Amelia Arnold Wednesday 2 May 2012 2:46pm

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It’s an interesting time to own a uterus in the United States. The debate between pro-choice and pro-life is as fierce as ever with a plethora of laws proposed and passed in recent months with the ability to have a colossal impact on the reproductive choices available to women and their families. Here are just a few of these pieces of legislature, both proposed and approved. Frightening.

“The Wrongful Birth Bill”

- The Bill: Senate Bill 1359, passed in Arizona in early March and headed for the state House, aims to exempt doctors from medical malpractice suits for effectively lying to their patients about the health of the foetus. If a doctor were of the opinion the pregnancy would be terminated after the patient learnt of a congenital abnormality, the doctor would be legally protected if they chose to withhold this information from the patient and her family. Oklahoma and Arizona are considering similar bills.

- The Debate: It’s pretty clear why people are outraged over this. For one it’s not the place of doctors to make this huge decision for their patients. Doctors are meant to allow their patients to make free and informed decisions about their health, not withhold information that could have life changing consequences. Withholding vital foetal health information goes against everything doctors are taught and prevents the family from effectively preparing for life with a child affected by a congenital condition if they were to choose to continue the pregnancy.

- The Facts: Preventing patient informed choice is medical malpractice, pure and simple. The most troubling thing about this proposed law is that politicians are enabling doctors to let their personal views come before their patients’ reproductive rights. They are enabling doctors to LIE.

- What this means for women: Under Senate Bill 1359, a women could carry her child for 9 months and deliver a child with a congenital abnormality after being reassured for the whole pregnancy her baby was healthy. Not only would this be a huge shock and could create trust issues with future doctors, it could be psychologically damaging to the mother, which could impact negatively on the care the disabled child would receive.

“The Foetal Pain Bill”

- The Bill: House Bill 954, passed in Georgia initially outlawed abortion after 20 weeks gestation under all circumstances, but has been revised to make an exception to ‘medically futile’ pregnancies and pregnancies dangerous to the mother’s health. No exceptions exist for rape or incest. Nebraska, Idaho, Indiana, Kansas, Oklahoma, and Alabama have similar ‘foetal pain’ restrictions and North Carolina restricts abortion after 20 weeks.

- The Debate: People are discussing the circumstances surrounding a ‘medically futile’ pregnancy and the conditions under which the abortion must be performed. There is also debate over what gestational age a foetus can experience pain, and the medical and psychological consequences of carrying an unwanted pregnancy. Dr. George Leach, an Emergency physician, gives his opinion here

- The Facts: The foetus must be diagnosed with a genetic or congenital illness that is incompatible with life for a pregnancy to be considered medically futile, and when aborted the foetus must be delivered alive for the patient and the doctor to avoid legal prosecution. This will most likely mean an unnecessary C-section, as inducing labour can fail early in pregnancy. No exemptions are made for the pregnant woman’s emotional or mental condition either, including suicide attempts. As for the ‘foetal pain’ arguments, scientists believe a foetus will not feel pain until at least 25 weeks, and likely not until 28 weeks gestation.

- What this means for women: Within the media women have been described as ‘barn-yard animals’ in relation to this bill, with individuals claiming that women must continue pregnancies as barn-yard animals do, whether the foetus is dead or alive. The bill will make it difficult for doctors who work with high risk or difficult pregnancies, as they could face jail if an abortion is performed outside of the specified guidelines.

“Mandatory ultrasounds for all abortions”

- The Law: In a collection of US states women will be required to have an ultrasound at least 24 hours before terminating a pregnancy, including pregnancies that are incompatible with life. There are a range of conditions in addition to the ultrasound, depending on the state.

- The Debate: the main argument here is that it would be psychologically damaging for a women to hear the foetal heartbeat and the physical description of the foetus, and then have to replay this information over a 24 hour period before being allowed to have an abortion. Many are claiming the law is designed to get the mother to change her mind, and some are saying the law aims to ‘guilt’ potential mothers into continuing their pregnancy.

- The Facts: In Texas it is currently law that a woman must have an ultrasound and listen to the foetal heartbeat prior to being granted an abortion. Alabama has the least severe law – women must have an ultrasound but are given the choice to view the images. It is being proposed in North Carolina that in addition to the mandatory ultrasound, the doctor that would perform the abortion is required to verbally describe the foetus throughout the ultrasound procedure and the woman must certify she has seen the ultrasound images. It is also being proposed that women must then wait 24 hours before being allowed to return for an abortion. However, in some states under certain circumstances women are not obligated to undergo the mandatory ultrasound, for example in the event of a pregnancy resulting from rape. Thankfully, Oklahoma has ruled the ultrasound bill as unconstitutional and Idaho has also thrown it out.

