Zero-sum medicine

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MARY REICHARD, HOST: It’s Tuesday the 10th of February.

Glad to have you along for today’s edition of The World and Everything in It. Good morning, I’m Mary Reichard.

MYRNA BROWN, HOST: And I’m Myrna Brown.

First up: Saving them both.

After the Dobbs decision returned abortion laws to the states, abortion advocates say that pro-life laws could restrict critical care for pregnant women.

REICHARD: While treating a pregnant mother can be more complicated, pro-life doctors argue that no woman should have to choose between her own life and the life of her unborn child.

WORLD’s Lauren Canterberry has the story.

LAUREN CANTERBERRY: Tammy Hanson’s doctor called to deliver devastating news—that she had a brain tumor.

The Florida mother of three was celebrating her 39th birthday and had a large growth on the nerve leading from her ear to her brain. That’s rare in patients as young as Hanson. And when she was diagnosed in 2001, surgeons had only removed them successfully a handful of times.

Hanson and her husband sought specialists right away.

HANSON: As we were looking for, you know, options and doctors and things, I turned up pregnant.

At the time, Roe v. Wade was the law of the land, and Hanson’s doctors did not want to delay surgery.

HANSON: The doctor looked at me and said, ‘You really need to have an abortion, we need to take care of you.’

Both my husband and I totally agreed – no.We believe in the sanctity of life, and if this is what God has for us and something happens to me, you know, God knows. And we’re just going to trust Him through this whole thing. 

Doctors agreed to wait until after Hanson delivered her baby girl to operate.

Three months after giving birth to her healthy daughter, Hanson went in for surgery. Doctors removed the tumor. Recovery took years—but today she has four adult children, all Christians.

HANSON: The journey has not been easy for me, but it's been well worth it.

Tens of thousands of women in the United States experience high-risk pregnancies each year. While both sides agree women need better maternity care, abortion advocates argue that ending a pregnancy must sometimes be an option. 

Pro-life physicians reject that framing.

They say high-risk cases highlight the importance of continuous, attentive prenatal care. They also say that delivering a baby early should always be the last resort, and that it is not the same as an intentional abortion.

Last month, ProPublica published a report blaming a woman’s death on her state’s protective pro-life law. 

Dr. Gary Ott is a pro-life cardiovascular surgeon:

OTT: They set up a false argument in that, "oh, if we only had abortion, this wouldn’t have happened."

The year was 2023 and the state was North Carolina. Ciji Graham sought treatment for an irregular heartbeat—atrial fibrillation. She expected the doctor to perform a procedure she had undergone previously called cardioversion. But while there, she learned she was unexpectedly pregnant.

OTT: We see increasing incidences of atrial fibrillation in pregnancy, and it's treated well with this.

Graham was sent home and told to follow up with other doctors. Ott finds that surprising.

OTT: There would have to be a good reason why you’re not doing it. And if you’re not doing it, you wouldn’t send her home.

The next day, another cardiologist sent Graham home with blood thinners and scheduled the procedure for weeks later.

The report says Graham believed ending her pregnancy was the only way to receive prompt treatment. She scheduled an abortion, but died at home before either appointment.

While atrial fibrillation usually doesn’t cause death, it can lead to serious complications. Doctors who spoke with WORLD and ProPublica agreed Graham did not receive care consistent with standard treatment for pregnant women.

But pro-life doctors disagree that abortion was her only option.

OTT: It's a false dichotomy. It's making a choice between two extremes that don't have to exist in that, because the obvious right thing to do here was to treat the mom properly, and mother and baby would both be healthy.

When a pregnant woman is diagnosed with a serious medical condition, an OB-GYN will typically oversee her care.

Dr. Ingrid Skop is an OB-GYN in Texas and the vice president and director of medical affairs for the pro-life Charlotte Lozier Institute.

SKOP: Often we will have a multidisciplinary conference to bring in the experts to discuss treatment options.

It is not clear if Graham ever visited an OB-GYN.

Skop said in rare cases doctors may recommend delivering a baby early to protect the mother—but those decisions usually come after hospital admission and close monitoring.

SKOP: If an emergency threatens my patient's life after the time ability viability, then my job is to separate the child from the mother... ending the pregnancy will help the mother to begin to recover from this complication, and I can hand that baby to the NICU team and say, “Please try to save his life.”

While pro-life laws explicitly protect these decisions, Skop said some doctors still do not have clear guidance or assurance from medical boards. 

No doctor has ever been sued for delivering a baby early to save a pregnant woman’s life, but many have been sued over claims that they denied or delayed care due to pro-life laws.

SKOP: No state requires that risk to be immediate, nor does any state require a doctor to be certain that she will die.

Ultimately, pro-life doctors agree that women should receive the critical care they need, but not at the cost of intentionally killing an unborn baby.

Dr. Gary Ott has occasionally had to tell parents that delivering their baby is truly the only way to save the mother’s life, even before that baby could reasonably survive. His most recent case involved a mother who developed a hernia and could not breathe at about 20 weeks pregnant.

OTT: She desperately wanted to keep that baby but there was no way to do it.

Doctors performed a c-section and gave the baby to the father while Ott fixed the mother’s hernia.

OTT: He held it til the baby stopped breathing.

And I can tell you, there wasn’t a dry eye in the room. There was no way you could go through that and not think that that baby meant something.

Prompt medical care is vital to protect pregnant mothers. But pro-life doctors argue it should never default to deliberately ending a child’s life.

Reporting for WORLD, I’m Lauren Canterberry.

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