Might be time to start talking about this

I wanted to talk about new laws limiting abortion and how they apply to miscarriages that require medical intervention. This isn’t a new topic, it comes up in the context of the religious directives that govern Catholic hospitals in the US, but I really think it deserves more practical, real-world discussion.

This is the text of the Heartbeat Bill, which is a proposed law in Ohio. Republicans acting on behalf of an extreme anti-abortion group introduced the bill prior to the 2012 election. Despite what national Republicans who are also paid media personalities have assured us about Republican lawmakers moderating their views regarding women, Republicans in Ohio plan to introduce the bill again.

This is the rule:

To amend section 4731.22 and to enact section 2919.19 of the Revised Code to generally prohibit an abortion of an unborn human individual with a detectable fetal heartbeat.

(E)(1) Except as provided in division (E)(2) or (3) of this section, no person shall knowingly perform an abortion on a pregnant woman with the specific intent of causing or abetting the termination of the life of the unborn human individual that the pregnant woman is carrying and whose fetal heartbeat has been detected according to the requirements of division (C) of this section. Any person who acts based on the exception in division (E)(2) or (3) of this section shall so note in the pregnant woman’s medical records and shall specify in the pregnant woman’s medical records which of the exceptions the person invoked.

And this is the exception for the life of the mother:

(2)(a) A person is not in violation of division (E)(1) of this section if that person performs a medical procedure designed to or intended, in that person’s reasonable medical judgment, to prevent the death of a pregnant woman or to prevent a serious risk of the substantial and irreversible impairment of a major bodily function of the pregnant woman.
(b) Any person who performs a medical procedure as described in division (E)(2)(a) of this section shall declare in writing, under penalty of perjury, that the medical procedure is necessary, to the best of that person’s reasonable medical judgment, to prevent the death of the pregnant woman or to prevent a serious risk of the substantial and irreversible impairment of a major bodily function of the pregnant woman. That person shall also provide in that written document, under penalty of perjury, the medical condition of that pregnant woman that the medical procedure performed as described in division (E)(2)(a) of this section will assertedly address, and the medical rationale for the conclusion that the medical procedure is necessary to prevent the death of the pregnant woman or to prevent a serious risk of the substantial and irreversible impairment of a major bodily function of the pregnant woman.
(c) The person who performs a medical procedure as described in division (E)(2)(a) of this section shall place the written documentation required under division (E)(2)(b) of this section in the pregnant woman’s medical records and shall maintain a copy of the written documentation in the person’s own records for at least seven years.
(3) A person is not in violation of division (E)(1) of this section if that person has performed an examination for the presence of a fetal heartbeat in the fetus utilizing standard medical practice and that examination does not reveal a fetal heartbeat or the person has been informed by a physician who has performed the examination for fetal heartbeat that the examination did not reveal a fetal heartbeat.

Here are some physician accounts of how a prohibition on abortion and reliance on a fetal heartbeat as an indication of viability play out in medical treatment of miscarriages in some US hospitals that are governed by religious directives banning abortion:

Obstetrician–gynecologists working in Catholic-owned hospitals described cases in which abortion was medically indicated according to their medical judgment but, because of the ethics committee’s ruling, it was delayed until either fetal heartbeats ceased or the patient could be transported to another facility.

Dr P, from a midwestern, mid-sized city, said that at her Catholic-owned hospital, approval for termination of pregnancy was rare if a fetal heartbeat was present (even in ‘‘people who are bleeding, they’re all the way dilated, and they’re only 17 weeks’’) unless ‘‘it looks like she’s going to die if we don’t do it.’’

In residency, Dr P and Dr H had been taught to perform uterine evacuation or labor induction on patients during inevitable miscarriage whether fetal heart tones
were present or not. In their new Catholic-owned hospital environment, such treatment was considered a prohibited abortion by the governing ethics committee because the fetus is still alive and the patient is not yet experiencing ‘‘a
life-threatening pathology’’ such as sepsis. Physicians such as Dr H found that in some cases, transporting the patient to another hospital for dilation and curettage (D&C) was quicker and safer than waiting for the fetal heartbeat to stop while trying to stave off infection and excessive blood loss.

“Because the fetus was still alive, they wouldn’t intervene. And she was hemorrhaging, and they called me and wanted to transport her, and I said, ‘‘It sounds like she’s unstable, and it sounds like you need to take care of her there.’’ And I was on a recorded line, I reported them as an EMTALA [Emergency Medical
reatment and Active Labor Act]. And the physician [said], ‘‘This isn’t something that we can take care of.’’ And I [said], ‘‘Well, if I don’t accept her, what are you going to do with her?’’ [He answered], ‘‘We’ll put her on a floor [i.e., admit her to a bed in the hospital instead of keeping her in the emergency room]; we’ll transfuse her as much as we can, and we’ll just wait till the fetus dies.’’

