A Trial in Philadelphia

[martha]

Who knew?

 

[anitram]

Here we go, Scott Walker and the GOP in Wisconsin sign an abortion bill on a holiday. What bravery.

Gov. Scott Walker signed a bill Friday requiring doctors who perform abortions to have admitting privileges, and abortion clinics responded by immediately suing state officials over the measure.

The law — signed Friday by Walker in a private ceremony — would cut the number of clinics offering abortions in Wisconsin from four to two, and one of the remaining clinics will have to dramatically cut the number of abortions it provides, according to the operators of the clinics. The law is to take effect Monday.

...

Huyck said if the suit does not block the law, Planned Parenthood would have to close its Appleton abortion clinic and offer at least 50% fewer abortions at its Milwaukee facility. Affiliated would have to close its Milwaukee clinic, according to the suit.

That would mean abortions in Wisconsin would not be available north of Madison, and after the 19th week of pregnancy would not be available anywhere in the state, according to the suit.

The clinics are asking the court to immediately block the law, contending it violates the constitution's due process guarantee, puts an undue burden on a woman's right to choose abortion and unconstitutionally treats doctors who perform abortions differently than doctors who perform other services.

...

Abortion is an outpatient service that rarely requires hospitalization, she said. When it does, patients quickly get into nearby hospitals without problems under the current system, she said.

She said getting admitting privileges would be impossible in some cases because some hospitals require physicians to admit a certain numbers of patients annually, and abortion doctors rarely have reason to admit patients to hospitals.

Larry Dupuis, an American Civil Liberties Union of Wisconsin attorney representing Affiliated Medical Services, said it would take that clinic months to obtain admitting privileges, if they could be obtained at all. Meanwhile, women with scheduled abortions would not be able to get them.

...

The law requires women seeking abortions to get ultrasounds and requires doctors providing them to have admitting privileges at a hospital within 30 miles.

The law's critics call the ultrasound provision an unnecessary infringement on the doctor-patient relationship but do not plan to challenge it in court at this time. Supporters say the provision makes sure women seeking abortions have as much information as possible.

Other states in recent years have also enacted ultrasound requirements. Wisconsin would become the ninth state to have such a law. Under the provision, the person performing the ultrasound must describe the dimensions of the fetus, its external features and its heartbeat. The ultrasound monitor would be in view of the woman, but she would not be forced to look at it.

This bill is also not related to a woman's right to choose.

Keep in mind that the state is down to only 4 clinics because the GOP previously de-funded Planned Parenthood.

Scott Walker signs abortion bill, providers quickly sue

 

[PhilsFan]

Scott Walker is an awful person.

 

[Galeongirl]

So now they figured they can't ban abortions completely by law, they found another way to make sure they will be much harder to provide?

 

[nathan1977]

Huyck said if the suit does not block the law, Planned Parenthood would have to close its Appleton abortion clinic and offer at least 50% fewer abortions at its Milwaukee facility.

Or PP could use some of its $150M profit to raise the standards of its clinics.

The law's critics call the ultrasound provision an unnecessary infringement on the doctor-patient relationship but do not plan to challenge it in court at this time.

My wife has been pregnant four times (three kids and one miscarriage). With every pregnancy, when we've thought she was pregnant, the first thing we've done after taking an EPT is schedule a doctor's visit which includes an ultrasound to confirm the pregnancy. This is a normal -- and critical -- part of the process for OB/GYNs. Does PP really want to interfere with that or -- more foolishly -- call it illegal? (Clearly not.)

Information about a fetus's viability is also important medical information. What the patient chooses to do with that information remains hers. Should she not be presented with it?

You have likened this process to dentistry. When I got my wisdom teeth out, I got all kinds of pamphlets and information about the process, including any risks; should those wishing to have an abortion receive less information?

You have said that you and I define "rare" differently, as well as the routes to "rare" (though I have to say, we agree on more than we disagree in terms of the value of and need for education, as well as economic assistance for those in need). Maybe we also define "safe" differently? From my perspective, the best choice is an informed one. Maybe we have different views on that.

