A letter from the American Congress of Obstetricians and Gynecologists
The onslaught of laws focusing on denying reproductive health care rights is a concerted campaign against women. These laws are not grounded in science or evidence-based medicine.
The American Congress of Obstetricians and Gynecologists believes that access to family-planning counseling and to the full array of contraceptives is a basic and essential component of preventive health care for women.
Efforts to defund Planned Parenthood, which provides cervical cancer and mammography screening, contraception and other preventive care to millions of women, are egregious and disproportionately hurt poor women.
As physicians for women’s health care, ob-gyns see firsthand the havoc that punitive ideology-based laws have on the health of women and their families. These ill-conceived laws are based on the pretext of protecting health, but they do anything but that.
Mandating that women be legally forced to undergo transvaginal ultrasound or any other medical procedure against their will and against their physician’s judgment is an outrageous violation of patient autonomy and the confidential doctor-patient relationship. Decreasing access to family planning and contraception will only increase unintended pregnancies and negatively affect family and societal health.
Politicians were not elected to, nor should they, legislate the practice of medicine or dictate the parameters of the doctor-patient relationship. Our message to politicians is unequivocal: Get out of our exam rooms.
JAMES T. BREEDEN
President, American Congress of Obstetricians and Gynecologists
[NB: more people than just cis women are affected by anti-choice laws.]
In the wake of the Virginia forced transvaginal ultrasound debate in Virginia, bill supporters have tried to justify their bill by stating that ultrasounds are the “gold medal standard” of pre-abortion care. But are they?
As one midwife explains in an article on The Clinical Advisor, unless a patient presents with an issue that would have a medical practitioner suspect an ectopic pregnancy, often they aren’t used at all.
Robyn Carlisle, MSN, CNM, WHNP, full-scope midwife at University Doctors and Kennedy University Hospital in Sewell, N.J., writes:
I recently saw a patient in the office for amenorrhea, severe left-sided pelvic pain, and a positive home pregnancy test. I ordered blood work and a stat ultrasound to rule out ectopic pregnancy. When I mentioned the ultrasound, the patient balked and confided that she was uncertain whether she wanted to continue the pregnancy.
My patient felt that an ultrasound would just complicate an already painful decision to terminate the pregnancy. I explained to her that while I understood her apprehension, given her clinical presentation, we needed to ensure this was not a tubal pregnancy and move forward with the ultrasound.
Under normal circumstances in New Jersey, this patient would not have needed an ultrasound to confirm her pregnancy, especially if she was considering an abortion. Unfortunately, not all women have this choice.
…
First trimester ultrasounds are not part of routine prenatal care. Many insurance companies will not cover first trimester ultrasound without a medical indication, such as vaginal bleeding or severe pelvic pain. So why are politicians now requiring this expensive procedure for a woman who plans to terminate her pregnancy?
Despite what some prolife advocates may think, the decision to terminate a pregnancy is never an easy one. Prochoice does not mean pro-abortion. Prochoice means supporting a woman’s legal choices regarding pregnancy and her body. Requiring unnecessary ultrasounds add to the pain women experience when making an already difficult decision, but will most likely not change the decision once it has been made.
Pregnant women who show signs or symptoms of ectopic pregnancies receive ultrasounds. Not every other woman does. Why are legislators insisting that it be different for women wanting to end a pregnancy?
When legislators mandate more “care” for a woman who wants to terminate than is usually given to a woman with a wanted pregnancy, and expensive, medically unnecessary care, how can that be anything but government sanctioned coercion?
______________________________________________
Emphasis mine. Pregnant people, not just cis women.
I’m running out of energy on this ultrasound issue but to reiterate:
- They most often are medically unnecessary
- They’re expensive and because they must be paid for out-of-pocket people in poverty will be affected the most, making abortion more inaccessible and in some cases unobtainable.
- There is no justification for legislators to mandate the medical practices of doctors in this fashion. If an ultrasound is necessary in a particular instance for an abortion to proceed, the doctor will do one. But mandating them is nonsensical and removes all consent from the procedure.
I am about to get personal in a way I rarely do, and emotional in a way that I haven’t, in this space. Bear with me.
My maternal great-grandmother died of breast cancer. She had 14 children.
Those 14 children were evenly divided. Seven daughters, seven sons.
My grandmother died of breast cancer.
All six of my grandmother’s sisters had breast cancer.
Five of my grandmother’s sisters died of breast cancer. The sixth is still with us after battling it three times.
But that sixth sister? Her daughter died of breast cancer at age 43. She left behind two daughters of her own.
And the seven brothers? Not unscathed. Each of them with a daughter has had a daughter with breast cancer.
Three of those daughters have died. Two also left behind daughters of their own as well.
This disease has more than decimated my family. It’s orphaned my mother and her sisters. It took my favorite aunt, the one I spent summers with as a little girl. It took my grandmother. It’s left my young cousins motherless girls. Girls need their mothers.
For me the fight against breast cancer is extremely personal.
For years my family has supported the Susan G Komen foundation. We’ve walked in the 5ks as a team, the survivors so proud in their pink shirts and hats. We’ve bought the pink ribbon items. Every one we could find. We pooled our money to buy my cousin the pink Kitchen Aid stand mixer to celebrate the end of her chemotherapy. All of our cars have sun fading in the shape of the pink ribbon magnets we happily stuck on our bumpers.
This isn’t political for me, beyond the continual fight for single-payer healthcare. Had some of the women in my family had earlier and stronger access to medical care they may have been spared the loss of their health, the loss of their breasts, the loss of their lives.
This isn’t political for me, beyond the continual fight in favor of what is derisively called Obamacare. I know as a person with pre-existing conditions, it is the only way I will have access to medical care. I am now in the age window when women in my family receive their first diagnoses. I have to be careful.
The Komen foundation has been selling us a bill of goods. They lobbied against improved and expanded health care access, breast cancer care access, for poor women.
And now this defunding of Planned Parenthood. (Don’t be confused by the headlines. Funding is “restored” but only for this year, and only to some affiliates. Next year? No one knows. And I think Komen is counting on us not remembering and not paying attention.) they made it political.
On a purely personal level I think I made it clear how I deal with my political opponents.
Some people are calling this partial restoration for 2012 a “victory” but for me? Victory will be the day that the Susan G Komen foundation no longer exists.
As for me, in the name of all the women who came before, whose memories I must bear as a legacy of the devastation of breast cancer, I vow: not another penny not ever again.
The Susan G Komen foundation has destroyed its goodwill, has squandered its good name. They did it long ago but we didn’t realize it then. Now we know. I for one will not forget.
I hope that you won’t forget either.
Not another penny. Not ever again.
Fund planned parenthood. Fund your local health clinics. Agitate so that no one has to rely upon charity and the goodwill of organizations to get basic health care, a human need, a human right, any more. We are better than that. We can do better than that.
Not another penny. Not ever again. It’s time for something new.
Will you help me find it?
