Saturday, July 29, 2006

Roe vs. Reality

The NEJM has a good article summarizing the current state of affairs with regard to abortion rights.

The darker the color on this map, the higher the ratio of women to potential abortion providers. Using the per capita ratio in this way highlights the destructive combination of rural life, with its already poor doctor-patient ratio, with the hysteria and physical threats to the physicians that anti-abortion forces create.

The article discusses the nationwide scene, and how Roe is being gutted from all directions, such as South Dakota's recent law defining abortion as murder commited by a doctor. The article particularly highlights one brave Nebraska physician, LeRoy Carhart.

In the United States, nearly 20 percent of hospital beds are in facilities with religious affiliations, most of which prohibit physicians from providing abortions. According to the Guttmacher Institute, although nationwide about 1 in 14 abortions is sought for health reasons, only two hospitals in Nebraska offer pregnancy terminations, and they do so only under rare circumstances, such as intrauterine fetal death; each of these hospitals performs fewer than 10 pregnancy terminations per year. Nevertheless, in 2004, women from many other states traveled to Nebraska for abortions — at Carhart's clinic. Occasionally, when a hospital refuses, Carhart is asked to terminate a pregnancy that threatens a woman's health. In a recent case, a woman with severe pregnancy-associated renal failure traveled 200 miles by ambulance for an abortion. She arrived with her hospital identification bracelet and an intravenous line in place, underwent the procedure, and was shipped back to her hospital bed.

Similar events have occurred in many other states. In 1998, the Louisiana State University Medical Center in Shreveport refused to provide an abortion for Michelle Lee, a woman with cardiomyopathy who was on the waiting list for a heart transplant, despite her cardiologist's warning that the pregnancy might kill her. Hospital policy dictated that to qualify for an abortion, a woman's risk of dying had to be greater than 50 percent if her pregnancy was carried to term; a committee of physicians ruled that Lee did not meet this criterion. Since her cardiomyopathy made an outpatient abortion too dangerous, she traveled 100 miles to Texas by ambulance to have her pregnancy terminated.
In other words, this latter woman had a heart so unhealthy that she couldn't even drive to Texas on her own: she had to contract an ambulance. But the Louisiana hospital still would have required that she carry her pregnancy to term.


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