Home Medizin Geburtshelfer und Gynäkologen stehen vor einer „Berufskrise“ bei der Bewältigung des Abtreibungsverbots

Geburtshelfer und Gynäkologen stehen vor einer „Berufskrise“ bei der Bewältigung des Abtreibungsverbots

von NFI Redaktion

A 14-year-old girl came to the clinic of Angela Dempsey-Fanning, MD, MPH, in South Carolina just one day after the state’s anti-abortion law would have allowed her to terminate a pregnancy in cases of rape or incest. Dempsey, a gynecologist in Charleston, had to inform the teenager, a victim of incest, that she could not legally provide abortion treatment, leading the girl and her mother to seek treatment in another state. „When I interact with patients in these situations and have to deny them my care, I carry the emotional and mental burden for weeks,“ said Dempsey, who is also President of the Society of Family Planning, a non-profit organization that advocates for access to abortions. South Carolina is one of 16 states that have implemented strict abortion restrictions following the Supreme Court’s ruling in June 2022, which overturned Roe v. Wade. This has created a „professional crisis“ for many gynecologists like Dempsey who practice in states where abortions are restricted or banned, according to a recently published study in JAMA Network Open. The study focused on the impacts of these laws on gynecologists practicing in states with limited or no abortion access. The researchers found that more than 90% of the participants reported experiencing moral distress due to legal constraints preventing them or their colleagues from adhering to clinical standards. They described cases in which state abortion restrictions forced them to delay what they deemed medically necessary treatment until a patient was faced with serious complications or even death. „They are bleeding with an intrauterine pregnancy with a heartbeat…there is no legal coverage for that, but there is only a limited number of times you can transfuse someone before you say, ’Enough is enough,'“ reported one clinician to the researchers. Another doctor asked, „Is a 5% risk of death sufficient? Is 20% required? Is 50% required? What is legally sufficient?“ This month, the U.S. Department of Health and Human Services announced a new team to ensure that hospitals in all states comply with the Emergency Medical Treatment and Labor Act, which the Biden administration says covers emergency abortions. Despite this, some hospitals may not have clear guidelines for defining pregnancy-related emergencies, making it difficult for doctors to feel protected in clinically complex situations. The study also highlighted „gag clauses“ that hinder gynecologists from recommending or discussing abortions with patients, impairing their medical expertise. „A part of the harm to these gynecologists is not only the laws themselves, but also their own institutions,“ said Mara Buchbinder, Ph.D., professor and Associate Chair of the Department of Social Medicine at the University of North Carolina Chapel Hill School of Medicine and co-author of the study. They described the limitations as impeding their medical expertise. „Patients, who live in areas with restricted access to obstetric services, often turn to emergency facilities or emergency rooms staffed with family doctors, internal medicine doctors, and emergency physicians,“ said Nucatola. „I don’t want anyone to think that this is limited to a specialty. It will affect anyone who cares for these patients. You lose the ability to use your medical knowledge and have to then navigate these legal restrictions that have nothing to do with anything that happens in medicine.“ Dempsey’s 14-year-old patient eventually received an abortion treatment outside of South Carolina, but Dempsey and her colleagues spent hours coordinating the patient’s treatment in another state. „They still feel like they were letting this patient down in multiple ways,“ she said. „I know I almost daily weigh the decision about my future practice and wonder how long I can stay and continue to fight for patients in an environment filled with fear, concern, and an overwhelming sense of injustice,“ Dempsey said. The study, quoting the authors and experts, does not disclose any relevant disclosures. Lara Salahi is a freelance writer based in Boston.

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