“I’ll never forget this; it was awful—I had one of my partners accept this patient at 19 weeks. The pregnancy was in the vagina. It was over. . . . And so he takes this patient and transferred her to [our] tertiary medical center, which I was just livid about, and, you know, ‘‘we’re going to save the pregnancy.’’ So of course, I’m on call when she gets septic, and she’s septic to the point that I’m pushing pressors on labor and delivery trying to keep her blood pressure up, and I have her on a cooling blanket because she’s106 degrees. And I needed to get everything out. And so I put the ultrasound machine on and there was still a heartbeat, and [the ethics committee] wouldn’t let me because there was still a heartbeat. This woman is dying before our eyes. I went in to examine her, and I was able to find the umbilical cord through the membranes and just snapped the umbilical cord and so that I could put the ultrasound—‘‘Oh look. No heartbeat. Let’s go.’’ She was so sick she was in the [intensive care unit] for about 10 days and very nearly died. . . .She was in DIC [disseminated intravascular coagulopathy]. . . . Her bleeding was so bad that the sclera, the white of her eyes, were red, filled with blood. . . .And I said, ‘‘I just can’t do this. I can’t put myself behind this. This is not worth it to me.’’ That’s why I left.
Dr G also circumvented the ethics committee in her southern Catholic-owned hospital. She was 14 weeks and the membranes were literally out of the cervix and hanging in the vagina. And so with her I could just take care of it in the [emergency room] but her cervix wasn’t open enough . . . so we went to the operating room and the nurse kept asking me, ‘‘Was there heart tones, was there heart tones?’’ I said ‘‘I don’t know. I don’t know.’’ Which I kind of knew there would be. But she said, ‘‘Well, did you check?’’ . . . I said, ‘‘I don’t need an ultrasound to tell me that it’s inevitable . . . you can just put, ‘The heart tones weren’t documented,’ and then they can interpret that however they want to interpret that.’’ . . . I said, ‘‘Throw it back at me . . . I’m not going to order an ultrasound. It’s silly.’’ Because then that’s the thing; it would have muddied the water in this case.

Clearly the national anti-abortion group that drafted the Ohio bill are aware of this, since it seems they included an exception that is meant to address medically-assisted miscarriage management. I don’t know why this doesn’t get discussed, but it seems like it’s past time to raise it.

Conservatives and media have quietly dropped the phrase “the health of the mother” in discussions about abortion and narrowed it to the “life of the mother.” I don’t accept those limits on this debate. Instead I’d like to return to a focus on health of the mother and actually broaden that to explore how these laws may reach women who are not seeking an elective abortion, but are instead receiving medical care for what is called “miscarriage management.”

Full sources are here and here (pdf)

Thanks to ABL for sending me the law review article.

118 replies
  1. 1
    Schlemizel says:

    aaaaaaand just like that the schadenfreude is gone & the slog to regain a rational nation is back on.

    Kay, is there any hope of winning Ohio into a reality-based government again? Are their elections next year or does it wait until ’14? Can you point out organizations or candidates that could use some off year money and make a bigger splash?

  2. 2
    Felanius Kootea says:

    I’m still stunned by the case of the Indian (Hindu, non-Catholic) mother who died in Ireland because they couldn’t help her miscarriage go faster since there was still a fetal heartbeat. I can’t believe that anyone wants more of that here in the US.

  3. 3
    me says:

    Yup, the Irish doctors said they wouldn’t give that woman an abortion as long as the fetus had a heartbeat.

  4. 4
    The Moar You Know says:

    We just saw this mindset kill a woman in Ireland.

    This is the tiring thing: they will never stop. Never. We’ll have to keep fighting them for eternity, because they’re so infected with the notion of their own righteousness and their need to control the lives of others that they can’t stop even if they wanted to. Even though they know it’s wrong.

    Eternal war is a depressing way to live, but we’re not going to be given an alternative save for “do what we tell you to.”

    Which I’m not OK with.

  5. 5
    WereBear says:

    @me: the Irish doctors said they wouldn’t give that woman an abortion as long as the fetus had a heartbeat.

    Yes. And now neither of them do.

  6. 6
    aimai says:

    Even without the law going into effect it is a fact that in many parts of the US a woman who has already experienced fetal death/miscarriage is denied a standard D and C (dilation and curettage) and told to go home and wait for “natural” passage of the dead fetus. Medically it makes no sense–the fetus is already dead and the risk to the woman of carrying around necrotic tissue is huge–but that is what happens. Many women don’t even know that the D and C option would be available to them in another hospital or another state. They are just told this is the way its going to be handled. Given the number of pregnancies that end in a miscarriage anyway within the first or second trimester, this is a large number of women whose health is put at risk for no reason at all, just because the hospitals or the doctors are afraid of being accused of giving an abortion.

    aimai

  7. 7
    Bulworth says:

    Is this more of that less government I keep hearing the GOPteabag demand?

  8. 8
    PeakVT says:

    Here’s the article about the woman in Ireland who died due to a law like the one proposed.

  9. 9
    Recall says:

    What laws prevent them from being sued for malpractice?

  10. 10
    scav says:

    @WereBear: It’s very hard not to think that they see this as a win-win anymore. They’ve really worn me down on crediting them with good intentions towards others. They really do seem to treat evreyone other than themselves as abject abstract moral chits in their moral calculus — gaming their own way into self-defined perfection.

  11. 11
    Patricia Kayden says:

    So will this pass? Are there enough Repugs in the Ohio legislation to get it passed? Can the Dems fillibuster it?

    Interesting that since 2010 when people decided to “punish” the Dems by staying home, we’ve had Repugs acting up in the states where they now have control. Hope we don’t sit at home in 2014.

    Based on what happened in Ireland, the anti-choicers seem to believe that allowing a full grown woman to die is okay, but allowing her to have an abortion is somehow wrong.

  12. 12
    SatanicPanic says:

    @aimai: That’s awful. I don’t even know what to say about that.

  13. 13
    wenchacha says:

    What utter bullshit. This is not a political question. It will be interesting to see if Ireland will change in response to the two deaths for which the state is responsible.

