Some gynecologists are not allowed to perform an abortion until the woman is “imminently dying” – what does that mean?

Abortion restrictions represented by a gynecologist, an examination table and a judge's gavel.

Many state abortion restrictions allow exceptions only when the mother’s life is in danger, often referred to as “imminent death.” (Illustration: Victoria Ellis; Photo: Getty Images)

Access to reproductive care in the US continues to evolve nearly a year after the fall Roe vs Wade, the landmark ruling establishing a constitutional right to abortion. These days, decisions about abortion are left up to states — and some have extremely restrictive policies.

In South Carolina, for example, this is being suggested Prenatal Equality Act covers an “unborn child at every stage of development from fertilization to birth” and would charge anyone who performed an abortion with murder, which would punish that person entitled to the death penalty. The bill would provide some exceptions, including if the mother chooses to have an abortion “because she was compelled to do so because of imminent risk of imminent death or serious bodily harm.” The bill would also exempt doctors from tax liability who perform an abortion to prevent the woman’s death but “result in accidental or unintentional injury or death of her unborn child when all reasonable alternatives to save the unborn child have been tried.” or none were available.” .”

in texas, Senate draft 8 An abortion exemption is only permitted in the case of “medical emergencies,” a term that is not well defined. For this reason, many medical professionals play it safe and only intervene in a woman’s pregnancy when she is seriously ill. Five are women Lawsuit against the state of Texas about the law, including one who said she had to leave the state to have an abortion after her waters ruptured a few months into the pregnancy and she was told her baby would not survive. The woman says she was told doctors in Texas could not help her until her life was actively in danger.

Accordingly, abortion is banned in 13 states Guttmacher Institute. While the wording varies by legislation, many measures provide exceptions only where the mother’s life is in danger, often referred to as ‘imminent death’ or ‘imminent danger’.

But what does “threatening death” mean in terms of abortion care and what are the consequences when doctors wait too long? Experts break down the problems.

What does “threatening death” mean from a medical point of view?

It’s a medical term dr Lauren Streicher, a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, tells Yahoo Life. “It means someone is dying,” she says. “The problem with ‘imminent death’ is that there is no time frame. When someone is told that death is imminent, it can be in five minutes or a week. However, it indicates that this trend is no longer reversible.”

Determining whether death is imminent ultimately depends on a doctor’s judgment. dr Emily Barkera gynecologist in missouri and a guy with Reproductive Health Physicianstells Yahoo Life.

What does “threatening death” mean from a legal point of view?

It is not usually clear Heather ShumakerDirector of Access to State Abortion National Center for Women’s Rights, tells Yahoo Life. “Health and legal exceptions to state abortion bans are intentionally vague and put pregnant people’s lives at risk,” she says.

Shumaker says the consequences of Dobbs v. Jackson Women’s Health Organization, the landmark US Supreme Court ruling, which was overturned Roe vs Wadehas “created an unprecedented legal and public health crisis”.

“Extreme state laws banning abortion have deliberately created chaos and confusion for pregnant people and healthcare providers,” Shumaker says. “Patient care should always come first. In a crisis situation, medical providers should be able to focus on the care that the patient needs. But in a climate hostile to access to abortion and the increasing criminalization of its care, physicians fear prosecution.”

Why the immediate death exception is problematic

Women’s Health Expert dr Jennifer Wider says Yahoo Life: “It is difficult to find out the reasons for such a limitation. There’s no point in putting a woman’s life in imminent danger. Waiting until a person’s life is in serious jeopardy is not an optimal time to respond.” in an operating room.

Streicher agrees. “You’re basically saying, ‘She has to die to intervene.’ How do you prove that? I guess she was dying because she’s dead now?” She continues. “This whole notion that you can have an abortion when someone is about to die… It’s too late. She is it.” Die. The idea that this would reverse the process and she would be fine is so problematic.”

This exception also makes it harder for patients to receive informed care, Barker says. “It is critical that all physicians are able to offer counseling based on a patient’s individual medical circumstances and that patients can weigh the information they receive to make decisions that best suit their needs and values,” she says. “Any legal or political interference in this process jeopardizes the ability of physicians to provide safe and essential healthcare to their patients.”

What is the “threatening death” like for pregnant women?

It really depends. “In my practice, I’ve seen people with serious heart or kidney disease, new cancer diagnoses, and life-threatening high blood pressure,” says Barker. “I also see people with pregnancy complications like heavy bleeding or a rupture of the amniotic membrane before the pregnancy is viable.”

A common example is sepsis, a life-threatening complication of an infection, says Streicher. “There is a woman whose waters rupture early and there is no chance that the pregnancy will continue,” she explains. “An infection sets in, but only when it becomes septic can we terminate the pregnancy. In some cases, if you are lucky, she can survive, but in many cases it is already too late.”

In many of these situations, a woman also has to undergo a hysterectomy “because the uterus is so infected that it can’t be saved,” says Streicher.

A ectopic pregnancy – A non-viable pregnancy This happens when an embryo implants outside the uterus and often in the fallopian tubes – another example cited by Wider. According to the American College of Obstetricians and Gynecologists, as pregnancy progresses, the fallopian tube can rupture, which can lead to life-threatening internal bleeding.

But Barker says, “Each patient is unique: their medical factors, values ​​and preferences guide our conversations and our decision-making. Abortion bans are based on politics, not science and medicine.”

Ultimately, Streicher says, “this means putting women to death and turning doctors into unwitting murderers.”

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