As a practicing obstetrician and gynecologist in Dallas for the past 39 years, one of the main lessons I have learned is you can never “walk in someone else’s shoes.”
Everyone has their own story and personal history. Even as their physician, I can offer medical expertise and options, but ultimately my role is to support my patients in their life decisions.
The issue of female reproductive rights is of critical importance to many women in this country, especially in Texas. It is also a crisis for their treating physicians. Not to be able to offer patients options for continuing or not continuing a pregnancy or simply family planning limits medical decision-making and puts the patient at risk. The fear of prison time and large fines place the physician in a situation of not being able to provide good, or even adequate, medical care.
Compromising a Women’s Health
Regardless of whether you yourself would terminate a pregnancy, options should be available and given based on individual circumstances. Many women I have cared for have had to make painful decisions regarding pregnancy.
Much has been written about potentially life-threatening conditions, from ectopic pregnancy, maternal hemorrhage, and life-threatening maternal infections. It is estimated that 700 women die from pregnancy and delivery complications in the United States each year.
No Two Situations Are the Same During Pregnancy
Furthermore, many non-obstetrical problems can occur in pregnancy. Cancers, for example, can occur during pregnancy. Several years ago, a 34-year-old patient of mine with two young children at home was diagnosed with an aggressive leukemia. Three oncologists told her if she did not terminate the pregnancy and start chemotherapy immediately, she would probably die within the year. She chose to continue the pregnancy and ultimately delivered a beautiful baby girl, starting chemotherapy as soon as it was medically safe. However, she died of leukemia when the baby was three months old.
A 29-year-old patient of mine was diagnosed with breast cancer when she was 14 weeks pregnant. Again, oncologists advised her to terminate, have a mastectomy, and start treatment immediately. She did terminate the pregnancy and had breast surgery two weeks later, followed by chemotherapy. Six years later, she is still alive.
Three years ago, another patient tried for two years to conceive. Finally, at her 19-week sonogram, she learned her baby had microcephaly and multiple congenital anomalies not consistent with survival. She tested positive for a virus associated with fetal microcephaly and sought multiple opinions from maternal fetal specialists. The patient was advised by all the physicians to terminate the pregnancy.
At that time, she had one week to decide under Texas law. It was excruciating for her. If this happened today in Texas, she would have no options available to her.
Because today, many patients facing fatal genetic anomalies or other fatal congenital anomalies are in the situation of having no option to continue or not continue the pregnancy.
Female Reproductive Rights are Vital When a Pregnancy Occurs
Many believe women who choose to terminate a pregnancy are irresponsible and use termination as birth control. This has not been my experience.
Women get pregnant after having a tubal ligation, when using contraception with an efficacy rate between 98% and 99%, and with a partner who has had a vasectomy. A woman who has an IUD in place or is using birth control is not seeking pregnancy — yet they can, and some do get pregnant. Birth control pills, patches, IUDs, hormonal injections, and sterilization procedures all have a failure rate. Some women decide another pregnancy is totally out of the question for them, medically, financially, physically. Others decide if another pregnancy was meant to be, they will accept it and continue the pregnancy.
Regardless, women should be able to plan and raise a family, if that is their choice, in a safe and healthy situation.
All of these situations concerning female reproductive rights are very real and difficult. These are not cavalier decisions, nor are they decisions any woman wants to make. For the overwhelming majority, it is a hard and very emotional choice. Every individual has their own circumstances, and their decisions are their own.
As a physician, I offer the best information I can. I offer to get them second and even third opinions. Most importantly I give them support. But you can never walk in someone else’s shoes.
