The state capitol building in Harrisburg

The state capitol building in Harrisburg

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Pittsburgh doctor: Pa. abortion bill would affect one of my patients every week

The bill “inserts politicians squarely between doctors and patients,” says the director of family planning at Magee-Womens Hospital.

Sarah Anne Hughes

The Pennsylvania legislature is poised to approve a bill that would ban abortions after 20 weeks except in extraordinary cases and effectively prohibit what is considered to be the safest second-trimester method of abortion.

The bill, which the Pa. Senate approved 32-18 this week without holding a hearing, is essentially identical to one that passed the House last year. While it was supported by a number of elected officials from Allegheny County, both Democrats and Republicans, this type of ban has been condemned by the Pennsylvania Medical Society, the American College of Obstetricians & Gynecologists and dozens of doctors.

Dr. Beatrice Chen, director of family planning at Magee-Womens Hospital of UPMC, is one of them.

The Pittsburgh physician told The Incline she treats one woman every week who would be affected by the ban.

“At our hospital, we are one of the last resorts for women who are, for example, diagnosed with fetal anomalies,” Chen said. “Anatomy ultrasounds for pregnancy are usually not performed until close to 20 weeks of pregnancy. And so many women are diagnosed at the time this ban would take place.”

Chen, who is also an assistant professor in the Department of Obstetrics, Gynecology & Reproductive Sciences at Pitt, sent a letter to the Pa. legislature in spring 2016 as it was considering the House version of the bill.

This bill inserts politicians squarely between doctors and our patients, forcing physicians to abandon our own ethics and good practice and provide lesser care, face criminal penalties, or deny women the care they need,” she wrote.

Like the House legislation, Senate Bill 3 provides exceptions to the 20-week ban when a “physician reasonably believes that it is necessary to prevent either the death of the pregnant woman or the substantial and irreversible impairment of a major bodily function of the woman,” but not for rape or incest.

It also prohibits the use of the dilation and evacuation procedure — called “dismemberment abortion” in the legislation — at any point in a pregnancy with few exceptions. Doctors can face a criminal felony charge if they perform the procedure without meeting strict requirements, including getting the written consent of another physician.

Chen, who has been in practice for ten years, also detailed in her letter the cases she’s handled that would fall under the ban:

My patient, Amanda, had a routine anatomy ultrasound in the second trimester. She and her husband found out unexpectedly that their baby had a severe lethal skeletal abnormality where bones fracture easily and frequently. There were already signs of multiple fractures by ultrasound, and the pressure of the ultrasound itself was clearly showing damage to the bones. If their baby survived to delivery, it would experience multiple fractures from the delivery process itself, before passing away. They felt that the most compassionate option was to terminate the pregnancy in the second trimester. This ban would have prohibited me from being able to take care of this woman and her family.

The ban, Chen told The Incline, would prevent women like Amanda from accessing “a safe method of abortion care.”

“We see women who are diagnosed late. They’ve been waiting for results of an amniocentesis or other genetic testing results, or maybe they were first diagnosed on an initial anatomy scan and were then referred to a specialist for an opinion about the diagnosis and what to do,” she said. “Having a 20-week ban in place would not give women the opportunity to have a diagnosis made and get the opinions that they need to seek care.”

For Chen and providers like her, the bill would “prevent us from being able to offer the best option for care for women,” she said. And not being able to provide that care to a woman is “outrageous” to Chen.

“It’s basically legislators telling me how to practice medicine when they haven’t had the training or the medical expertise and, in this case, they haven’t even had the input of physician communities to talk about what care women need and what options they should be given for care,” she said.

Before yesterday’s vote, state Sen. Michele Brooks, the bill’s sponsor, said her legislation “seeks to reflect” changes in fetal medicine, namely the viability of children born before 24 weeks. “Currently in Pennsylvania, a live, six-month-old fetus can be ripped apart and left to bleed to death,” she said.

Chen said she thinks “there’s a lot of misinformation” and “rhetoric out there” about abortion care.

“If legislators had a chance to talk to patients, to talk to physicians who provide this kind of care for women, I wish they would have a better opportunity to understand what this ban would mean for women and their families,” she said.

Even if the bill passes the House, Gov. Tom Wolf has pledged to veto it. As Anna Orso of Billy Penn reported, the state Senate could override Wolf’s veto thanks to its veto-proof majority. However, “Wednesday’s vote of 32-18 wouldn’t be enough votes to override,” she reported.

Three Republican senators voted against the ban Wednesday, including Sen. Lisa Baker, who shared her own story about losing a child “with a rare genetic condition well after the twenty-week threshold.”

“This is not a matter to be decided based upon misperception or misrepresentation. Efforts to legislate and criminalize the practice of medicine set a dangerous precedent,” Baker said. “The concerns of hundreds of obstetricians and gynecologists should matter, and it is hard to discount their worry and concern for their patients.”

As Chen wrote in an email to The Incline, “Women have multiple personal and valid reasons for terminating their pregnancies, and I trust women to make the decision that is best for themselves and their families.

“Legislators should do the same.”