As an obstetrician with 20 years of experience, I have been trusted by more than 10,000 patients to care for them at critical moments in their pregnancies. I have witnessed the exhaustion, elation, pain, grief and relief of patients during natural childbirth, Cesarean sections, abortions and miscarriages. From these experiences I have learned two very important lessons about trust and freedom.
First, I have learned to trust people to make their best decisions when presented with an incredible array of pregnancy related challenges. Second, I have learned that freedom means respecting that other people make decisions that I may not make for myself.
These values are under imminent threat from the Utah Legislature, which is why more than 500 local health care providers have signed a statement urging lawmakers to avoid interfering with the patient-provider relationship, and why I’m asking Utah providers to consider adding their names.
To better understand trust and freedom in medicine, consider the cases of two patients with planned pregnancies who, at 13 weeks, discovered that the pregnancy was affected by the same genetic disorder. The women were of the same age, both already had a child and had supportive spouses. The prognosis for each pregnancy was a shortened life with likely severe developmental delay. One person elected to end her pregnancy and one elected to continue. I cared for both.
The woman who decided to have an abortion underwent a five-minute procedure provided with compassion ending in relief mixed with grief. She asked for and kept her ultrasound pictures. For the other patient, we focused prenatal care visits on preparing for the ordeal of having a newborn in the intensive care unit. In both cases I was able to provide personalized, compassionate care so that each felt respected in their decision.
Physicians regularly encounter complex situations where people in similar circumstances make different decisions. Like the two people mentioned above, most people who have abortion care are already parents. Their decisions are informed by a desire to do the best for the children they already have.
The complexities around deciding whether to have an abortion means simultaneously acknowledging that abortion stops the development of a potential human being and respecting that a pregnant person has the agency to decide what is best for her and her family. For some, only one of those things matters. My patients have taught me that compassion means recognizing that both can be true.
As a physician, I build trust through understanding the unique situation of each patient. Members of the 2020 Utah Legislature, 96% of whom are not working as medical professionals, are poised to severely damage that trust.
According to bills circulating this session, I may be required to coerce a person having an abortion to view an ultrasound even when they say they don’t want to. I may need to tell a person seven weeks into a pregnancy with an abusive partner that no one in Utah can provide their abortion care. I may even be forced to broach the subject of burial or cremation with someone immediately following the trauma of a miscarriage. In all of these clinical situations I would not be permitted to honor the individual’s freedom to decide.
Abortion care is extremely safe, using exactly the same techniques employed for managing miscarriages. The American College of Obstetricians and Gynecologists “strongly opposes political efforts to limit a woman’s ability to get the care she needs, including bans on abortion care … abortion is an essential component of health care for millions of women."
Utah politicians’ interference with the patient-provider relationship will worsen the current state of medical care and jeopardize the future provision of care here because medical providers do not want to practice in an such an environment.
The Utah Legislature can do better than replicate the shaming and blaming we see in state legislatures across the country. We can show dignity and respect for people who deserve our trust to make the best decisions for themselves and their families.
David Turok
David Turok, M.D., is an obstetrician/gynecologist practicing in Salt Lake City.