As an ObGyn physician in my 26th year of practice, I feel compelled to comment on recent developments in our country regarding late-term abortions.
The Reproductive Health Act (RHA)
On January 22, 2019, not coincidentally the 46th anniversary of the United States Supreme Court Roe v. Wade ruling, the Reproductive Health Act (RHA) became a statute in the state of New York.
Other states including Rhode Island, Vermont, New Mexico, and Illinois are rumored to soon follow suit by voting on similar legislation.
This law states that a medical provider can perform an abortion, “according to the practitioner’s reasonable and good faith professional judgment based on the facts of the patient’s case: the patient is within twenty-four weeks from commencement of pregnancy, or there is absence of fetal viability, or the abortion is necessary to protect the patient’s life or health.”
This means that medical providers can legally abort babies from 24 weeks of pregnancy up to full term pregnancy for essentially any reason they choose.
What Is The Age of Viability?
Medically speaking, we know that babies as young as 24 weeks of pregnancy (24 weeks gestational age) up through full term (37-40 weeks gestational age) are able to survive after birth (also termed the age of viability).
To provide a quick quarter decade perspective, it is relevant to know that in my personal career, medicine has seen the gestational age of potential viability become earlier by 2 weeks.
During my residency training almost 27 years ago, we considered an unborn baby of 26 weeks gestational age to be potentially viable should that infant need to be emergently delivered.
Nowadays, with the continuing advancements in medicine, babies born as early as 24 weeks, 0 days gestational age can be considered as viable should an emergent delivery be necessary.
There are in fact numerous ObGyn physicians and hospitals systems, in partnership with their Neonatology teams, who perform emergency deliveries, at the maternal patient’s request, as early as 24 weeks gestational age with the assumption that those infants can survive.
In fact, on February 27, 2019, CBS reported on a baby in Tokyo who was going home from the hospital after being delivered at 24 wks weighing under 10 ounces; the smallest surviving baby of record.
Certainly, this was a worldwide extreme, and 10 ounces is exceptionally small even for 24 weeks, yet this child is now home.
Thus in my relatively short 26 years of practicing Obstetrics and Gynecology, medical advancements have pushed the age of potential viability back 2 weeks, from 26 weeks to as early as 24 weeks gestational age.
Will this trend continue? Quite possibly.
The RHA’s Misleading Medical Rationalization
I feel compelled, even obligated, to give my opinion regarding this new legislation, the RHA, and the misleading medical rationalization as to its necessity.
I am admittedly a person who believes that life begins before the physical birth of a “fetus”; which I prefer to call a baby.
In addition, I try to live my life and practice my profession as an ObGyn physician in a way that honors and protects life in accordance with my worldview.
From that perspective, which I believe both sides would label as “pro-life”, let me state that in my 26+ years of practice, out of medical necessity I have delivered hundreds of babies (from over 6,000 deliveries) before natural labor had begun and before completion of a “full term” pregnancy (37 weeks).
These were done toward the goal of protecting my pregnant patient’s “life and health.”
Many of these deliveries have been performed in the extreme prematurity phase of 23- 28 weeks gestational age, and even others at pre-viable gestational ages, in the name of protecting the life of the mom. Sadly, some of these babies passed away after birth.
Again, I am a “pro-life” person, and I practice Obstetrics and Gynecology in accordance with my worldviews regarding life, and it’s inherent value.
Even still, I have delivered hundreds of babies prematurely and unfortunately have had to deliver some previable in the name of protecting my patient’s life and health.
That being said, I have NEVER had to actively end the life of a baby before delivering my pregnant patient and cannot think of a single instance where it would be necessary to do so.
There is no medical rationale for needing to end the life of a baby post the age of viability before delivery in order to protect the pregnant female patient. Period.
If mom’s life is in danger, or even if her undefined “health” as stated in RHA, is jeopardized to the professional opinion of the medical provider and patient, then simply deliver the baby by induction of labor or Cesarean Section, and in this manner tend to the mother’s health needs.
There is just simply no medical reason that the post viable baby has to be aborted (it’s life ended) prior to delivery.
The Reproductive Health Act Makes No Medical Sense
Many supporters of the RHA, and similar bills, are stating that it is in the name of a woman’s health, and perhaps her very life, that laws allowing abortion are needed beyond 24 weeks until the time of full-term delivery.
This simply makes no medical sense to me, a physician of three decades, whatsoever.
Again, if mom’s life or “health” is in jeopardy, deliver that pregnancy and protect the woman, but there is no medical reason for the baby’s life to be terminated first.
I am certain if this opinion is read by those who oppose my view, that some medical expert will try to present an example where they believe I am wrong.
They may present a medical condition in which they believe ending the life of the baby is, in fact, safer for the pregnant patient than simply delivering the baby alive.
While I would respectfully evaluate the medical specifics of any example offered, I believe that all parties with true medical knowledge of the facts regarding any such scenario will be forced to agree that 99.9% of the time, it will not be to the pregnant woman’s medical benefit to actively end the life of the baby before delivering her by induction of labor or by Cesarean Section.
Is The Reproductive Healthcare Act About Women’s Health, Or Something Else?
The RHA and similar bills dealing with abortions post age of viability is legislation about protecting abortion rights, it is not about protecting the life of the pregnant woman.
The proponents of these laws need not complicate this very difficult issue with unsound medical statements. These laws are in fact about protecting what is labeled as a woman’s right to choose.
Let’s keep this intent of these laws clear and forthright.
Where The Abortion Debate Should Be Focused
It is my opinion that our country’s debate on abortion needs to concentrate on the very difficult argument of when “life” begins.
Once we come to some legal agreement on that foundational issue, then the laws of the land can get back to protecting “life” as they were originally intended to do.
Legally coming to agreement on when a pregnancy becomes a life however will not be easy, as the opinions vary greatly.
Some believe that life begins at conception, while others do not believe that life begins until after a full term delivery and perhaps some don’t even believe that a baby’s life is a life deserving of legal protection for minutes, hours or even longer post full-term delivery as that is what is implied in other opinion articles regarding the implementation of the RHA.
Noteworthy, at the time of my final edit of this opinion paper our country’s legislators did not pass the “Born Alive Abortion Survivors Protection Act.” Thus for political reasons, including protecting abortion rights, a subset of our country’s legislators have decided that a baby born alive after an attempted abortion does not warrant protection under our laws, it is not a “life” of any value.
These issues are extremely challenging for a variety of reasons including misleading medical information, as well as strongly held conflicting beliefs regarding the issues of abortion and the sanctity of life.
The Reproductive Health Act Just Pretends To Have A Medical Argument
I do not believe we are helping any of these issues whatsoever by passing laws such as the RHA and pretending there is a reasonable argument to actively stop an unborn baby’s heartbeat after 24 weeks in order to protect the life or health of the woman carrying that pregnancy.
Again, simply induce the labor or perform a Cesarean Section, deliver that pregnancy in the name of protecting the mom if and when that is medically needed…but you don’t need to end the baby’s life before the delivery.