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By EMILY YOUNG, MD
I am a doctor training at the Family Medicine Residency of Western Montana to become a rural family physician. I am also the mother to my giggling 6-month-old son, Theodore. The journey to my baby was long and painful, starting with a five-week miscarriage, then a 13-week “missed miscarriage.” At our second routine ultrasound, I was told, “I am so sorry; there is no heartbeat.” We had made it through the first trimester, but for some still-unknown reason, our tiny boy had died. When I decided I wanted the chance to hold him, rather than have him removed through surgery, my doctor prescribed misoprostol, a medication known for its use in abortions, to induce cervical dilation to make my body let go. I am immeasurably grateful for the chance my husband and I had to hold our baby, to name him, and to bury him.
LR-131 terrifies me because it would take those moments away from parents solely on whether their baby’s heart had, or had not yet, stopped beating.
The poorly conceived aim of bill LR-131 is to reduce abortions after viability by punishing doctors who induce labor to cause preterm birth and then do not initiate all possible life-saving measures. But these are rare: fewer than 1 percent of all abortions occur after 21 weeks (6), and many of these are surgical procedures.
While this bill intends to punish abortion, it will have broader effects for women and their babies who experienc preterm labor and severe fetal anomalies. We already see this in Texas, where some pharmacies refuse to stock methotrexate (7), the medication used to treat ectopic pregnancies by stopping the growth of the embryo, and providers hesitate to prescribe misoprostol and mifepristone (8), medications that treat missed miscarriages and also initiate medication abortions. Many patients who receive terminal diagnoses for their babies are being told to continue the pregnancy until the baby either dies, or is born and placed on brief, isolating, and even painful life support (9). Continuing any of these pregnancies can become medically life-threatening to the mother, in addition to the mental pain of carrying a child destined for death.
Montana, like most of America, faces a primary care provider shortage and will need 200 more PCPs by 2030 (1). I aim to fill one of those slots as I train in Missoula to become a full-spectrum family doctor: I will deliver babies, care for hospitalized patients, cover the emergency room, and see patients in clinic. “Born Alive” LR-131, however, makes me worried that I could not stay in Montana to provide the quality care my patients need. LR-131 would allow physicians to be charged with a felony, fined up to $50,000, or sentenced to twenty years in prison if they do not resuscitate any infant born with a heartbeat.
I am not alone in this fear. Hospital recruiters are struggling to fill OBGYN slots (2) in states with abortion bans, even amongst doctors who do not provide abortions, because of the extensive crossover between abortions, miscarriages, ectopic pregnancies, and caring for patients who find themselves or their fetuses at risk of death or disability.
I chose medication to induce labor to give birth to my dead son for the chance to hold him. I wanted to touch his tiny fingers and look at his face. The only photo I have of him is the most important picture in my world. In it, he has a soft smile on his lips and one arm behind his head; he looks relaxed and mischievous. He is as small as a peach and his skin is too see-through and I adore him.
When doctors and parents already know that the best choice for a family is to NOT pursue intensive medical treatment, I cannot fathom taking away those precious minutes of life to inflict pain on a baby, alone and separated from its parents. As a doctor, I refuse to participate in harming a family like that. As a wife and mother and the sole financial provider for my family, I cannot risk prison time. I will leave Montana, if that is what it takes to be allowed to provide compassionate, quality care to all my patients.
Vote NO to LR-131 to keep Montana a state that protects constituents right to privacy and decisions over bodily autonomy. Vote NO to LR-131 to keep Montana a state where doctors feel safe to practice appropriate, compassionate medicine. Vote NO to allow heartbroken parents the chance to hold and love their non-viable babies. MSN
CITATIONS:
- https://www.graham-center.org/content/dam/rgc/documents/maps-data-tools/state-collections/workforce-projections/Montana.pdf
- https://www.washingtonpost.com/business/2022/08/06/abortion-maternity-health-obgyn/
- https://www.nejm.org/doi/full/10.1056/NEJMoa1410689
- https://fn.bmj.com/content/88/3/F199
- https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/implementing-standards-resources/skin-to-skin-contact/
- https://www.cdc.gov/reproductivehealth/data_stats/abortion.htm
- https://www.npr.org/sections/health-shots/2022/05/10/1097734167/in-texas-abortion-laws-inhibit-care-for-miscarriages
- https://www.pbs.org/newshour/nation/texas-hospitals-delaying-care-over-violating-abortion-law
- https://www.nejm.org/doi/full/10.1056/NEJMp2207423