    A pregnant woman is so vulnerable to unexpected situations, many of them which threaten her life and/or the viability of the fetus. Pregnancy isn’t an illness, but it is also not just a benign condition.

    It would be swell to put the geniuses who come up with this sort of legislation in the public eye so they can defend their death sentence for women who have the bad luck of being in the midst of a miscarriage.

  14. 14
    PeakVT says:

    @PeakVT: Oops, missed the link in Kay’s post.

  15. 15
    JPL says:

    The Irish law states that doctor’s can act to save the life of the mother but you have to be able to prove it. Had they aborted the fetus, the mother might not become septic. If the law is the health of the mother it could be interpreted that since the woman was miscarrying, it was medically necessary to prevent further physical or emotional harm to the woman.
    There is a big difference.

  16. 16
    SatanicPanic says:

    @Recall: Delivering babies already has some of the highest insurance costs of any medical field. Which is probably just fine with the fundies, who want babies delivered in a barn by a witchdoctor.

  17. 17
    aimai says:

    In the comments thread below the blog post on the Irish death in the Guardian a self satisfied anti-abortion Irishman argued that 1) You couldn’t know definitively if the woman died because she couldn’t get the abortion and 2) even if that is true the number of lives “saved” by refusing abortions to all women is greater than the number of maternal/fetal deaths that occur because the abortion is refused and both patients die. So suck on that, libs, seemed to be his main argument.

    aimai

  18. 18
  19. 19
    Pooh says:

    Psychopaths

  20. 20
    JPL says:

    @aimai: Just wow! So much for being pro-life.

  21. 21
    peorgietirebiter says:

    After taking the Catholic vote so convincingly, this might be a good time for a teaching moment from the White House. Maybe clear up the confusion over Catholic businesses, Catholic churches and the co mingling of taxpayer funds. The whole first amendment as a shield and not a value added business model.

  22. 22
    Mnemosyne says:

    IMO, the Irish case makes it very clear that this really is an issue of religious freedom — namely, people are having other people’s religious beliefs forced upon them when they’re in the middle of a medical crisis and are being forced to follow the tenets of someone else’s religion.

    As Halappanavar’s parents and husband pointed out several times, they are not Catholics, and yet they were forced to follow the rules of the Catholic Church when it came to medical treatment.

    If believing Catholics want to follow those beliefs and choose medical treatment for themselves based on those beliefs, then they can do that, but what the fuck gives them the right to insist that people who believe differently have to follow the same rules?

  23. 23
    Robin G. says:

    Been watching this play out on my home turf, by the way. Summary: my friend has had severe, non-life-threatening gestational diabetes, which will likely have long-term negative health effects but will not kill her over the course of the pregnancy. OB-GYN (who seems to have Opinions) has basically told her no, it’s okay, just stick it out, you’ve gotten this far, you don’t want to give up now, do you?

    At the same time, she’s also had to give up vital psychiatric meds for the purpose of the pregnancy. The OB-GYN doesn’t want her to so much as lick a sedative; her psych has begged her to take at least tiny amounts and just run the risk — or, failing that, have an abortion. Because while the OB-GYN is going on and on about risk of defects, that won’t matter if my friend jumps off a bridge because her head isn’t working right anymore.

    (I’ve begged my friend to get a new OB-GYN, but the thing is, when you’re not altogether mentally stable and in the middle of a very rough pregnancy, you don’t want to shift doctors. Especially when the doctor is working hard on your head and has basically convinced you that taking care of your own health is selfish.)

    It’s impossible to convince these nutjobs that the diabetes is an important health of the mother issue; it’s laughable to think they’d consider mental health to matter. I really hate these motherfuckers.

  24. 24
    Mnemosyne says:

    @SatanicPanic:

    There’s a famous (infamous?) article written for Ms. Magazine where the writer’s fetus died in utero (no heartbeat) and was sent home to wait for a natural miscarriage because no hospital in the area was willing to take on a late-term abortion.

    And, yes, it’s still an abortion even if the fetus is already dead because an abortion is the ending of a pregnancy, not the “killing of a baby” or whateverthefuck fundamentalists are trying to make it mean. This is why you have women in the midst of miscarriages who are being treated this way — even if there’s no possible way for the fetus to survive, ending the pregnancy is still an abortion and some hospitals just won’t do it. Hell, Catholic hospitals are even forbidden from ending ectopic pregnancies, which by definition will end in the death of both mother and fetus, because ending them is “an abortion.”

  25. 25
    chmatl says:

    Kay, as hard as it is to read these accounts, thank you so much for keeping us informed on this issue. It is a unique kind of insanity (or something) that people who profess to be “pro-life” would let a woman die in the middle of a miscarriage.

  26. 26
    Citizen_X says:

    @aimai: Wow. Ends justify the means, gotta break a few eggs to make an omelette, etc etc.

  27. 27
    The Other Chuck says:

    @Felanius Kootea:

    I can’t believe that anyone wants more of that here in the US.

    Unfortunately, I can. A sizeable chunk of this country has gone from merely callous and uncaring to outright homicidally psychopathic. These people are not only willing to let people suffer and die to make their righteous points, they actually want it that way. They *hate* you, and everyone else who doesn’t obey their moral code. That is the beginning and the end of their belief system, and it’s time people recognized that.

  28. 28
    sharl says:

    @aimai: Ah, sounds similar to adorable commenter ‘Clare’ in this post that PZ Myers linked to yesterday. If you want an example of just how determined and unmovable many of the “pro-life” rank-and-file supporters are, there’s one right there.

