Miri from Brute Reason has asked me to snork her work. It’s a post calling for a veto of a proposed abortion bill in Ohio. And I figured I could expand on what she wrote and write something educational… and then snork it.
[warning]Trigger Warning – Medical Descriptions of Abortion[/warning]
Now this Bill doesn’t “ban” abortion.
It just makes it much more convoluted. This will do two things.
- Abortion Providers who don’t meet the new rules will shut down. If one said “All abortions have to be performed by a left doctor”, you would be in the same ballpark as these kind of rules. They are designed to frustrate and make abortions less easy to perform resulting in a dearth of suppliers.
- It will drive the costs up. It will make an abortion a bigger burden on those who need it. Clinics that can follow the rules will have to pass on the extra costs to the customer.
In short? It’s designed to harm the supply and punish monetarily the buyers of abortions.
But here is the thing. If the supply of abortion does not meet the demand, the numbers of abortions do not drop.
There are between 40 to 45 million abortions per year across the world.
50% of those are unsafe and done in unsanitary conditions by non-medical professionals.
This results in around 70,000 maternal deaths per year and 5 million hospitalisations. By contrast? The skilled termination of pregnancy by a doctor ranks among the safest procedures.
Medically speaking? Abortions are classified according to why you chose them. Elective abortions are done at the choice of the mother. Therapeutic abortions are where a condition forces the choice of abortion in order to save the mother.
There are many reasons for a therapeutic abortion. To save the life of the pregnant woman; prevent harm to the woman’s physical or mental health; terminate a pregnancy where indications are that the child will have a significantly increased chance of premature morbidity or mortality or be otherwise disabled; or to selectively reduce the number of fetuses to lessen health risks associated with multiple pregnancy.
As for elective? Also many reasons. The most common one is responsibility and monetary reasons. The woman (and her partner) decide that they cannot responsibly care for a child at this point and time and that the child born out of this pregnancy may not receive the highest quality of care that the parents are capable of providing. Economics? Well that is simple. You can only afford to have x no. of kids and x + 1 child would cause an economic destabilisation of your family.
AKA I have to work 2 jobs to put food on my kids plates and even then they are eating junk. So why do people do this for economic reasons? In the simplest terms “When you have food for 4 people but you need to feed 5, then 5 people starve”. It’s hard to understand why this occurs, but if you thiink carefully as to how families eat. Food is split between members. So if 5 people eat 4 people’s food then all 5 are technically starving. Not all starvation is the acute starvation that we associate with Africa. Chronic starvation is bad too. But I digress.
Before we move on to the “types of abortion” we must look at one more type. The “natural” abortion or a miscarriage. Depending on individual between 30 to 50% of all conceptions make it to implantation. The biggest cause of abortion is ironically conception. In order to give the world a population of 7 billion, there would have been around 7 billion miscarriages.
The thing is at an early stage this is so “eventless” that most people never notice. In fact the Christian argument of ensoulment at conception and the often ludicrous claims from the very hippyesque Crunchy Parent brigade about feeling the presence of their child at conception is laughable in light of this fact. That in some cases more zygotes and foetuses die without the parents even realising it. That the biggest abortionist is “god” and that crunchy mums who claim to have “been communing with their baby” probably weren’t communing all that much with the zygotes that didn’t make it. It’s sad to think about but that’s unfortunately how nature works.
The human uterus is not a masterpiece of form and function, it is an evolutionary product of “It works well enough”. Our K-Selected nature means that a reduced fertility rate is actually of benefit to us because when children are spaced out they learn better and survive better.
Abortion is classified as “Safe” and “Unsafe”.
When we discuss abortion in the developed world we are discussing safe abortion.
Let’s look at Medical Abortions.
In the majority of the developed world the norm for abortions is a MEDICAL abortion. So when pro-lifers claim it’s all doctors cutting up foetuses and using vacuum cleaners with funky attachments up the cervix, they are kind of “lying”.
Roughly 90% of abortion in the UK occurs within the first trimester and is usually done via medical methods. In fact it is a testament to the lack of availability of these to American women because the US rate of first term abortion is far lower than other nations.
The usual method is using Mifepristone (hormone competitor) or Methotrexate with a Prostaglandin Analogue. They are effective for around 9 weeks of gestation. In very early abortions, up to 7 weeks gestation, medical abortion using a Mifepristone–Misoprostol combination regimen is considered to be more effective than surgical abortion (vacuum aspiration), especially when clinical practice does not require examination or collection of tissue. Regimens using Mifepristone, followed 24–48 hours later by buccal or vaginal Misoprostol are 98% effective up to 9 weeks. It is also the first line of treatment for second trimester abortions and if this fails a surgical option may be taken.
