ABC’s Private Practice Takes On Teen Pregnancy

Last night, ABC’s Private Practice took on the very challenging issue of teenage pregnancy in a story arc that began with last week’s show when 15 year old Maya announced to Addison that she was pregnant. The show well depicts the shock, the emotion and the difficulty of handling the pro-choice/pro-life discussion when a teenager is at the center of the discussion.  It was a raw episode at times and in the end we are left with a 15 year old opting to keep her pregnancy.  It’s tempting to criticize the writers for not focusing enough on Maya but, in truth, the show was more realistic than you may realize.

In the episode, Maya’s mom, Naomi, basically freaks out from the start. This pro-life mom first storms out of the room then tries to force an abortion onto her daughter. When that doesn’t work, she shows Maya a woman in labor only to have Maya entranced by the sight of a baby and determined to keep the pregnancy even more. The show concludes with Naomi leaving the building not talking to anyone, in tears. True to life? You bet. (more…)

*This blog post was originally published at Dr. Gwenn Is In*

UN’s Sex Education Guide Generates Opposition

The UNESCO (United Nations Educational, Scientific and Cultural Organization) proposed sex education guidelines are stirring up quite the controversy - before they are even published! I will give you one guess who is attacking them - oh come on, guess!

That is correct - conservative and religious groups are attacking the guidelines because of their portrayal of issues like sex education, abortion and homosexuality. Specifically, the guidelines describe sexual abstinence as only one of a range of choices available to young people to prevent disease and avoid pregnancy. The guidelines also dare to suggest that families discuss masturbation with their children, starting as young as five, but definitely with preteens.

UNESCO has been working on this document for two years, drawing on experts around the world and more than 80 studies about sexuality education. The goals of the document is to help countries, especially developing countries reduce sexually transmitted infections (STIs) and illegal abortions, as well as improving the overall sexual health of all people.

Why shouldn’t we be blocking these guidelines? Well, here are a few reasons. WHO estimates:

• 340 million new cases of curable STIs (syphilis, gonorrhea, chlamydia and trichomoniasis) occur annually throughout the world in adults aged 15-49 years.
• In developing countries, STIs and their complications rank in the top five disease categories for which adults seek health care.
• Infection with STIs can lead to acute symptoms, chronic infection and serious delayed consequences such as infertility, ectopic pregnancy, cervical cancer and the untimely death of infants and adults.
• Between 10% and 40% of women with untreated chlamydial infection develop symptomatic pelvic inflammatory disease. Post-infection tubal damage is responsible for 30% to 40% of cases of female infertility.
• Women who have had pelvic inflammatory disease are 6 to 10 times more likely to develop an ectopic (tubal) pregnancy than those who have not, and 40% to 50% of ectopic pregnancies can be attributed to previous pelvic inflammatory disease.
• In pregnant women with untreated early syphilis, 25% of pregnancies result in stillbirth and 14% in neonatal death – an overall perinatal mortality of about 40%.
• Syphilis prevalence in pregnant women in Africa, for example, ranges from 4% to 15%.
• Up to 35% of pregnancies among women with untreated gonococcal infection result in spontaneous abortions and premature deliveries, and up to 10% in perinatal deaths.
• The presence of an untreated STIs increases the risk of both acquisition and transmission of HIV by a factor of up to 10.

Need I say more?

This post, UN’s Sex Education Guide Generates Opposition, was originally published on Healthine.com by Nancy Brown Ph.D..

Ultrasound Image Of Baby Girl Sucking Her Thumb Changes Parents’ Minds About Aborting Her

via The ultrasound that saved a baby girl’s life - guest post by Dr Linda M. Lee at KevinMD.com. Originally posted at Dr. Linda’s Life Lessons

“We already have two girls at home and we want a son. We have too many girls.” My eyes welled with tears as I thought of the fate of this poor, helpless baby who had no voice, no rights, and who was about to be “attacked just because she was female.”

I pulled the ultrasound image from the chart and my heart quickened. The image was of the perfect outline of the precious little baby girl sucking her thumb. The timing of the ultrasound image was perfect.

I proudly showed them the image, and the look and emotion on their faces changed.

“That is our baby?” they inquired. “We didn’t think it had that much form, and she is sucking her thumb already?”

Read the rest of the post here or here.

…

Score one for ultrasound!

The Hyde Amendment: Abortion Coverage and Health Insurance Reform

I’m going to wade right in here.  I am not a fan of abortions, but neither am I of amputations.  Both are sometimes necessary.  To me, too often abortion opponents forget the mother.  She is a life present before us.  Her care should not be forgotten.

I have been listening and reading the discussions over how the abortion coverage may sink health care reform.  I think it would be a shame if this one issue does sink reform.

If my understanding of the Hyde Amendment (and it’s amendments over the years) is correct the Federal Government covers the cost of abortions in cases of rape or incest or when the life of the mother is at risk.  It does not cover the cost when the health of the mother is at risk:

With these bans, the federal government turns its back on women who need abortions for their health.  Women with cancer, diabetes, or heart conditions, or whose pregnancies otherwise threaten their health, are denied coverage for abortions.  Only if a woman would otherwise die, or if her pregnancy results from rape or incest, is an abortion covered.  The bans thus put many women’s health in jeopardy.

I agree with opponents who do not wish to cover abortions for simply any reason (i.e. the timing for a pregnancy is not good, etc).  Abortion should never be used for birth control.  That should be done using birth control pills, condoms, abstinence, etc.

Currently, the only abortions available under Medicaid are the ones mentioned above.  I think it’s a shame that distinctions can not be made to provide coverage for a woman who’s HEALTH would be negatively affected by her pregnancy.  All insurance policies should do so in my opinion.