- What this means for women: For some women, having a child is not something that was planned to happen. They may want a child later on, or they may not want any children. Also, different women have different views on congenital abnormalities. But I personally don’t believe having an abortion is a choice that a majority of women make lightly. So to legislate that women must have this obligatory ultrasound and possibly also listen to a description of the foetus, and then have to reflect on this experience before undergoing an already undoubtedly traumatic termination, is insulting to the intelligence of all women. Another scenario this law doesn’t always consider is the necessity of the ultrasound and verbal foetal description in cases where the pregnancy is being terminated as a result of rape or irreversible foetal abnormality – not all states that propose this law show special consideration to those wishing to terminate due to extenuating circumstances.

“Personhood USA”

- The Law: The Personhood movement believe that human life begins at conception, and the ultimate aim of the movement is to pass a Federal Amendment deeming “legal personhood be granted to all human beings from the beginning of their biological development”.

- The Debate: The controversy surrounding this legislation is divisive and the most heated of all. The Personhood Amendment aims to give a foetus equal rights to life, but many argue that the rights of the mother come before those of the foetus, referencing the well known philosophical dilemma, ‘who came first, the chicken or the egg?’. However a growing group of mainly religious activists are in support of the Personhood Amendment, and claim 50 million ‘victims’ have been killed since Roe v. Wade decriminalized abortion in 1973.

- The Facts: Personhood poses a significant risk to the advances in Reproductive Medicine. If a foetus is granted a right to life from conception, women face a risk that medical decisions could be made about their body without their consent if a medical professional deems the choice in the best interests of the foetus, regardless of the best interests of the mother.

- What this means for women: Under the Personhood Amendment, in America a stillbirth could be considered a homicide. A woman could undergo life-threatening surgery without her consent. Assisted reproductive technology labs could be outlawed. Contraceptives could be a thing of the past. Reproductive Medicine would be completely transformed to revolve around the rights of an accumulation of cells. I know ‘cells’ sounds harsh, but if the Personhood Amendment somehow passes it would be scientifically true. Below are a series of videos with several cases related to the Personhood movement.

House Bill 2036 (Arizona) – The “pregnant before you’ve ovulated” Bill

- The Bill: This Bill reviews the gestational age of a foetus, which is to be calculated from the last menstrual period of the pregnant woman. The Bill also bans abortion after 20 weeks of gestation with the exception of for the health of the mother on the belief that the foetus will experience pain from an abortion after this time.

- The Debate: The main points of controversy surrounding HB 2036 are the beliefs that women can be considered pregnant even before conception, and that the Bill actually bans abortion after 18 weeks.

- The Facts: According to the American College of Obstetricians and Gynaecologists, the best practice for estimating gestational age prior to ultrasound is by the calculating the first date of the last menstrual period, so this Bill merely clarifies the legality surrounding the gestational age of the child.

- What this means for women: Women are not being limited to abortions before 18 weeks, but 20 weeks after the first date of the last menstrual period as before.

Is it troubling to know that I am barely skimming the surface of the potentially dangerous and ethically questionable laws being proposed and approved in the U.S?

My poor backspace button has resigned after the bashing received from writing this article – there’s just not enough time to explore all of the craziness here. But first and foremost, the pieces of legislature outlined above take away the freedom of choice that women should be entitled to have regarding their own bodies. That is the main point here.

Wade through all of the numbers and cases and ultimately the thing that’s being lost is reproductive freedom. When was it decided that politicians are entitled to decide if a woman is forced to have a caesarean over a natural birth without her consent? Whose right is it to deprive a woman of an abortion in the face of a life-threatening pregnancy? And why in the name of all things sane in 2012 must a woman be forced to view a propaganda filled website and be subjected to an emotional guilt trip before exercising her right to choose to continue or terminate a pregnancy that would dramatically change her life?

These choices are of a deeply personal nature, and whilst legislature surrounding maternal and foetal health is necessary to protect the rights of both mother and child, the line has to be drawn when the best interests of the mother are simply being ignored. It’s high time politicians stop hawking their personal views and political agendas and wake up to the need for women to be free to make choices regarding their reproductive health. Doctors take the Hippocratic Oath upon graduating from medical school. They claim they will do no harm. It’s clear from the laws outlined above that legislators in the U.S. are making liars of a new wave of doctors.

Amelia is currently completing her Masters in Reproductive Medicine and has a strong interest in women’s health, psychology and reproductive ethics. She is travelling to Nepal in July to learn about maternal and neonatal medicine in a third world community hospital (you can follow her blog here and click here to donate towards medical supplies for the maternity and NICU wards).