Between a Woman and Her Doctor

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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Between a Woman and Her Doctor

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