This bill is also not related to a woman's right to choose.

The right to choose is different from the right to access. The right to choose remains Constitutionally-protected; I did not realize that the government was also Constitutionally-mandated to also provide access to abortion. That's a pretty big stretch.

To use a different (but, perhaps, relevant) example: the Constitution allows the freedom to bear arms. This however does not restrict the government from putting stronger and better restrictions on who gets to carry a weapon, for the safety of the gun owner, as well as anyone who may be injured by such a weapon. The right to bear arms cannot be equated with the right to bear arms without restrictions, and those restrictions are constantly evolving.

 

[anitram]

O
You have said that you and I define "rare" differently, as well as the routes to "rare" (though I have to say, we agree on more than we disagree in terms of the value of and need for education, as well as economic assistance for those in need). Maybe we also define "safe" differently? From my perspective, the best choice is an informed one. Maybe we have different views on that.

Maybe. I am with these people.

The Wisconsin Medical Society, the Wisconsin Association of Local Health Departments and Boards, the Wisconsin Academy of Family Physicians, the Wisconsin Hospital Association, and the Wisconsin Public Health Association all declined to endorse the proposals when Republicans fast-tracked the bills through the legislature in June.

Why do you think they all refused to support the bill? Because they are leftist extremists? Could it be that medical professionals don't want to endorse intrusive, unnecessary medical tests?

 

[Pearl]

I once thought about moving to Madison, WI because it has a good job market, plus it's a nice small city with a progressive attitude, and much cheaper than NYC.

Looks like I'm staying put here in NYC. If worst comes to worst, and somehow the lawmakers in New York lose their minds and jump on the radical anti-abortion measurement bandwagon, I might consider fleeing the country. I might be a little facetious there, but what's happening is scary.

 

[nbcrusader]

Or PP could use some of its $150M profit to raise the standards of its clinics.



My wife has been pregnant four times (three kids and one miscarriage). With every pregnancy, when we've thought she was pregnant, the first thing we've done after taking an EPT is schedule a doctor's visit which includes an ultrasound to confirm the pregnancy. This is a normal -- and critical -- part of the process for OB/GYNs. Does PP really want to interfere with that or -- more foolishly -- call it illegal? (Clearly not.)

Information about a fetus's viability is also important medical information. What the patient chooses to do with that information remains hers. Should she not be presented with it?

You have likened this process to dentistry. When I got my wisdom teeth out, I got all kinds of pamphlets and information about the process, including any risks; should those wishing to have an abortion receive less information?

You have said that you and I define "rare" differently, as well as the routes to "rare" (though I have to say, we agree on more than we disagree in terms of the value of and need for education, as well as economic assistance for those in need). Maybe we also define "safe" differently? From my perspective, the best choice is an informed one. Maybe we have different views on that.



The right to choose is different from the right to access. The right to choose remains Constitutionally-protected; I did not realize that the government was also Constitutionally-mandated to also provide access to abortion. That's a pretty big stretch.

To use a different (but, perhaps, relevant) example: the Constitution allows the freedom to bear arms. This however does not restrict the government from putting stronger and better restrictions on who gets to carry a weapon, for the safety of the gun owner, as well as anyone who may be injured by such a weapon. The right to bear arms cannot be equated with the right to bear arms without restrictions, and those restrictions are constantly evolving.

While many may not agree with your conclusions, you present a very rational analysis of these elements.

 

[nathan1977]

Could it be that medical professionals don't want to endorse intrusive, unnecessary medical tests?

As I have stated previously, an ultrasound for a possibly-pregnant woman contemplating abortion is hardly "unnecessary."

