Good law, bad medicine

A recent investigation by The New Yorker highlights the dismal state of prenatal care in Texas. The findings highlighted in the article intend to demonstrate a clear and direct link between the passage of the Texas Legislature’s SB 8, which limited elective abortions, and the state’s reportedly increased maternal mortality rate. Yet the magazine fails to demonstrate how Texas abortion regulations caused even one maternal death after the passage of SB 8. Instead, The New Yorker inadvertently reveals the reality of substandard healthcare for primarily poor minorities in areas with limited or nonexistent healthcare facilities, inaccurately attributing this reality to abortion regulation.

The truth is that there are no instances when an elective, voluntary abortion in the absence of a preceding complication is medically necessary to provide good prenatal care. The issues revealed by The New Yorker do not show how abortion restrictions result in substandard care. Instead, they may demonstrate how the absence of legal abortion reveals the practice of substandard care for vulnerable populations.

Stories across the country have been used to argue that legal abortion must be reinstated to ensure quality prenatal care. But perhaps elective abortions have been used as Band-Aids by bad actors and the medical system to provide substandard healthcare for decades, and removing this morally reprehensible action has only exposed the true state of prenatal healthcare for poor and vulnerable women.

The New Yorker investigation opens with the story of a woman named Vanessa Garcia, who was inexplicably denied a dilation and evacuation procedure after a miscarriage at 15 weeks of gestation. Garcia was sent home for expectant management and was finally referred to a pro-abortion physician to perform the procedure several weeks after fetal demise was confirmed. The article goes on to assert that Texas physicians have been delaying miscarriage care since the passage of SB 8, or “denying it outright,” even though miscarriage treatment is legal statewide, without any evidence to substantiate this claim.

It’s challenging to imagine this same level of miscarriage management being offered to a wealthy, white woman. Like Garcia, I have had a second-trimester miscarriage in a state with abortion regulations. However, I was admitted to the hospital, where I went through the labor and delivery process by choice. After the baby had been delivered, I hemorrhaged while attempting to pass the placental tissue and lost consciousness from blood loss. I was grateful to be in the presence of my treating physician, whose quick action resolved a scary situation and stemmed my bleeding. Sadly for Garcia, she was not offered the same high level of prenatal care when she experienced a miscarriage. This complication was not the result of Texas’ SB 8 but instead illustrates how a bad actor practices bad medicine on vulnerable populations unchallenged.

Tony Ogburn, the focus of the remainder of the article, is a Texas-based OB-GYN who recounts multiple instances of substandard care at DHR Health Women’s Hospital in Texas’ Rio Grande Valley. Ogburn describes instances of substandard prenatal care that threatens women’s health and lives—like high C-section rates, untreated cervical cancer, and a woman who received a D&E without a fully dilated cervix. Yet it’s unclear how any of these issues relate in any way to legalized, elective abortion.

Every instance highlighted in the article, like a delayed miscarriage treatment, failed ectopic pregnancy resolution, and hesitation of induction of labor for a previable preterm rupture of membranes (PPROM), falls outside the scope of elective, voluntary abortions that are restricted by Texas law. Resolutions for these prenatal complications are protected in Texas. Preserving women’s lives and health is always legal. Furthermore, treatments for ectopic pregnancies and management of PPROM are specifically protected by addendums in Texas law.

Instead of focusing on abortion regulations as a scapegoat for a broken medical system, perhaps The New Yorker should investigate how substandard, prenatal healthcare is undeniably foisted on poor minority women with multiple, preexisting comorbidities.

Reinstituting legal elective abortion will do nothing to fix this prenatal healthcare crisis. It will simply create new victims—babies, in addition to mothers.

These uncovered instances of substandard prenatal care should be taken seriously, but not because of the reasons argued by The New Yorker. States committed to preserving a high regard for both mothers’ lives and babies’ lives should examine their abortion regulations to ensure clarity. Any instance of maternal mortality in a pro-life state must be demonstrably due to medical malpractice and never due to badly written abortion regulations. Pro-life supporters should be the first to hold physicians accountable for practicing bad medicine and ensure high standards of care for pregnant women.

Where there are egregious instances of substandard prenatal care given to poor and minority women, pro-life physicians should be the first to speak up. Protecting vulnerable women and the unborn are not mutually exclusive aims, and both goals are inherently pro-life.