Citizens understand that legislators must make laws impacting areas in which they lack expertise. That is their job. It is also their responsibility to listen to expert opinion and make laws that result in the greatest benefit and the least harm.
We are maternal fetal specialists who care for women with complicated pregnancies. Many women ending a pregnancy after 18 weeks do so because of complications in a desired pregnancy. In some cases, families are devastated to find out that their unborn baby has severe abnormalities during the routine prenatal ultrasound, typically performed at 19-20 weeks gestation. (And no, we are not referring to cases of isolated Down Syndrome.)
After extensive counseling, some women choose to end their pregnancies out of compassion to prevent suffering for their unborn child. In some cases, women end pregnancies complicated by a life-limiting fetal abnormality because continuing the pregnancy will lead to the need for a complex cesarean delivery that will increase maternal and neonatal risk in every future pregnancy she carries. Ending a high-risk pregnancy with a grave fetal prognosis can sometimes be important to preserve future childbearing. This is called an abortion, though perhaps not what most people think of when they hear that word. These cases are invariably complex.
Some of us met with legislators individually to voice our concern. We explained the medical complexity of pregnancy termination after 18 weeks to the bill’s sponsor in a private meeting. An exception was later added to the bill that is vague, uses medically inaccurate terminology and belies the author’s lack of medical knowledge. We offered to discuss it and explain why it made no sense but no one responded.
We testified to the House and Senate before this bill was passed. Thirty-six specialists, from across the political and religious spectrum, with over 300 years of clinical experience, signed a letter sent to every senator detailing our medical concern. We did not come forward to represent either “side” in the national abortion debate, but rather to protect our vulnerable patients who are caught in the crossfire from medical harm. We offered to answer questions and discuss the medical impact of this legislation, giving our personal contact information. How many senators who voted to pass HB136 reached out to understand the medical ramifications of this bill? Zero.
One Utah representative said, “A typical NFL season is 17 weeks … you have an entire football season to make this decision [to have an abortion]. That’s not a small amount of time.”
This flippant comment trivializes the heart-wrenching situations in which our patients find themselves and it’s incorrect. Many severe fetal anomalies cannot be diagnosed prior to 18 weeks. These families were celebrating their pregnancies until they got devastating news. The representative knew this information because we told him in person right before he made the comment.
A Utah senator asked another of our partners during testimony at the public meeting, “Where have you been [if you had concerns about the bill]?” The question left us virtually speechless, as we had exhausted every avenue to alert lawmakers to our concerns.
This bill will have a demonstrable negative impact on the health of women in our state. This experience has left us with the impression that Utah legislators wanted to pass an “anti-abortion” bill, no matter the consequences, perhaps with greater interest in making a political statement than in protecting vulnerable women and families.
Alexandra G. Eller, M.D., and Cara C. Heuser, M.D., are both maternal fetal medicine specialists with Intermountain Healthcare, affiliated with the American College of Obstetricians and Gynecologists and the Society for Maternal Fetal Medicine. They do not speak on behalf of IHC. Their submission has been co-signed by 29 other maternal fetal specialists: Robert Andres, M.D.; Ashley Benson, M.D.; Nathan Blue, M.D.; D. Ware Branch, M.D.; Jan Byrne, M.D.; Heather Campbell, M.D.; Erin A. Clark, M.D.; Michelle Debbink, M.D.; Brett Einerson, M.D.; M. Sean Esplin, M.D.; Helen Feltovich, M.D.; Julie Gainer, M.D.; Kurt Hales, M.D.; Ibrahim Hammad, M.D.; Calla Holmgren, M.D.; G. Marc Jackson, M.D.; Torri Metz, M.D.; Martha Monson, M.D.; Jessica Page, M.D.; T. Flint Porter, M.D.; Douglas Richards, M.D.; Nancy C. Rose, M.D.; Glenn Schemmer, M.D.; Rita Sharshiner, M.D.; Marcela Smid, M.D.; Shannon Son, M.D.; Amy Sullivan, M.D.; Lauren Theilen, M.D.; Paul Whitecar, M.D.