  29. 29
    burnspbesq says:

    @wenchacha:

    This is not a political question

    Like hell it’s not. Whether you think it should be is irrelevant.

    You have two options, Either take action or live with the conseqences of your inaction. There is no third option.

  30. 30
    CA Doc says:

    This makes me so crazy, as a physician and as a woman who’s been through 2 miscarraiges. A woman should be able to decide for herself, when a fetus is non-viable, when and how she wants to have it out, given the risks. I had a patient who for various reasons didn’t know she was pregnant with an anencephalic baby(no brain development) until she was 18 weeks, and even in enlightened California we were scrambling around to find someone to do her termination. These people have no concept of what physical and mental torture it would be to be forced to carry a non-viable fetus.

  31. 31
    aimai says:

    @The Other Chuck:

    I guess after this last election my feeling is that we need to go around and under and through the legislators with a totally novel public relations strategy aimed at reproductive aged women and their families. There is an entire subculture of fertile women who are fully intending to get pregnant and have small or large families. They are often extremely committed to natalism–but they are also the most likely to know someone who has had a miscarriage, or to be at high risk for a miscarriage for themselves. A ton of women are on bed rest and many children are born prematurely and end up in the NICU.

    It would be extremely non traditional to try to organize these women–and quite difficult too–but a seriously pissed off voting block of these women would be a force to be reckoned with. And their need and desire to have a safe, healthy, pregnancy and/or miscarriage without undue interference from or attack by their medical professionals really trumps any anti abortion rhetoric or even anti abortion feelings they may have.

    I think of it pragmatically in terms of interest group formation: you have a huge and ever renewed “customer base” of women and their families who are engaging in desired but high risk/high reward behavior with a medical component. They are routinely marketed to by popular culture because they are going to spend a lot of money during their pregnancy and their early years as mothers. And yet no one organizes them politically? There is no “union of pregnant women” they get invited to join which keeps them apprised of the legal encroachments on their status as patient? On their control over their own pregnancy risk? There are whole websites devoted to pregnant women and their wants/issues/desires. I wonder if it would be possible to begin to run Planned Parenthood and ACLU advertising on those websites or to offer them emergency medical/legal coverage if they need to fight for their rights as a patient while they are pregnant?

    aimai

  32. 32
    mainmati says:

    I know it doesn’t compare against the moral evil of allowing a woman to die or to be gravely ill because she can’t have an abortion nevertheless, this and other bills like it would also have the effect of greatly increasing health care costs in hospitals due to the number of resulting complications to the woman, something the right is supposedly trying to prevent. Hypocrites, as usual.

  33. 33
    Sgaile-beairt says:

    Remember Georgia Rep. Terry England (R) who says its okay to let women just suffer like this bc on his farm thats how they deal with bovine miscarriages when sponosring a fetal heartbeat bill here this past year??

    http://www.rawstory.com/rs/201.....-and-pigs/

    http://videocafe.crooksandliar.....ws-and-pig

    http://terryenglandforgeorgia.org/

  34. 34

    @scav:
    Absolutely one hundred percent correct. Other people’s lives are meaningless compared to their arbitrary ideal. Since enforcing their ideal lets them force their culture and their way on other people, and lets them feel really self-righteous about it, they get a huge kick out of making others suffer for that ideal. A death like this gets a tiny drop of ’tisk tisk’ and a bathtub full of ‘Yay, people are dying so that I can get my way!’

  35. 35
    Villago Delenda Est says:

    Sluts…even married ones who have never had a sexual partner other than their husband…MUST be punished!

  36. 36
    Betty Cracker says:

    @aimai: That is a brilliant idea, Aimai. I went through a high-risk / bed-rest pregnancy myself back in the day, and even in the late 90s, there were tons of sites for women in that situation but nothing at all like what you describe in the way of organization.

  37. 37
    Watusie says:

    @aimai: Along a similar vein: do you know what the advice of the Catholic Church is to women who discover that their pregnancy is ectopic? Pack a suitcase and wait for your fallopian tube to burst. You’ll recognize it when it happens because of the searing pain. Then you can go to the hospital and ask the doctors to sew you back together.

  38. 38
    me says:

    @JPL: It’s Catch 22 then. You can’t know the woman’s life was in danger until she’s dead.

  39. 39
    gelfling545 says:

    I am just sick over the death of that poor woman in Ireland. As I have mentioned here before it was only about 3 years ago that my daughter was turned away from a Catholic hospital in the midst of a miscarriage because they “couldn’t interfere”. Fortunately we were able to get her to another hospital – several miles away – for appropriate treatment but the thought of what could have happened is just chilling. The danger is just as real for women in the US.

  40. 40
    Villago Delenda Est says:

    @me:

    That’s some catch.

    The best there is!

  41. 41
    Felinious Wench says:

    I don’t think these people realize how offensive it is to read something like this and know it’s about me and my ability to make the right choices for my healthcare. I can’t quite express how offensive it is.

  42. 42
    Persia says:

    @aimai: I remember hearing of a woman this happened to, and (I was in high school and this was secondhand) the impression I got was that the doctors recommended she not have the D & C. Now medical knowledge may have changed, or the fetus might not have been, you know, all the way dead, but that story is now even more horrifying than it was when I was a kid.

  43. 43
    Cassidy says:

    @The Moar You Know: I like the”line them up against the wall” solution.

    @CA Doc:

    These people have no concept of what physical and mental torture it would be to be forced to carry a non-viable fetus.

    Oh they get it. They just don’t give a shit.

