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    Op-Ed
    Thursday, April 25, 2024

    Indiana abortion law will produce suffering

    Even after years of education, training and experience as an obstetrician/gynecologist, I am never prepared to deliver the news that a pregnancy is abnormal. There is no good way to tell a pregnant woman–a woman who may already be wearing maternity clothes, thinking about names and decorating the nursery–that we have identified a fetal anomaly that can lead to significant, lifelong disability or even her baby's death.

    In such situations, physicians have two responsibilities. First, we must always be supportive of the mother or family who has suddenly been confronted with the loss of an imagined ideal pregnancy and child. And second, we help them understand that they have options, one of which is the termination of the pregnancy.

    Unfortunately, that's no longer the case in Indiana, where a new law signed by Gov. Mike Pence, R, punishes doctors if they perform abortions for women because of their fetus' race or sex, or after a diagnosis of disability. Indiana's state government is intruding on the doctor-patient relationship at one of its most vulnerable, sensitive times. It is bad medicine.

    As a mother as well as a doctor, I am acutely aware of the intensity and fear of the unknown inherent in pregnancy and childbirth. Indiana now expects women who live here to experience them without trusting their doctors' knowledge and with strict limits on how doctors may treat patients–limits driven not by science or research, but by politics.

    Supporters of the new law, such as Pence, say the measure "affirms the value of all human life." And yes, some women do choose to carry abnormal pregnancies to term. I am honored to care for them and their babies.

    Not every woman can handle such horror.

    Trisomy 13, or Patau syndrome, can leave babies with one eye, no nose, kidney defects and a spinal cord without skin covering it. Most are stillborn, but of those that are born alive, more than 80 percent die before they turn 1, only surviving that long after cardiac, spinal and other surgeries.

    Spinal muscular atrophy, one type of which is Werdnig-Hoffman disease, is characterized by rapid neurologic degeneration, causing an infant to die within a year because of respiratory failure.

    Duchenne muscular dystrophy is a sex-linked disease that causes muscle degeneration starting around 2 years old leading to profound weakness, a need for braces and wheelchairs by age 10, and eventual paralysis. This disease occurs almost exclusively in boys and carries a life expectancy of less than 25 years. It can't be detected with any existing prenatal test. But because Indiana's law also prevents termination of a pregnancy for reasons of gender, parents who already have a child with this horrible disease, and who find out they're expecting a son, will have a 50 percent chance of their newborn also having the disease. And they won't be able to do anything about it.

    Preventing women with these fetal diagnoses from choosing abortion forces them to watch their children die a slow, painful, premature death.

    For those mothers who will now be forced to deliver babies they might not otherwise have had–the babies "saved" by this law–Indiana sets aside no additional funding or services. These babies will require long and repeated hospitalizations, surgeries, office visits, physical and speech therapy, home nursing care, and more. Rather than protecting life, the state has only prolonged suffering.

    There is no room for legislators in the exam room, and there is no space for politics in medical decisions. This law forces me to ignore my medical training and stand idly by while my patients suffer. This is not the care I want to provide, nor is it what my patients deserve.

    Katherine McHugh is an obstetrician/gynecologist in Indianapolis. She wrote this for the Washington Post.

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