It is cheap, effective and above all less invasive for the woman.
Upto 15 weeks the procedure of choice is aspiration either electric or manual suction is applied to remove foetus and placenta. The basis is the same the apparatus varies.
The other welll known one is called a D&C in medical parlance. It stands for Dilatation and Curretage. This is the “standard” WHO abortion. It is done for a variety of other issues such as testing for malignancy and examination of Abnormal/Dysfunctional Uterine Bleeding. The walls of the uterus are scraped with a sharp bladed instrument that removes the walls of the uterus. Now you may wince at this, but the walls of the uterus are not supplied with pain fibre so this does not hurt.
Above the 15th week till the 26th the technique of choice is D&E (Dilatation and Evacuation) which is the opening of the cervix, rupture of the membrane and removal of contents via surgical instrumentation. Premature labour and delivery can be induced by prostaglandin and amnion injections of saline or urea solutions.
This is where the most controvertial procedure exists. IDX or Intacct Dilation and Extraction. Or to the American Infidels who read my blog? Partial Birth Abortion. We won’t go into too much detail, but it involves the rapid delivery of the foetus. There are some advantages to this procedure. It is rapid and the foetus is delivered in one piece with little trauma to the woman and with low usage of anaesthesia. This makes it an ideal procedure for use during emergency abortion for women of unknown “work up status” and also for women who wish to hold their child.
We will digress here to quash a major notion that mothers don’t wish to hold their child. This is a late term abortion procedure. The head of the foetus is reduced or collapsed in utero to a more passable size and labour is induced causing the foetus to be expelled. The foetus is effectively destroyed in utero and removed in one piece. The difference between this and D&E is that the foetus has to be dismembered in order to be removed. Some mothers want to bond with even a dead child. I have made enough footprints of miscarried, still birth and aborted children to know that.
It is banned in the USA. It is the bogeyman of abortion. If one listened to the pro-lifers you would think every abortion is this. It’s not. In it’s heyday in the USA around 0.17% of all abortions were this procedure. It is primarily an emergency procedure to save the mother’s life. A friend of mine had this done, her baby could not urinate and his bladder had swollen to the size where it crushed his heart preventing pumping. The foetus was delivered via this method. She held him, had footprints done to remember him and even had a funeral. This would not have been possible had they done a D&E and would not have helped her with closure and had the emergency procedure to save her life take more time.
The other options include Hysterotomy. This is the most dangerous of the methods used and basically is the same procedure as a C-section. It’s no longer done except in cases of Placent Accreta (A serious condition where the placenta attaches to the muscle wall of the Uterus rather than just the surface layers. This can kill the mother during the birth.
Per Vaginal Delivery of foetus can also be done. The two methods of abortion during “late” term are the IDK and Hysterotomy. Less than 0.2% of all “abortions” are these. They are tragic rarity done in cases of severely disabled children, incest, rape.
As for Unsafe Abortion?
Many women across the world who either cannot afford an abortion or cannot access one opt for unsafe abortion. I wrote about experiences in the Philippines quite early on in my piece “The Rise of the Backstreet Abortionist“. This can lead to severe complications, such as incomplete abortion, sepsis, hemorrhage, and damage to internal organs.
The usual methods are by using “herbal” abortifactents, trauma to the abdomen (I met a woman who hurled herself from a window to cause an abortion) and by rupturing the uterine membrane with a sharp object (the infamous “Coathanger abortion”).
Now that we have the brunt of the physiology done we can look at some stuff…
Banning abortion does not reduce abortions.
On average, the incidence of abortion is similar in countries with restrictive abortion laws and those with more liberal access to abortion. Simple provision of contraception would result in about 14.5 million fewer unsafe abortions and 38,000 fewer deaths from unsafe abortion annually worldwide. Provision of safe abortion would drop those deaths further.
So what does this mean for Ohio?
With thiis basic knowledge in hand let us look at what Ohio’s “regulations mean”.
Doctors must explain to patients seeking abortion how their foetus’ nerves develop, and to tell them that, even in the first trimester, a foetus can feel pain.
There is no scientific evidence that foetuses can feel pain. In fact, pain responses are often “less” in new born babies than in older ones. There is no evidence to suggest any of this and this is “bunk science”. In fact the most WIDELY accepted rational figure for pain is around 29 to 30 weeks and even then it’s not fully developed.
There is no scientific evidence for this and there is no logical reason why this would be the case. It’s like claiming that shaving your beard causes testicular cancer. You may as well claim that abortion empowers Moon Nazis and be done with it for all the validity this statement has. The uterus is an effector organ. The ovaries and pitutary gland are responsible for hormonal imbalances that promote BRCA1 gene related breast cancer. To make this claim is to not understand the basic physiology of pregnancy, the uterine cycle and how cancer occurs.