  44. 44
    Trakker says:

    How do we get testimony like this out to the public? Our politicians and the press won’t do it. It’s not just this issue but a whole slew of issues from poverty to guns that no one in power will touch but I think would resonate among the people.

  45. 45
    Roger Moore says:

    @aimai:

    my feeling is that we need to go around and under and through the legislators

    For some of these legislators, the only way we should be going through them is in the spirit of Vlad Tepes.

  46. 46
    Richard says:

    These people are happy to see women get murdered to keep a nonviable fetus alive for a few extra hours. My, what admirable “family” values.

  47. 47
    Arm The Homeless says:

    So which FPer is going to be responsible to unpack this lunacy?

    I am very much in favor of the GOp turning itself into a Dadaist comedy troupe, but when your members are fighting against mind-control and water fluoridation, you’re giving away the joke way too easily.

    I sure hope this stuff is being collected for Oppo-research

  48. 48
    The Moar You Know says:

    I can’t believe that anyone wants more of that here in the US.

    @Felanius Kootea: An arena full of people, on national TV, leapt to their feet and cheered when GOP candidates were asked how they feel about people who die from not having healthcare.

    From the available evidence, about 48.5% of Americans do “want more of that here in the US”.

    Along a similar vein: do you know what the advice of the Catholic Church is to women who discover that their pregnancy is ectopic? Pack a suitcase and wait for your fallopian tube to burst. You’ll recognize it when it happens because of the searing pain.

    @Watusie: Sometimes it doesn’t hurt at all. A neighbor just collapsed in front of my parents one day, my mom had just enough nursing school to figure out that it was because she had lost all blood pressure. If the hospital had been ten minutes further away she’d have died.

  49. 49
    Chris says:

    @The Moar You Know:

    No, people like this will never stop existing, but you can fight them one issue at a time and make a lot of people’s lives better every time you win.

    (The way you know you’ve won: when they start trying to claim the credit, in “we were totally on board with that all along” fashion, for one of your victories. Like they do with abolition and desegregation today).

  50. 50
    Richard says:

    The Catholic Church should be pushed out of the hospital business.

  51. 51
    gnomedad says:

    @Mnemosyne:

    Hell, Catholic hospitals are even forbidden from ending ectopic pregnancies, which by definition will end in the death of both mother and fetus, because ending them is “an abortion.”

    I’d swear I heard in Catholic high school (Jesuit) in the late 60’s that terminating an ectopic pregnancy was permissible because the fetus is doomed anyway and the death of the fetus is a secondary effect – not the goal of the procedure. Does anyone out there know more about this?

  52. 52
    liberal says:

    @wenchacha:

    Pregnancy isn’t an illness, but it is also not just a benign condition.

    On this blog or some other, some concern troll went on about how pregnancy isn’t a “disease,” I think in the context of discussions about forcing insurance coverage of female contraception.

    While it indeed might not be a “disease” in some senses of the word, the rate at which women will die if the condition isn’t “treated” (meaning, an abortion, or a medically assisted pregnancy/birthing process) is scarily high.

  53. 53
    RedKitten says:

    I honestly just don’t GET this. I really don’t. If a woman is in the middle of a miscarriage, it’s not like she’s wanting the pregnancy terminated for shits and giggles. Why can we not just let doctors and patients work together to determine patient care, based on the patient’s needs, and leave religion and politics out of it?

    That poor, poor woman…the hell she went through!

  54. 54
    Yutsano says:

    @gnomedad: Jesuits are sometimes heretical in their deviance from papal teachings. So my guess is that doesn’t get discussed anymore.

    @RedKitten: Becuz JEEBUS!! Or something. Not in the Bible blah blah blah…How these people manage to tie shoes (which also isn’t in the Bible!) in the morning sometimes amazes me.

  55. 55
    McJulie says:

    @gelfling545: probably not an option in Ireland, but what about an organized boycott of Catholic hospitals here in the US?

  56. 56
    liberal says:

    @Cassidy:

    I like the”line them up against the wall” solution.

    This kind of thing makes human seem a lot less violent than other evidence would dictate.

    If doctors did that to my wife, I’d seriously contemplate blowing their damn heads off.

  57. 57
    liberal says:

    @CA Doc:

    I had a patient who for various reasons didn’t know she was pregnant with an anencephalic baby(no brain development) until she was 18 weeks…

    One thing that sticks in my mind is some woman who testified before some House panel about having a relatively late abortion of her anencephalic fetus, then having home wrecker Henry Hyde lecture her, IIRC.

    What a f*cking moral monster.

  58. 58
    gwangung says:

    @McJulie:

    probably not an option in Ireland, but what about an organized boycott of Catholic hospitals here in the US?

    Not sure that’s an option here, either, given how Catholic health care systems have merged with other systems.

  59. 59
    scav says:

    @McJulie: Minor difficulty being there may not be any other viable options nearby.

  60. 60
    peorgietirebiter says:

    @Frankensteinbeck: and it’s an ideal that, for themselves, is effortless to uphold. When droves of combined families and divorcees began fleeing from weekly harangues about their mortal sin, the church needed to provide an object of hate that didn’t cut so close to the bone. Thus a cottage industry was born.

