to abortion into state law, our ability I practice all aspects of high-risk pregnancy care, including the delivery and delivery of the abortion pill, is unchanged. However, the reality of Roe v. Wade has significantly influenced our friends and colleagues practicing in states where policymakers have passed legislation that makes no medical sense. These laws prioritize continuing pregnancy first – situations where a heartbeat may be present but no chance of survival – over the health and autonomy of a person who is actually pregnant. Some of these laws make no exceptions for ectopic pregnancies, which may have a heartbeat but which, by definition, are located outside the uterus, can never persist at any gestational age and are in fact life-threatening. threaten the life of the pregnant woman. (However, hospitals must provide abortion services if the mother’s life is at risk, Biden Administration announced July 11; in these cases, federal law bypasses state abortion bans.)
Colleagues in these states describe that the practice of obstetrics now feels like we are back in the Middle Ages. They followed women with previous pregnancies who had hemorrhaged during an early miscarriage, waited for the embryo’s heart to stop, or whose mother had lost enough blood to feel legitimate to undergo a simple, safe procedure to remove fetal tissue. They followed women who were partially pregnant before giving birth through an abnormally dilated cervix, again waiting for the fetal heart to stop or the mother to be sick enough from a preventable infection to receive treatment. Legitimate evidence to help what started — a preterm birth — continues. They have also diagnosed serious fetal malformations in pregnancies that are highly desirable but are no longer able to offer the option of abortion, even if the patient wishes to discontinue the pregnancy.
Prior to June 24, 2022, these common clinical situations were devastating for pregnant women. But the dismissal of Roe v. Wade deprives many of our patients of their pregnancies and reduces our ability as high-risk pregnancy providers to provide abortion services when they are medically recommended or personally desired. The deliberate decision by policymakers to prioritize the health of the fetus with a rapid heart rate over the health of the pregnant woman is not only medically wrong but also socially reprehensible with serious consequences.
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