Abortion providers in Ohio must be within 30 miles of a private hospital – it cannot be a public hospital. So if there are no non-public hospitals within 30 miles of an abortion clinic, then the clinic must shut down.
Why? It’s cheaper for the “state” to pay for an abortion or the “complications of abortion” (*lightning and thunder*) than it is to pay for disability costs or indeed “child benefits for poor families”.
Nope, it’s sneaking Christianity via the backdoor and crippling the supply of a medical procedure. In the rough parlance it is called a “Coathanger decision”.
Doctors must inform patients seeking abortions exactly how much money the clinic made from abortions within the past year, and how much money the clinic stands to lose if the patient chooses not to get an abortion.
This is to shock people into going “YOU MAKE MONEY OFF SOMETHING PEOPLE NEED! YOU HEARTLESS MONSTERS”. This is a groundwork law to make doctors out to look like the benefit of the suffering of others.
No abortion doctor I am aware of has done abortions without suggesting to the mother to utilise proper contraception. In “business parlance” it’s “shooting yourself in the foot”.
Medicine is the only job that seeks to put itself out of a job. A lot of what doctors do is to reduce incidences of disease. If we thought like the way this rule implies we think then I would be telling you to eat naught but Big Macs and that Seatbelts are for Squares and Clean Drinking Water Reduces Your Immunity To Bacteria and you should totally eat uncooked chicken
We make money on Abortions. If we didn’t then you wouldn’t have any professional abortionists, you would have amateur ones. And there is nothing more terrifying in this conversation than the term Amateur Gynaecologist.
There is a conflict of interest in purchasing a cup of coffee but we don’t have to dance through fucking accounts of Starbucks everytime I want a latte. And neither do I need the shoe size of the man who picked my coffee because the next one is everyone’s favourite way of making abortions that much more horrible for those involved.
Before this bill, patients seeking abortions in Ohio were already required to view an ultrasound of the foetus. Now, the doctor must describe the foetus visually and explain the current development of its features. Victims of sexual assault are not exempt, and the patients must pay extra for the ultrasound.
This is just “taunting” women who want abortions by making an already emotional procedure (for some) more stressful.
In the case of first trimester pregnancies this is a pointless bit of rigmarole designed to make the procedure of the majority of abortion seem more complicated than it actually is. While I am not “taken” on the notion of trans-vaginal ultrasound being invasive, I am however coming from a ethos where patients care more about the disease than any discomfort in the treatment, so it isn’t as much of a problem in my experience, but if women in the USA find it invasive then it probably is invasive to them.
What it is though is unnecessary. You may as well demand women do the Macarena before they are allowed to have an abortion.
Extends the waiting period for abortion to 48 hours, and eliminates the option for women to bypass it because of a medical emergency or as a victim of rape.
This just makes it harder to get an abortion. Reduced clinics plus this mean that most people will have to waste up to a week travelling to a place where they can get an abortion. And again it makes it harder for rape victims to get help and delays in medical emergencies can kill. This is just a dangerously stupid law. It inordinately punishes the poor (days off work?), rural people and generally is meant to traumatise women into “Just Accept It”. Which as we know doesn’t work.
Before, a doctor could get a medical waiver to bypass these restrictions if the pregnancy was causing health problems. But now, doctors will only be able to get those waivers if the potential health risks are so great that the pregnant person could die.
There are two indicators for bad outcomes in any disease. Mortality and Morbidity. A disease may not be very good at killing people, it may be excellent at harming them in other permanent ways. Rubella is a great example. Harmless to the mother, great at harming foetuses.
Punishes doctors who don’t comply with the new restrictions with a felony charge and up to a $1 million dollar fine.
This causes doctors to leave the practice. While it harms careers, medicine is a more recession proof economy than most. In light of “laws like this one” most doctors stop doing the procedure.
Doctors have stated that they oppose this and other bills like this because it compromises patient care. It is a bill designed to provide an inferior, unscientific, unprofessional and traumatic service to women at a time when they require compassion. It is a bill designed to increase the cost of abortion, decrease the availability and reduce the quality of care.
It is a bill designed to force the moral choices of Christian Fundamentalists onto others under the guise of “Won’t Someone Think of the Children” and with a healthy dose of “Speaking as a Mother”. Any non-evidence based approach to Medicine can only be called one thing. Quackery.
And to the pro-lifers? IF you don’t like abortion then don’t have one. Don’t force your choices onto other women.