Comments on: Chip, chip, chipping away at abortion access

By: baraqiel

baraqiel — Thu, 15 Apr 2010 15:56:31 +0000

@DirtyLaundry – Just because the procedure is legal until viability doesn’t mean that clinics will actually perform the procedure until viability. For example, the clinic where I normally escort will perform abortions only up to the 21st week. At the Planned Parenthood where I sometimes escort, they stop at 15 weeks. Once the patient is in the second trimester, the surgical procedure changes and not every clinic has a doctor who is qualified to perform that surgery.

Again, just because it’s legal doesn’t mean it’s accessible.

By: DirtyLaundry

DirtyLaundry — Thu, 15 Apr 2010 15:43:29 +0000

You seem to be missing my point. I do know that those are the only reasons women get late term abortions because those are the guidelines set for them. MY POINT is that if there were no guidelines the results might be a bit different.
However, I do agree that it might be difficult to find a doctor willing to perform a late-term abortion even if there were no restrictions.
“And no, it’s not true that women can access abortion services after 20 weeks anywhere they want. Most clinics won’t do them after 20 weeks”
Did you read past this sentence in SarahMC’s post:
“The current standard in abortion restrictions is viability: generally 22 to 24 weeks.”

By: mischiefmanager

mischiefmanager — Thu, 15 Apr 2010 13:56:00 +0000

@Pedimd: Also, doesn’t it worry you that he legislators want someone to come in and do an in-depth psych exam on the woman and that this would go into a permanent medical record? For what other procedure is this required? Remember also that legislators and anti groups around the country have attempted to gain access to these records for various transparently false reasons. They claim to want to examine a clinic’s safety record, for example, when in fact what they want to do is find out who the patients are, as well as jam up the clinic’s operations.

@Dirty Laundry: I repeat, the reason women get late term abortions is because there is an urgent medical reason for it. Either the woman’s life or health is at immediate risk, or the fetus is dead or so damaged that it would die on birth. I don’t know of any reputable doctor anywhere who would do an abortion on a 30 week pregnant woman just because she wanted one. And no, it’s not true that women can access abortion services after 20 weeks anywhere they want. Most clinics won’t do them after 20 weeks, and if you don’t live near a hospital that will do them, you’re screwed.

By: DirtyLaundry

DirtyLaundry — Thu, 15 Apr 2010 03:38:49 +0000

I also want to state that I agree with the term restrictions as they are now, in such that they restrict it to when the fetus can survive on it’s own.
Just in case anyone wanted to know.

By: DirtyLaundry

DirtyLaundry — Thu, 15 Apr 2010 03:29:20 +0000

@mischiefmanager: I meant that is where adoption would come in for these people who are pushing this bill. I NEVER said or even implied that I supported this legislation.
The is no evidence to suggest because there is no access. I believe the only country that does not have restrictions is Canada, and you cannot let one country be the determining factor. Sure there can be online polls but the answer to a poll and actual behavior can be quite different.
@Av0gadro: A woman has up to 24-30 weeks to get an abortion for any reason. I never said I didn’t support elective abortions at all, I said I support them up to a certain stage in the pregnancy.
“If you don’t want to be pregnant, no matter how “selfish” your reason, you shouldn’t be pregnant.”
Yes, and if a women decided at 30 weeks into her pregnancy that she didn’t want to be pregnant at that point an emergency cesarean section and adoption should be the next alternative. What is the point of ending the life of a 30 week old fetus that can survive on it’s own? My point was that unlike AmBam implied, term restrictions are not insulting to women.

By: pedimd

pedimd — Thu, 15 Apr 2010 01:34:44 +0000

@Avogadro and Baraqiel: Thank you. That was very helpful.

By: Av0gadro

Av0gadro — Thu, 15 Apr 2010 00:24:28 +0000

You’re missing that women have to be screened for any risk factor cited in a peer-reviewed journal, without setting limits or defining peer-reviewed. It’s a trap for clinics – there will be more paperwork, more expense, and more ways to inadvertently mess up and get a visit from a biased prosecutor.

By: baraqiel

baraqiel — Thu, 15 Apr 2010 00:01:16 +0000

@pedimd – I strongly recommend this post from Fugitivus: http://fugitivus.wordpress.com/2010/01/03/my-new-job/

Basically, a lot of states pass these laws such that the language includes penalties for noncompliance but no real definition of what compliance is. In other words, the law isn’t designed to help anyone or perform any function except giving an excuse to punish doctors.

