An OB-GYN’s Perspective on Ohio Abortion Laws

This November, Ohio citizens will be asked to make a big determination on the most important issue of our time, abortion.   I am a board-certified OB-GYN, 10 years in practice, living and working in the greater Cincinnati area.  And I am confidently voting against the misleadingly named “The Right to Reproductive Freedom with Protections for Health and Safety” amendment. 

I have found that defining abortion and understanding exceptions to abortion laws are difficult tasks, even among physicians.  But it is time to clarify what an abortion is, and what would still be “allowed” as healthcare if this extreme abortion-permitting amendment does not pass. 

So what is an abortion?  An abortion is the purposeful killing of the unborn in the termination of a pregnancy.   The intent of the provider performing the abortion is to remove a deceased baby from the womb.  This can involve injection of medication into the baby’s heart if the pregnancy is more advanced, or traumatizing the child prior to full birth with use of suction apparatuses, sharp tools, or grasping tools.  This may be done electively, for any reason, even up to the due date of the baby should the amendment pass given the (intentionally) vague language utilized.  In contrast, a “medically indicated maternal-fetal separation” is one in which the baby is treated with dignity and care as the provider separates the child from the mother using usual labor induction methods, due to medically significant risks to the mother, with the hope the child can be born alive even if only for a short while.  Even the most conservative pro-life OB-GYN understands there are times a baby must be born, even before the child will be mature enough to live outside the womb, to protect the life of the mother.  Complications arise such as pre-eclampsia, an infection in the uterus, or a maternal severe illness where the baby must be delivered to allow a mother to survive.  And the law as it stands, without this extreme and dangerous proposed amendment, allows the OB-GYN to proceed with delivery.  The law states such intervention is acceptable “in order to prevent the death of the pregnant woman or to avoid a serious risk of the substantial and irreversible impairment of a major bodily function.”  In other words, women are already protected from harm or death due to those rare circumstances when continuing a pregnancy becomes an acute threat under the current law. 

So how is miscarriage different from abortion?  Despite miscarriage being often called a “spontaneous abortion” or “incomplete abortion”, it is entirely distinct from an induced, elective abortion.  A miscarriage is a spontaneous loss of a baby less than 20 weeks, and this can happen when the baby’s heart stops on its own, or when the body expels a living baby for a multitude of reasons such as infection or a weak cervix.  If the baby’s heartbeat has stopped spontaneously and the body has not expelled the baby and placenta on its own, a surgical or medical procedure may then be used to empty the uterus.  In addition, in the relatively rare event that a woman has begun bleeding heavily despite the baby still having a heartbeat, this is medically distinguished as an “incomplete abortion” or “inevitable abortion” and may be expedited with surgical intervention for the safety of the mother under the current law.  Again, women are already protected from harm or death due to miscarriage under the current law.

With similar concern for the health of the mother, we must consider ectopic pregnancies.  The so-called “heartbeat law” specifically states it applies only to intra-uterine pregnancies.  An ectopic pregnancy is extra-uterine by definition.  The baby is most often growing in the fallopian tube, but could be attached to the mother’s ovary, her bowel, her cervix, or inside the scar from a prior cesarean delivery.  In cases of ectopic pregnancy, loss of human life is unavoidable because the child is unable to grow to viability in these locations.  In addition, an ectopic pregnancy puts the mother at grave risk of severe harm or death.  Therefore, the law as written currently permits removal of the ectopic pregnancy. 

To put it simply, the amendment does nothing to protect the “health and safety” of women.  Women are already prioritized and protected under the current law.  What the backers of this amendment do not want you to know is that the amendment is really about the first half of its title; the extreme, unlimited “reproductive freedom” which eliminates any care or concern for pre-born children.  Pregnant women are already protected under the current law, and OBGYNs such as myself who have dedicated their lives to serving and protecting women would never stand for less. 

If The Right to Reproductive Freedom with Protections for Health and Safety amendment is not passed, no women will be harmed or die as a result.  But, on the contrary, pass this amendment and countless innocent pre-born babies will die without cause, without care, without dignity.

By: Angela Beale Martin, MD, board-certified OB-GYN