Declining to endorse is hardly an indemnification. As I have said before, this issue is such a complicated, loaded political football that it's easier not to say anything at all. This allows people like Gosnell and Karpen (and, historically, other providers like Raymond Showery (Controversial El Paso abortion provider dies - El Paso Times) to operate. It took years for the associate of Dr. Tiller in KS (no stranger to controversy himself) to lose her license after a lengthy investigation which concluded that she put her patients health at risk. (Kan. doctor loses license over abortion referrals)

Additionally, famously, back in the late-90s, a prominent abortion rights advocate admitted that he had lied about statistics related to the rarity of late-term abortions, saying that they were performed far more often than was reported. (An Abortion Rights Advocate Says He Lied About Procedure - NYTimes.com)

I think the medical community has a history of sticking their heads in the sand about this issue. To be sure, I don't think there's some grand conspiracy at play. But when your only options are to be labeled a baby killer by the right or a woman hater on the left, and you're supposed to remain neutral for the sake of your patients, sometimes neutrality is the best option.

 

[Jive Turkey]

As I have stated previously, an ultrasound for a possibly-pregnant woman contemplating abortion is hardly "unnecessary."

What purpose does it serve? "Oh, look. See? It's a baby"

Honestly though, what is the benefit of a pre-abortion ultrasound?

 

[nathan1977]

What purpose does it serve? "Oh, look. See? It's a baby"

Honestly though, what is the benefit of a pre-abortion ultrasound?

Besides confirming the pregnancy, you mean?

 

[Jive Turkey]

Besides confirming the pregnancy, you mean?

Are we having abortions to terminate non-pregnancies?

 

[nathan1977]

Are we having abortions to terminate non-pregnancies?

The first step after you believe you may be pregnant -- and taking an EPT which can generate false positives -- is to go to a doctor who can confirm whether or not you are indeed pregnant. This is neither invasive nor unnecessary, but rather a crucial step in determining whether you are actually pregnant.

Do you believe otherwise? Or do you believe that the best choice is the least informed one?

 

[Jive Turkey]

Is there an issue with women going in for abortions only to find out they weren't pregnant to begin with? I've never heard of that. Or is this an attempt by pro-lifers (fuck, I hate that term) to rub their noses in it?

 

[anitram]

The first step after you believe you may be pregnant -- and taking an EPT which can generate false positives -- is to go to a doctor who can confirm whether or not you are indeed pregnant. This is neither invasive nor unnecessary, but rather a crucial step in determining whether you are actually pregnant.

By a blood test! I've never known anyone to go in after a positive HPT to confirm with an ultrasound because the gestational sac does not form immediately. It's disingenuous to suggest that ultrasounds confirm pregnancy - blood tests do. Ultrasounds are used later to look for a heartbeat.

 

[Pearl]

The first step after you believe you may be pregnant -- and taking an EPT which can generate false positives -- is to go to a doctor who can confirm whether or not you are indeed pregnant. This is neither invasive nor unnecessary, but rather a crucial step in determining whether you are actually pregnant.

Do you believe otherwise? Or do you believe that the best choice is the least informed one?

I agree with Jive. Mandatory ultrasounds before an actual abortion is a just a way for anti-abortionists to rub their noses into this.

Women who intend on having an abortion know full well that they are not in the emotional and/or financial state to bring a child into this world. Some of them have lousy boyfriends and if they were to go through the pregnancy, that boyfriend would still be present in their lives. Like I said once before, pregnancy involves two people: the mother and the child. And sometimes both are not on the same page, and that is when abortion must be considered. It is unfortunate, but who said life was easy or even fair?

 

[Irvine511]

It seems emotional abuse isn't a part of our women's health concerns.

 

[nathan1977]

Is there an issue with women going in for abortions only to find out they weren't pregnant to begin with? I've never heard of that. Or is this an attempt by pro-lifers (fuck, I hate that term) to rub their noses in it?

Abortion is a form of outpatient surgery. Yes?
Before you have a surgery (dental, dermatological, etc.), you have an initial exam for the doctor to evaluate you. Yes?
Should abortion be any different?

