Pregnancy

Doctors fear ending abortion protections will hurt miscarriages and pregnancy care – WABE

Doctors fear ending abortion protections will hurt miscarriages and pregnancy care - WABE

A few weeks ago, Dr. Leilah Zahedi-Spung received an emergency call to transfer a patient to the operating room. She is a Maternal Fetal Medicine physician specializing in high risk pregnancy complications.

The patient was only 19 weeks pregnant and bleeding rapidly.

“When she arrived and moved from stretcher to stretcher,” she said, “she lost 500cc of blood in front of me in less than two minutes.”

The patient had placenta previa and critical issues with her uterus, and was in early labor. It can be a life-threatening condition. By the time she stabilized, the patient had lost a third of her total blood volume. The baby was not viable.

Zahedi-Spung says she worries about what could happen in a similar emergency if the U.S. Supreme Court overturns Roe v. Wade, as she stated in a draft notice disclosed written by Judge Samuel Alito and obtained by Politico.

“Do I need to watch her bleed to death while I call a lawyer to make sure she’s ‘dyed enough’ to do a procedure that will save her life? I don’t have the answer to that. , and that’s terrifying to me.

Zahedi-Spung now practices in Tennessee. Until recently, she worked in Georgia. She is one of many doctors and nurse-midwives across the country who have been sounding the alarm since the Supreme Court’s draft opinion leaked this spring.

Southern women’s health experts are planning how they will treat patients who experience miscarriages and pregnancy complications if the Supreme Court overturns Roe v. Wade, the landmark 1973 decision that guaranteed access to abortion nationwide, and states enact their own abortion restrictions.

Medical experts say the prospect of abortion bans raises important questions about possible impacts on doctors’ training and the care they provide to women with high-risk pregnancies and miscarriages.

“And how can we get patients the care they need quickly and safely, because there are times when miscarriages get very complicated,” says Zahedi-Spung.

Miscarriages are very common. In fact, it’s estimated that 1 in 4 pregnancies end in miscarriage, mostly in the first trimester. The American College of Obstetricians and Gynecologists finds that early miscarriage is the most common form of pregnancy loss. And sometimes pregnancy tissue can be left in the uterus after a miscarriage or the bleeding continues. To prevent infection or other complications, doctors may need to remove it. This is done using techniques that are also used for abortion.

Dr. Carrie Cwiak is a professor of gynecology and obstetrics at Emory University School of Medicine.

“The same drugs are used for early pregnancy loss,” she says. “The same surgical techniques are used for early pregnancy losses.”

For example, with a procedure known as dilation and curettage or D&C. And medical abortion drugs mifepristone and misoprostol.

“It’s really a form of general training for all obstetrician-gynecologists,” says Cwiak, who says the abortion ban could weaken the training doctors need to deal with complications of pregnancy. pregnancy and fueling suspicion. And that, she says, could shut down access to abortion skills training currently available to medical students.

“In fact, it is required by the ACGMEthe governing body of all residence halls for most institutions.

People’s lives could be at stake, Cwiak said.

“If I limit my use of these health care, these drugs and these surgeries in my ability to train people, they will be less prepared to deal with early pregnancy loss, early obstetric complications, certainly fetal abnormalities . The consequences will be significant, the consequences harmful.

Texas may already be seeing some of these adverse consequences. Kaiser Health News reports that state abortion restrictions are already making it difficult for some patients to access medication after a miscarriage.

In a recent interview, CDC Director Rochelle Walensky told the online news site Statistical it is important to preserve access to abortion skills.

“Our OB-GYN programs need to be trained in how to safely terminate pregnancy and all of that training potentially wouldn’t be happening in many states,” says Walensky. “So I think there will be broad implications to that.”

Still, it’s important to note that Georgia’s proposed six-week abortion ban includes exceptions for miscarriages and ectopic pregnancies, and for pregnancies that a doctor deems “medically futile.”

The 2019 law signed by Governor Brian Kemp remains pending Supreme Court ruling on the 15 weeks of 2018 Mississippi Abortion Law at the center of the Roe v. Wade disclosed. The Supreme Court is expected to rule on the case soon.

After that, abortion restrictions in Georgia could go into effect within weeks or months.