The Ultimate In "Pro-Life" Rhetoric: Forced C-Sections

One thing this bill is definitely not about is fetal pain and compassion: It’s about restricting access to health care for people who need it.

May 14, 2012 at 5:00pm | Leave a comment

Meet Representative Doug McKillip of Georgia.

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Representative McKillip, doublechecking his latest legislative brilliance with the G-man before proceeding.

This Republican lawmaker just successfully championed a bill banning abortions after 20 weeks, set to go into effect on 1 January. Not without throwing a tanty along the way when lawmakers attempted to modify the bill to make it less stringent; once he was satisfied those pesky “loopholes” like rape and incest were closed, he got back on board.

Under the law, abortions after 20 weeks are forbidden except when necessary to save a mother’s life or in the case of a fetal abnormality incompatible with life, which means that if a woman comes into a hospital at 22 weeks with her water broken, for example, “you deliver the baby in the way that’s most likely to save both lives,” said McKillip when asked a hypothetical question about that situation by obstetrician Ruth Cline.

What does that mean in practice? A C-section, in effect, because if the fetus goes into distress, which is likely to occur at that stage of development, the fastest and most effective way to deliver successfully is with surgical intervention.

In a case where parents are prepared for this, for both the intervention and the intensive care that will follow, surgery is entirely appropriate. They can discuss the risks, benefits and other aspects of the situation with a doctor to decide what would be the best choice for them. As autonomous adults, people can make decisions in their best interests and those of the fetus. When that pregnancy is wanted, trying to save both lives absolutely makes sense.

Delivery in such situations might not be the best option for everyone, though, and McKillip is a member of the very same party that’s slashing the social services intended to help people in a situation like this. He's also attempting to crush choice for people who vehemently do not want a pregnancy after 20 weeks, and haven't been able to access abortion prior to that, for whatever reason. 

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Some people want you to think "life" begins at this moment. 

McKillip is so committed to undermining patient autonomy that he's demanding that a pregnancy which might terminate naturally be salvaged no matter what, including through an aggressive surgery that will alter the body forever.

Vaginal birth after Cesarean is possible, of course, but it’s not supported in all hospitals and by all medical providers. People who want to have additional children in the future may be compelled to deliver by C-section again, and again, and again. In cases where they are allowed to labour naturally to determine if it’s possible, they may have to do so under careful monitoring, and could require surgical intervention if a crisis develops.

McKillip is making a huge and life-altering choice for patients, both by dictating the course of treatment in specific pregnancies, and influencing how future pregnancies will go. Naturally, he has no interest in supporting his precious babies once they’re brought into the world; after that, they’re the parents’ problem.

As if that wasn’t appalling enough, the reason he’s doing this? To “save 1,000 babies,” except he’s got his numbers wrong: CDC surveillance data from 2007 shows that approximately 3 percent, or 984, abortions occurred at 21 weeks or longer. Oh and by the way, Mr. McKillip, that’s fetuses, not babies.

A fetus delivered at 22 weeks, as in the example posed by Cline, will need a lot of support to survive, and might not make it; the survival rate is lower than 10 percent. Parents face a difficult choice with premature delivery at this stage because the fetus simply isn’t developed enough, and they need to consider a number of factors in their decision. Each week in the womb, the survival rate goes up, but even good survival rates, like 85 percent at 26 weeks, can come with a high cost.

So how many "babies" would he be saving here exactly? Assuming every single one of those 984 abortions involved fully viable fetuses and no threat to the life of the patient, he's "saving" less than a whopping 9.84 "babies" with absolutely perfect neonatal care.

Meanwhile, Georgia has one of the highest infant mortality rates in the nation, costing far more than 9.84 lives annually. And those include wanted and loved lives of infants who die of things like fully preventable infections. That's a far better area for McKillip to be directing his energies if he cares about babies.

He’s claiming that Georgia has become a hotbed of “abortion tourism,” with people traveling across state lines to get abortions past 20 weeks. The reason people do that usually isn’t for fun or convenience: It’s because they can’t access abortions in their home states. That includes victims of rape and incest whom McKillip so callously dismissed by saying they had “20 weeks to make their decision.”

Because we all know that everyone finds out they’re pregnant the minute it happens, and are in an immediate position to take action. They certainly aren’t in abusive relationships or families, and aren’t limited by issues like lack of access to health care providers. Not in the least. And it’s not at all daunting or unsafe to cross state lines to get an abortion.

This is being billed as a “fetal pain” bill, positioning the authors as saviours who want to prevent suffering, and care practitioners as knife-wielding fiends who enjoy tormenting fetuses. There are a whole slew of problems with this, not least of which is that most medical evidence indicates fetuses do not experience pain until the third trimester. The American Pain Society has conducted a detailed review of the evidence and points out that politicisation of fetal pain makes it difficult to study and discuss appropriately. One thing this bill is definitely not about is fetal pain and compassion: It’s about restricting access to health care for people who need it.

In rare cases when fetal pain is a consideration, physicians offer analgesics and usually inject medication to confirm that fetal death has occurred before proceeding, because they don’t want to inflict pain on their patients, and pledge an oath to limit suffering. Such abortions are extremely rare and unanticipated, typically involving very much wanted babies and an immediate threat to the life of the mother. Making bodies into political footballs makes it extremely dangerous for these surgeries to be provided, even though they save lives and are unutterably emotionally difficult for all parties involved.

Lawmakers restricting abortion access in the name of “fetal pain” should be ashamed of themselves. And lawmakers claiming to care about babies who flagrantly ignore infant mortality rates and lobby for cuts to social services should be doubly ashamed of themselves.