Even an EPT box tells you to go to an OB/GYN or consult with your doctor to confirm your pregnancy, for pity's sake. A standard aspect of that exam is an ultrasound. It is neither excessive, unnecessary, nor emotionally abusive. Arguing that it is, flies in the face of common medical practice, and is an overreach that even PP -- with all its vague assertions and implications -- refuses to back up.

 

[Irvine511]

Abortion is a form of outpatient surgery. Yes?
Before you have a surgery (dental, dermatological, etc.), you have an initial exam for the doctor to evaluate you. Yes?
Should abortion be any different?

Even an EPT box tells you to go to an OB/GYN pr consult with your doctor to confirm your pregnancy, for pity's sake. A standard aspect of that exam is an ultrasound. It is neither excessive, unnecessary, nor emotionally abusive. Arguing that it is, flies in the face of common medical practice, and is an overreach that even PP -- with all its vague assertions and implications -- refuses to back up.

What do the doctors say? We've heard your opinion and what you believe to be sound medical practice.

It would be nice to hear from someone with an actual background in medicine.

 

[Popmartijn]

Abortion is a form of outpatient surgery. Yes?

In the majority of situations, no. The most common method of abortion is medical.

BTW, have we established yet if the Wisconsin and North Carolina anti-abortion laws require a transvaginal ultrasound or not. I mean, if you want to harass a woman who wants to have an abortion, you do need to harass her well.

 

[anitram]

Even an EPT box tells you to go to an OB/GYN or consult with your doctor to confirm your pregnancy, for pity's sake. A standard aspect of that exam is an ultrasound. It is neither excessive, unnecessary, nor emotionally abusive.

It's NOT a standard aspect for anyone I've known (and certainly not at one of our best fertility clinics, where I attended). The standard means to confirm a pregnancy following a + HPT is a blood test for HCG serum levels (which must be over 25 mIU for a positive). As I said, the gestational sac does not form as soon as the HCG rises in the blood serum (produced by the early form of the placenta) and therefore the ultrasound would see nothing.

Moreover, if you have an ultrasound of you uterus, and I've probably had more than anyone here, including women who were pregnant several times (no joke), there is NO NEED for you as a patient to stare at the screen and be described exactly what is being seen. Moreover, it is also not necessary for a medical doctor to run the actual ultrasound - a tech is more than sufficient. I was never forced to look at any of the tumors on the ultrasound and believe me, I understood quite well that they were there.

This is all to say nothing of transvaginal ultrasounds which are intrusive and uncomfortable and entirely medically unnecessary.

I also ask, who is paying for these medical procedures? The taxpayers?

 

[nathan1977]

It's NOT a standard aspect for anyone I've known

We had ultrasounds for all four, as soon as we were pregnant. And I can say that each time we had someone there to explain to us exactly what we were seeing, especially since the first time we were six weeks pregnant and had no idea what we were looking at. (It's tricky for those of us who aren't medical professionals.)

As I said, the gestational sac does not form as soon as the HCG rises in the blood serum (produced by the early form of the placenta) and therefore the ultrasound would see nothing.

This may be true in the very early stages of pregnancy, but 40% of abortions take place after the tenth week, at which point not only has the sac formed, but the heart has begun pumping (in week six). And I can certainly testify that whatever you can't see at two weeks, you sure do at eight, ten or twelve.

 

[IWasBored]

This may be true in the very early stages of pregnancy, but 40% of abortions take place after the tenth week, at which point not only has the sac formed, but the heart has begun pumping (in week six). And I can certainly testify that whatever you can't see at two weeks, you sure do at eight, ten or twelve.

But if the sole purpose of the ultrasound in the bill is to confirm pregnancy, none of that still makes it a necessary procedure.

 

[nathan1977]

But if the sole purpose of the ultrasound in the bill is to confirm pregnancy, none of that still makes it a necessary procedure.

Except that the difference between aborting a four week old sac and a twelve or fourteen week old baby is substantial, from both a procedural perspective as well as a physical one. And given that some abortion providers have a history of lying to their patients about the ages of the babies growing inside them (Gosnell had a habit of lying to women about whether they were in the third trimester or not), a second -- and more objective -- opinion seems like a wise one.