In particular, the language of the law:
“Risk factor associated with abortion means any factor, including any physical, psychological, emotional, demographic, or situational factor, for which there is a statistical association with one or more complications associatedwith abortion such that there is 1 less than a five percent probability (P < .05) that such statistical association is due to chance. Such information on risk factors shall have been published in any peer-reviewed journals indexed by the United States National Library of Medicine’s search services (PubMed or MEDLINE) or in any journal included in the Thomson Reuters Scientific Master Journal List not less than twelve months prior to the day preabortion screening was provided;"

A woman is only considered to have given informed consent to an abortion if:
"At least one hour prior to the performance of an abortion, a physician, psychiatrist, psychologist, mental health practitioner, physician assistant, registered nurse, or social worker licensed under the Uniform Credentialing Act has:
(a) Evaluated the pregnant woman to identify if the pregnant woman had the perception of feeling pressured or coerced into seeking or consenting to an abortion;
(b) Evaluated the pregnant woman to identify the presence of any risk factors associated with abortion;
(c) Informed the pregnant woman and the physician who is to perform the abortion of the results of the evaluation in writing. The written evaluation shall include, at a minimum, a checklist identifying both the positive and negative results of the evaluation for each risk factor associated with abortion and both the licensed person’s written certification and the woman’s written certification that the pregnant woman was informed of the risk factors associated with abortion as discussed; and
(d) Retained a copy of the written evaluation results in the pregnant woman’s permanent record;"

According to wiki, PubMed has 19.5 *million* citations. It is now the responsibility of anyone who wants to perform an abortion in Nebraska to search all of these citations for any paper that has shown any "risk factor" as above described. Note that, according to the law as written, if a study found such a risk factor in, say, the 1980s but the study was since disproved, it still has to be included as a risk factor. Moreover, note the language used for the description of the written report — "at a minimum, a checklist". Would they really accept a checklist? Who knows? How are the evaluations supposed to occur? And so on.

But the section on punishment is quite clear — noncompliance opens the doctor up to all sorts of civil lawsuits and cost liabilities, including the following clauses:
"If a physician performed an abortion on a pregnant woman who is a minor without providing the information required in section 28-327 to the pregnant woman’s parent or legal guardian, then the physician bears the burden of proving that the pregnant woman was capable of independently evaluating the information given to her."

"Except in the case of an emergency situation, if a pregnant woman is provided with the information required by section 28-327 less than twenty-four hours before her scheduled abortion, the physician shall bear the burden of proving that the pregnant woman had sufficient reflection time, given her age, maturity, emotional state, and mental capacity, to comprehend and consider such information."

"In determining the liability of the physician and the validity of the consent of a pregnant woman, the failure to comply with the requirements of section 28-327 shall create a rebuttable presumption that the pregnant woman would not have undergone the recommended abortion had section 28-327 been complied with by the physician;"

And yet no information is given as to how any of these things could be proven or how this presumption could be rebutted.

(All from here: http://www.nebraskalegislature.gov/FloorDocs/Current/PDF/Final/LB594.pdf)

That, personally, is my problem with this law.

By: pedimd

pedimd — Wed, 14 Apr 2010 23:15:54 +0000

I don’t exactly see why the screening legislation is so bad — it’s redundant, but basically it’s just telling doctors to do what they do already. Abortion is a surgical procedure, so of course the doctor should get a medical history beforehand. And if a woman seems depressed or coerced, then the doctor should explore that with the patient prior to the procedure. And, finally, if the woman is mentally impaired enough, then she can’t give consent for the procedure. That doesn’t mean she can’t have it — just that her legal guardian or someone like that has to give consent for her. What am I missing?

By: mischiefmanager

mischiefmanager — Wed, 14 Apr 2010 22:04:00 +0000

This proposed legislation blew my blood pressure right over the top. Who the bloody hell do these cowboys think they are? When do we start having a public vote on whether men can procreate? How do demographics have anything to do with the decision to abort? And by situational, do they mean that if the sperm provider wants the pregnant woman to carry to term, she has to do it?

Nebraska goes on the list of states to boycott, along with Virginia.