Opponents of abortion want language that would prohibit any private insurance company that accepts federal funds from offering to policyholders abortions other than those already eligible under Medicaid.

Sources

How Abortion Could Imperil Health-Care Reform by Michael Scherer; Monday, Aug. 24, 2009; Times.com

What is the Hyde Amendment? (July 21, 2004); ACLU

In Response To Dr.Val On The Abortion “Issue”

Abortion and the intense debate about it in an otherwise enlightened (?) country was the topic of two of my earliest posts in this blog (this post and this one). I posted again when it looked like the debate was going to start in India. Thankfully, it died a natural death.

Those of you who follow me on twitter know that abortion has been on my mind following the sickening murder of Dr. Tiller. For the record, I didn’t even know that there existed such a doctor as he till I chanced upon news of his death. I refrained from writing anything here as I figured I had stated my views already.

Then I saw this post in my friend Dr. Val’s blog.

The abortion “issue” is such a hot topic that I have never written about it on this blog until today. I hope I won’t regret that decision but I felt it was appropriate to respond to this medical student’s essay - and the ~560+ comments that follow it - as a physician who has witnessed (but never performed) about 100 abortions. Let me explain.

Read the entire post at Better Health: A Third-Year Medical Student Discusses Her Views On Abortion In The Washington Post.

Also read the medical student Rozalyn Farmer Love’s post, My Choice, in the Washington Post.

I’m a third-year medical student at the University of Alabama at Birmingham. I plan to become an obstetrician-gynecologist. I dream of delivering healthy babies, working with families and supporting midwifery. But as part of my practice, I also envision providing abortions to women who need them. …

I agree that ending an unwanted pregnancy is a tragedy. When I advocate for reproductive rights, for choice, I don’t claim that abortion is morally acceptable. I think that it’s a very private, intensely personal decision. But I was stunned when one of my professors, a pathologist and a Planned Parenthood supporter, told me that decades ago, entire wings of the university’s hospital were filled with women dying from infections caused by botched abortions. It’s clear that women who don’t want to be pregnant won’t be deterred by limited access to providers or to clinics. And I believe that it’s immoral to let them die rather than provide them with safe, competent care.

The lines that affected me the most were…

I plan to choose a residency program that provides further training — a place where I won’t worry that asking to be taught to perform an abortion could somehow limit my future options. At the start of medical school, I was very careful about how I presented my pro-choice views to the faculty for fear that I could jeopardize my grades or hurt my chances for recommendations or of being accepted into a program run by any of the professors. This experience of treading lightly is unique to medical students in more conservative parts of the country, where opposition to abortion is widespread…

I was equally moved by these lines from Val’s post…

I initiated rapid sequence intubation with the assistance of the anesthesiologist, and then moved to get the ultrasound machine to visualize the uterus and its contents. Much to my discomfort the fetus was fairly large - and was moving around normally, even sucking its thumb at one point. I asked the Ob/Gyn resident why the fetus was being aborted since it didn’t appear to have any structural abnormalities. She responded that the mother simply didn’t want to have the baby, and had wrestled with the idea of abortion for a long time before she made her final decision. The rest of the procedure is a bit of a blur - with details too graphic to describe here. But suffice it to say that the resident performing the dilatation and curettage had a fairly difficult time removing the fetus through the cervix, and had to resort to eliminating it in smaller parts, rather than a whole. It was very sad and it took a long time to make sure that the uterus was fully evacuated. I decided that I couldn’t watch another one of these procedures.

All I can say to Val is: Do not visit any ObGyn procedure room or OT if/when you visit India.

I did not set out to write this to hand out that gratuitous bit of advice to Val. I wanted to highlight something else that she had written that caught my attention and raised some doubts.

In my opinion women should have the right to choose to have an abortion, but I’d hope that they also consider their right to choose to give their baby up for adoption as well. Some believe that an abortion is “easier” than giving up a baby for adoption - but I’m not so sure that’s the case from an emotional perspective.

I want Val and all those who share similar views re. adoption as an alternative to abortion to read this moving essay by Judy Brown in which she says When Abortion Was a Crime, I Would Have Sought One. Read the entire essay and pay particular attention to the two paragraphs at the end…

There are approximately 500,000 children in the foster care at any time in the United State — many of those children are adoptable, but will not be adopted — why don’t “pro-life” advocates step forward to adopt them now? Do they want the forced return to warehouse orphanages for still more unwanted children? Do they want women sent to prison for seeking an abortion, and doctors also jailed, when we already have a shortage of doctors in this country? And nurses jailed, when we have a shortage of nurses in this country? How much damage and destruction of life will they support to force the rest of us to subscribe to their “religous” views? I’ve never heard a so-called “pro-life” advocate answer those questions honestly. Making abortion illegal will not stop abortions, it will just stop safe abortions, as is the reality in the few civilized countries in which abortion isn’t legal, but their abortion wards are full to bursting with maimed women, and whose morgues overflow with dead women.

I agree with Val’s concluding paragraph that Rozalyn, the third year medical student may change her mind after witnessing or performing a few procedures.

Even in a country where abortion is a non-issue, I believe there are many medical professionals who are troubled by late trimester abortions and abortions-on-demand. I am one such. But the sad reality is that we are the minority here. I feel particularly sad because occasionally in my professional role as a diagnostic radiologist I am the cause of some of these wrenching cases of late trimester abortions. Some of them I can agree with, though they could have been avoided by earlier diagnosis and decision-making,  like an anencephaly being diagnosed at 35 weeks gestation. But most are not that morally or ethically clear cut.