  61. 61
    gnomedad says:

    @gnomedad:
    Just learned something new (if Wikipedia is accurate):

    Using the Thomistic Principle of Totality (removal of a pathological part to preserve the life of the person) and the Doctrine of Double Effect, the only moral action in an ectopic pregnancy where a woman’s life is directly threatened is the removal of the tube containing the human embryo (salpingectomy). The death of the human embryo is unintended although foreseen.
    __
    In Catholic theology, it is never permissible to evacuate the fetus using methotrexate or to incise the Fallopian tube to extract the fetus (salpingostomy), as these procedures are considered to be direct abortions.

    So you can extract the tube with the fetus, but you are not allowed to leave the tube intact. Yikes.

    While searching for this, I saw suggestions that you can just extract the fetus after it’s viable and everything will be swell.

  62. 62
    Chris says:

    @Yutsano:

    Jesuits are sometimes heretical in their deviance from papal teachings. So my guess is that doesn’t get discussed anymore.

    Yep. That and the RCC’s spent at least the last two papacies turning back as much progress as they conceivably could. I swear I remember that in the 1990s it wasn’t considered wrong for a gay man to be a priest (after all, if he obeys his vows, how’s he going to act on it anyway?) but as of the early 2000s, they were out of the priesthood.

  63. 63
    Kristine says:

    @Cassidy: @CADoc:

    These people have no concept of what physical and mental torture it would be to be forced to carry a non-viable fetus.

    Part of me–well, most of me–thinks that they are content, if not eager, for women to suffer whenever possible. Payback for the Sin of Eve.

    That, and the fact that they consider women interchangeable incubators. If a woman dies, there will always be a mother/sister/cousin available to pick up the slack.

  64. 64
    Mnemosyne says:

    @McJulie:

    Because Catholic hospitals have been buying up a lot of nonprofits, that would leave people in less populated areas with no hospital they can go to within 100 miles. Kay has had some good stuff about this.

    This is, frankly, yet another of the problems of our fucked-up health care delivery system — if people complain that they’re being treated according to Catholic doctrine at at Catholic hospital, the hospital says, “Fine, then we’ll shut down and you won’t have a hospital available within 200 miles. Too bad, so sad,” because there’s no requirement that, say, people have medical services available within X distance from population centers.

  65. 65
    beltane says:

    @liberal: Pregnancy is not a disease but it is a medical condition with the potential for an extremely high mortality rate in the absence of proper medical care. Just as the anti-vaxxers have forgotten the days of high childhood mortality from what are now preventable diseases, the forced-birthers have forgotten that until recently, maternal death was a very real risk with each and every pregnancy.

  66. 66
    Yutsano says:

    @gwangung: Swedish (big hospital system in the Seattle area for you non-residents) just merged with a Catholic hospital system. I can’t wait for the inevitable howls when procedures that used to be done there get denied because of this.

  67. 67

    […] women could face—might already face in some places in America in Catholic hospitals. Or, soon enough, in the state of Ohio! The current crop of religious nutjobs who think women exist to be self-propelled wombs, they who […]

  68. 68
    slag says:

    @RedKitten:

    I honestly just don’t GET this. I really don’t. If a woman is in the middle of a miscarriage, it’s not like she’s wanting the pregnancy terminated for shits and giggles.

    Nothing about this makes sense. Even if a woman were wanting a pregnancy terminated for shits and giggles, I think it might be best for all concerned if she, in fact, were allowed to terminate the pregnancy. Unless we’re intent on starting up a Feckless and Reckless Coalition for Motherhood, that is.

  69. 69
    beltane says:

    @Yutsano: Maybe we ought to follow the example of the forced-birthers and protest outside of Catholic hospitals. Most women probably have no idea that their lives or future fertility are in grave danger by receiving “care” at these institutions.

  70. 70
    wenchacha says:

    @burnspbesq: Maybe I was not clear. This should not be a political issue, any more than how we treat a broken arm. Politicians who interfere with a women’s ability to get life-saving treatment have blood on their Bible-thumping hands.

  71. 71
    Syrbal says:

    Oh, so we can have in Ohio what an unfortunate young woman suffered in Ireland:
    death by heart-beat?

  72. 72
    gwangung says:

    @wenchacha: And they’re proud of it.

  73. 73
    CA Doc says:

    @Cassidy: This is one of my big problems: I’m forever assuming other people are capable of empathy. I’m so naive.

  74. 74
    burnspbesq says:

    @McJulie:

    what about an organized boycott of Catholic hospitals here in the US?

    Look at a map, identify the (large) parts of the country where the only hospital available within a reasonable distance is a Catholic hospital, and get back to us. I think you’ll rethink that idea.

  75. 75
    burnspbesq says:

    @wenchacha:

    Maybe I was not clear. This should not be a political issue

    I understood you perfectly. Whether or not it should be a political issue is irrelevant. It is a political issue. Deal.

  76. 76
    Cassidy says:

    @burnspbesq: Dude? Who pissed in your cheerios this morning?

  77. 77
    lafcolleen says:

    @CA Doc:
    A close relative’s first child was acephalic. Born several weeks premature and died a n hour later. Later pregnancy had massive birth defects (brain developing outside the skull plates because the plates didn’t close properly as well as spina bifeda(?). She had asecond trimester abortion. That was in Georgia almost 20 years ago. And that is why I stopped being squimish about abortion rights – because why do I get to decide her reasons were good enough? Once I realized I didn’t want veto power over her decision, I was able to walk away from the concept of anyone having veto power over that decision.

  78. 78
    liberal says:

    @beltane:

    …the forced-birthers have forgotten that until recently, maternal death was a very real risk with each and every pregnancy…

    Yeah. It’s not like I’m all that old, but I’m pretty sure my mom told me that one of my great grandmothers died sometime postpartum due to complications from childbirth.

