AUSTIN – Fear, bewilderment and helplessness are feelings that have dominated obstetrician and gynecologist offices in many parts of the United States for the past year due to laws that have restricted access to abortion, affecting health professionals who care to women.
After the Supreme Court of the country ended the protection of abortion at the federal level on June 24, 2022, numerous state laws have emerged that prohibit it and threaten doctors with harsh penalties such as jail or the withdrawal of the license to work.
“As a doctor, my hands are tied. When I’m interacting with a patient, I’m not saying what’s the best medical care, I’m asking what my legislators think is right,” Amna Dermish, an obstetrician-gynecologist, said in an interview.
She works for the organization Planned Parenthood, the largest provider of reproductive services in the country, and in recent months she has experienced two consequences that the restrictions have brought: “the deterioration of women’s health” and the radical change of her own work.
When taking a tour of the facilities of the Austin clinic where this interview takes place, Dermish stops in front of the door of one of the rooms: “Today we use it as a store, hoping to find another use for it.” It was the office where abortions were performed.
Today the most you can do is give women guidance on how to travel out of state. “After the Dobbs decision (which knocked down Roe v. Wade), my ability to provide direct care completely disappeared,” she explains. There are several times that the doctor cries during this talk.
RESTRICTIVE STATE LAWS
Dermish’s life changed long before the Supreme Court’s decision, as Texas, with its governor, Republican Greg Abbott, at the helm, was a pioneer state in the setback of the right to abortion.
Months before the ruling of the highest judicial entity in the United States, on September 1, 2021, the “Heartbeat Law” entered into force in Texas, which prohibits abortion if cardiac activity is detected in the fetus, something that happens at six weeks gestation, when many women don’t even know they are pregnant.
This state law, which different instances tried to overthrow without success, was the example that many states used to create their own regulations.
Among other aspects, the Texan norm authorizes any citizen to denounce those who have helped a woman to abort, so doctors are vulnerable to any private lawsuit and can even face jail sentences.
According to Dr. Kristyn Brandi, a spokesperson for the American College of Obstetricians and Gynecologists, the hardest thing these months has been understanding what can be done because “the rules can change every day” and “it’s really confusing and chaotic to provide care.” .
This is the first attempt by Democrats to defend abortion access after the controversial US Supreme Court ruling.
She practices in New Jersey, a state that has protected abortion rights, but even there she gets questions from patients about whether the care they need is legal, “because they see things on the news and it’s so confusing.”
Doctors, he explains, have had to “hire lawyers” who are available 24 hours a day in case they need advice.
“Imagine if there’s an emergency, it’s really upsetting to have to stop everything and call a lawyer to find out if it’s within the rules,” he says.
For Dr. Dermish, the hardest part of this situation is having to look a patient in the face and tell her that there is nothing she can do for her.
“The time to do the ultrasound, see the cardiac activity and know that I am going to tell them that I have to turn them down is devastating and I still can’t get over it,” he says.
In Texas there are no exceptions to abortion, except when the life of the mother is at risk. The problem comes when assessing that risk.
In a report prepared with testimonials from doctors, the organization Advancing New Standards in Reproductive Health denounces that many health workers cannot properly care for their patients in situations such as premature rupture of membranes.
One of the testimonies collected is that of a doctor, whose patient’s water broke between 16-18 weeks of gestation -when the fetus is not viable- and he had to send her home. She developed a serious infection and she ended up being admitted to the intensive care unit.
Before Dobbs, patients were offered abortion or labor induction. Now the prescription is to go home and wait for a serious infection.
“People show up bleeding in emergency rooms and in hospitals they tell them that as long as there is a fetal heartbeat they can’t do anything for them. It’s apocalyptic,” denounces Dermish, more sure today than ever that her specialty, that of a doctor abortionist, it will not be very popular, but it is absolutely necessary.