Additionally -- I hope we can agree that the best choice is the most informed one. There are numerous stories of women who wanted an abortion and then changed their minds when they heard a heartbeat, saw the ultrasound, etc. Is that choice any less legitimate than the choice to abort? Should the option to change their mind not be afforded them?

 

[Jive Turkey]

Gosnell had a habit of lying to women about whether they were in the third trimester or not

Let's not use Gosnell as an example of an abortion doctor

 

[Pearl]

This isn't about abortion, but it does relate to women not being allowed to have dominion over their bodies:

Some inmates who spoke with the Center for Investigative Reporting said they were coerced by doctors into getting tubal ligation surgeries. The procedures allegedly took place between 2006 and 2010 at the California Institution for Women in Corona and Valley State Prison for Women in Chowchilla, which is now a men's prison, according to CIR.
Doctors conducted the surgeries "without required state approvals," and inmates and prison advocates said they were aimed at pregnant prisoners who were "deemed likely to return to prison in the future," CIR found.
Dr. James Heinrich defended the operations: In an interview with CIR, Heinrich said he provided an important service to poor women who faced health risks in future pregnancies because of past Caesarean sections. The 69-year-old Bay Area physician denied pressuring anyone.
Jezebel's Laura Beck reacted with outrage, saying, "Another day, another step toward living in an even more twisted version of The Handmaid's Tale."
Writing for Politicususa.com, Jason Easley said the report offers proof that "forced or coerced sterilizations aren’t something that just happen in other countries. They are happening in the United States of America."

Female Inmates Sterilized Illegally In California Prisons: Report

 

[nathan1977]

Let's not use Gosnell as an example of an abortion doctor

Was he not in fact an abortion provider who operated for decades despite numerous complaints filed against him?

We could always use the other doctors I've mentioned.

He's not the rule, but he is sadly not the exception either.

 

[anitram]

He's not the rule, but he is sadly not the exception either.

Yes he is. Don't be ridiculous.

 

[anitram]

And I can say that each time we had someone there to explain to us exactly what we were seeing, especially since the first time we were six weeks pregnant and had no idea what we were looking at. (It's tricky for those of us who aren't medical professionals.)

Of course you did. You and your wife presented as a couple who was very much committed and interested in having a baby.

Let's consider some other examples:

What about a couple who have had a couple of children born and die with a very serious genetic defect that is passed on and they decide that they no longer want to try to have children since the risk of them passing the gene on is too high. But they get pregnant accidentally. They don't wish to have another child die and their decision is made. Why should that poor woman be forced to stare at the screen and be described, in great detail, how the embryo is developing while somebody shoves an 8 inch transvaginal probe up her vagina?

What about a drug addict who is high as a kite most days and knows she can't/won't kick the habit and doesn't want to have the baby?

Or a young 17-year-old honor roll kid who gets pregnant accidentally but doesn't have a supporting family and wants to have an abortion so that she can take advantage of that full scholarship at a top university and go to med school like she's always planned?

Or a woman who was raped after a bar one night, or a teenager who was raped by her uncle who had been molesting her for years?

The more you write, the less I think we agree. You want to badger these women whose stories you know nothing about. And please don't tell me that this is about informed consent because no court that I am aware of has ruled that for informed consent you need to have a transvaginal probe up your vagina and you need to be forced to look at the ultrasound screen and listen to a narrative. If that was the case, half the medical procedures in the country would be performed without informed consent.

 

[Jive Turkey]

He's not the rule, but he is sadly not the exception either.

If you seriously believe this, then your idea of what goes on at an abortion clinic is terribly skewed. I'm not sure how anyone can carry on a reasonable debate with you past this point.
You might as well cite Hannibal Lecter as a fine example of a psychiatrist. Or John Wayne Gacy as a reason the clown industry needs better safety guidelines