    I’ve never researched on the intertubes what the actual numbers are, but I assume they’re at least on the order of 1%, not 0.1%.

  79. 79
    Cassidy says:

    Maternal death is still a very real risk of childbirth. We’ve just gotten better at identifying and managing the symptoms. Still, with the wonders of modern medicine, pregnancy and childbirth is probably the most potentially dangerous activity a woman will go through.

  80. 80
    Recall says:

    Why aren’t we using this as a wedge issue?

  81. 81
    liberal says:

    @gnomedad:

    While searching for this, I saw suggestions that you can just extract the fetus after it’s viable and everything will be swell.

    Yeah, I’ve heard such things from anti-abortion people myself. The ignorance is stunning.

    One biological fact which I’ve never been able to understand—there really have been cases where human “abdominal pregnancy” has produced a viable infant.

  82. 82
    liberal says:

    @Recall:
    That’s a great mystery.

    For the issue of abortion and rape, the ads write themselves. Start with a very genteel couple crying because the state has mandated that their daughter bear her rapist’s child.

  83. 83
    burnspbesq says:

    Here’s a thought.

    The Federal agency in the best position to resolve this issue the way y’all want it resolved is the IRS. It writes the regulations that specify what tax-exempt hospitals have to do in order to retain their exempt status.

    The job of Commissioner of the IRS is currently vacant. Obama will have to nominate someone to succeed Doug Shulman, who recently retired. When that successor is nominated, there will be a confirmation hearing before the Senate Finance Committee.

    Write to all the Democratic members of the Finance Committee. Tell them that you want this issue to be raised in the confirmation hearing, and that you want them to vote “no” unless they get assurances that the problem will be addressed to your satisfaction.

  84. 84
    Roger Moore says:

    @burnspbesq:

    Look at a map, identify the (large) parts of the country where the only hospital available within a reasonable distance is a Catholic hospital, and get back to us. I think you’ll rethink that idea.

    The obvious solution is to get the Catholic health care system as part of the penalty in the RICO suit over hiding child rapists. It can be the foundation for our new single provider health care system.

  85. 85
    beltane says:

    @liberal: Or an ad featuring young children crying because their mother was murdered by ideologues at a Catholic hospital.

  86. 86
    liberal says:

    @beltane:
    Yeah.

    I was surfing once and came upon some kind of Church of England blog. Might have belonged to the Archbishop of Canterbury himself; don’t recall.

    Anyway, while I got the sense that the religious official was somewhat anti-abortion, they were repulsed at this idea of putting a mother’s life at risk. I think the issue being discussed might have been the excommunication of a nun at a Catholic hospital in the US who saved a woman’s life.

    In the comments section, somewhat raised the issue of all these pedophiles who’ve been defrocked but not excommunicated. Some commenter, almost certainly Catholic, gave out the standard line that the priests had sinned but not taken life, blah blah blah.

    It really dawned on me, beyond the fact that these people are wrong, wrong, wrong, is that they’re f*cking perverts. Only someone with a completely perverted sense of right and wrong would think that the good done by the nun is somehow more immoral than the bad done by pedophile priests.

  87. 87
    liberal says:

    Another case this discussion brings to mind was that couple, where the woman was dying from some condition while pregnant and was in a coma. Doctors told the husband that if they performed an abortion, she might make it. The husband decided to do that, but then things got tangled up by some right-to-life people who legally petitioned to become guardians/whatever.

    That was finally taken care of in a court, the abortion was performed, and the woman recovered. I think it was NY state but am not sure.

  88. 88
    ellie says:

    These people are absolute fucking monsters.

  89. 89
    beltane says:

    @liberal: Yes, it was in New York State. And I believe the couple in question were not even Catholic.

    There is a strain of Catholic thought that regards women as the polluted vessels of sin whose only legitimate reason for existence is to incubate future Catholics, particularly males. Given this way of thinking, there is a certain nasty logic in allowing women who aren’t competent breeders to perish and be tossed in the dumpster like a broken toaster oven. Most lay Catholics do not think this way but the hierarchy certainly does and always has.

  90. 90
    Another Halocene Human says:

    Yes, Kay, please don’t stop talking about this. The stuff that happened at that hospital in Phoenix is prologue for the rest of the country. This is part of the reason the Catholic hierarchy didn’t lift a finger to support the ACA being passed and squealed like stuck pigs when Sebelius put forward that rule on birth control. They are gaining more and more control over the lives and deaths of Americans, many of whom are not even Catholic, and their greatest fear is the government, representing the non-Catholic majority, stepping in. They’ve gained control as hospital after hospital went bankrupt. They’re the biggest enemy of the public option and public hospitals there is. And they’ve tried to shut up the nuns because the nuns emphatically are not on their side.

    I’ve followed this story for a while on Pharyngula. That blog produces a crapflood of posts but I think PZ’s old posts on ScienceBlogs about the Phoenix situation have a lot of good info without digging into the rather bloody-minded comments sections.

    OT whining ahead:

    The problem with the comments is that atheists attract the worst trolls, and then PZ has the temerity to be a feminist, too, so he gets these MRA trolls, and his cadre of regular posters, some of whom are these hardbitten feminists, I picture them like Patty and Selma but with Prodigy accounts, execute the trolls with extreme prejudice. PZ is from the old school and tends to argue with and warn trolls before nuking them, meaning more troll spoor per thread. Also, wherever he goes the server always seems to be slow (usually b/c it’s the highest activity blog) so I finally tired of following Janine, Vile Bitch, Salty Current, and the ever-witty ‘Tis Himself.

