Tuesday, May 22, 2012

Can abortion save the mother's life?

Anthony Levatino, MD, JD: I want to make a comment on the claims that I often hear that we must keep abortion legal in order to save women’s lives, or prevent grave physical health damage, in cases of acute conditions that can and do arise in pregnancy.

Albany Medical Center, where I worked for over seven years, is a tertiary referral center that accepts patients with life-threatening conditions related to or caused by pregnancy. I personally treated hundreds of women with such conditions in my tenure there.

There are several conditions that can arise or worsen, typically during the late second or third trimester of pregnancy, that require immediate care. In many of those cases, ending or “terminating” the pregnancy, if you prefer, can be life saving, but "terminating a pregnancy" does not necessarily mean "abortion." I maintain that abortion is seldom if ever a useful intervention in these cases.

Here is why: Before a Suction D&E procedure can be performed, the cervix must first be sufficiently dilated. In my practice, this was accomplished with serial placement of laminaria. Laminaria is a type of sterilized seaweed that absorbs water over several hours and swells to several times its original diameter. Multiple placements of several laminaria at a time are absolutely required prior to attempting a suction D&E.

In the mid-second trimester, this requires approximately 36 hours to accomplish. If one were to use the alternate method defined in federal law as Partial-Birth Abortion (but now generally banned), this process requires three days, as explained by Dr. Martin Haskell in his 1992 paper that first described this type of abortion.

In cases where a pregnancy places a woman in danger of death or grave physical injury, a doctor more often than not doesn’t have 36 hours, much less 72 hours, to resolve the problem.

Let me illustrate with a real-life case that I managed while at the Albany Medical Center. A patient arrived one night at 28 weeks gestation with severe pre-eclampsia or toxemia. Her blood pressure on admission was 220/160. A normal blood pressure is approximately 120/80. This patient’s pregnancy was a threat to her life and the life of her unborn child. She could very well be minutes or hours away from a major stroke. This case was managed successfully by rapidly stabilizing the patient’s blood pressure and “terminating” her pregnancy by Cesarean section. She and her baby did well.

This is a typical case in the world of high-risk obstetrics. In most such cases, any attempt to perform an abortion “to save the mother’s life” would entail undue and dangerous delay in providing appropriate, truly life-saving care. During my time at Albany Medical Center I managed hundreds of such cases by “terminating” pregnancies to save mother’s lives. In all those cases, the number of unborn children that I had to deliberately kill was zero.

From the Testimony of Anthony Levatino, MD, JD, before the Subcommittee on the Constitution, Committee on the Judiciary, U.S House of Representatives on The District of Columbia Pain-Capable Unborn Child Protection Act (H.R. 3803), May 17, 2012. Video.

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