Between a Woman and Her Doctor

A story about abortion you will never forget

| September 16, 2004

The limitation of women's access to safe abortions has claimed a number of casualties over the years, from inadequate clinical care to unsafe non-clinical procedures. Another tragic side effect of anti-choice legislation, however, is the severely limited ability of women and doctors to perform second- and third-trimester dilation and evacuations, even for women whose fetuses are not alive. Dilation and evacuation is the safest means of removing a larger fetus from a woman's body -- the American Journal of Obstetrics & Gynecology in 2002 reported that 20 percent of women who went through labor and delivery abortions in their second and third trimesters had complications, whereas only four percent had complications with dilation and evacuation (D & E). Yet the ability of doctors to perform D & Es is rapidly dwindling. Fewer than seven percent of obstetricians are trained to do D & Es, and those that are, are almost always over 50 years old. Thus, the medical community is woefully unprepared for situations that require D & Es, like that of Martha Mendoza.

Mendoza's doctor told her that her 19 week old fetus was not alive. Her doctor explained her options: she could opt for the more traumatic and dangerous procedure of chemically inducing labor and delivering the already-decaying fetus at a local maternity ward, or she could wait an indefinite amount of time for a safer and saner D & E, which offered the additional possibility of determining the cause of fetal death. When Mendoza chose the D & E, her doctor was forced to recommend a specialist in a nearby county. The wait? Almost a week. As Mendoza unsuccessfully tried to find a clinic that would perform the procedure sooner, she experienced persistent and disturbing uterine bleeding. Though Mendoza increasingly began to feel the imminence of a traumatic and dangerous spontaneous abortion, she received absolutely no help from the many doctors and hospitals she contacted. Nobody could do a D & E, so nobody could help her. Her requests were often met with fierce defensiveness and evasion, and she was forced to wait almost a week, living in motel rooms and continuing to bleed, until the procedure was finally done.

Though Mendoza later had a healthy baby, her case could easily have been disastrous, and many other women are currently in her predicament. The lack of access to D & Es means that women's lives and reproductive health are under constant and serious threat, and the Bush administration's push for a ban on partial birth abortion is only intensifying that threat. The intense debate over abortion has clouded a critical fact -- overly intrusive abortion laws threaten all women that need D & Es, whether or not their fetus is even alive.
-- Brendan Themes

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