  91. 91
    Another Halocene Human says:

    Also, if you support Planned Parenthood, please consider supporting Americans United as well. They were active back in the 50’s fighting the access to birth control wars and they are active now fighting public funding for church schools, forced religious exercises in public schools, and increasingly they are knee-deep in this war on women bullshit. They do tons of media outreach, do a great job of communicating with members, and they have lawyers and they sue and they win. (They were one of Judge Roy Moore’s nemeses.)

  92. 92
    gelfling545 says:

    @McJulie: One begins to feel that perhaps the time has come but it might be difficult as in some areas there is only the catholic health care system.

  93. 93
    Another Halocene Human says:

    Oh, and FUCK Huckabee for saying “life begins at conception, that’s scientific”. Bullshit. Huckabee cannot define life without reference to the Bible. By any SCIENTIFIC standard, human gametes, spermatazoa and ova, are ALIVE. Cut the motherfouling crap already. That is a theological argument.

    Guess what, folks, sometimes you have to kill things in order to live, just like when you eat food, despite what some vegans believe–in fact, animals die for that soya. Vegans think animals should never suffer, the RCC decrees that humans can’t be killed (suffering is AOK), they’re both in la-la land and their opinions need to be set to ignore.

  94. 94
    Another Halocene Human says:

    @CA Doc: These people have no concept of what physical and mental torture it would be to be forced to carry a non-viable fetus.

    Plus there’s the issue of natural economy. Which suits them just find because they’re either misogynists who consider that just punishment for their wet, dripping womanliness, or they’re FYIGM’s who think that life is a zero sum game and are laughing that someone else has been put back in the rankings.

  95. 95
    Schlemizel says:

    @Richard:

    HA! NOT LIKELY. The hospital business is big money & going to get better this is a huge income source for the church. Once they no longer have to even pretend to give services away there is going to be a lot more cash flowing in.

    The RCC is well aware of this & has been moving to ‘consolidate’ hospitals to control a larger portion of the market

  96. 96
    Another Halocene Human says:

    @aimai: You’re making really good points, aimai. Mommy blogs, tv shows… part of the problem is that a lot of people don’t believe this stuff really happens or that it could happen to them.

  97. 97
    Recall says:

    @liberal:
    @beltane:

    You guys aren’t being creative enough. What we need to do is crack down on hospitals that let unsafe abortions happen through negligence.

  98. 98
    Another Halocene Human says:

    @gnomedad: I’d swear I heard in Catholic high school (Jesuit) in the late 60’s that terminating an ectopic pregnancy was permissible because the fetus is doomed anyway and the death of the fetus is a secondary effect – not the goal of the procedure. Does anyone out there know more about this?

    And they told me the same in the 1990s, that they would never (priest said this, regular parish priest, not Jesuit) tell a woman to carry a non-viable pregnancy which would result in her death because she needed to think of her other children.

    They lied.

    That’s all.

    Once again, they lied.

  99. 99
    Schlemizel says:

    @liberal:

    Nah, I’d look to take out someone they love – spouse, lover, kid so they could have the joy of attending the funeral.

  100. 100
    Another Halocene Human says:

    @gnomedad: So you can extract the tube with the fetus, but you are not allowed to leave the tube intact. Yikes.

    In this most misogynistic of religions, the harm to the woman is not a moral consequence worth noting.

    Is anyone left wondering why so many Catholic women used to become nuns?!

  101. 101
    Another Halocene Human says:

    @liberal: One biological fact which I’ve never been able to understand—-there really have been cases where human “abdominal pregnancy” has produced a viable infant.

    Pubmed link please, as that would indeed be extraordinary if true.

  102. 102
    liberal says:

    @beltane:

    And I believe the couple in question were not even Catholic.

    Right, that’s exactly the point—the husband was just minding his own business, and these assholes barged in.

    I’m not sure if the assholes were Catholic though; they might have been evangelical (though I guess Catholic is more likely).

  103. 103
    Another Halocene Human says:

    @Schlemizel: An eye for an eye–Biblical law. Read it and weep, Miter-heads.

    //

  104. 104
    Persia says:

    @Schlemizel: Yep, two of the biggest hospitals in New Hampshire were looking to merge. The deal fell apart after Catholic Medical Center determined that Dartmouth-Hitchcock might continue to harm the babbies, and DHMC determined that CMC had crazy people in it.

    At least that’s the impression I got.

  105. 105
    Sister Rail Gun of Warm Humanitarianism says:

    @liberal:

    It’s not like I’m all that old, but I’m pretty sure my mom told me that one of my great grandmothers died sometime postpartum due to complications from childbirth.

    I’m closing in on fifty, and I used to work with a man only a few years older who lost his wife in childbirth. Also used to work with a woman maybe ten years my senior who was sterile because of complications after delivering her son.

    This isn’t something from a few generations ago.

  106. 106
    liberal says:

    @Sister Rail Gun of Warm Humanitarianism:
    Right, though the rate (thankfully) is a lot lower.

  107. 107
    liberal says:

    @Another Halocene Human:
    Wikipedia article on “Abdominal pregnancy” has a pub med reference. (Sorry, my posts containing links are being eaten up.)

  108. 108
    burnspbesq says:

    @Roger Moore:

    Of you’re going to dream, there’s no harm in dreaming big, I guess.

  109. 109
    Another Halocene Human says:

    @Sister Rail Gun of Warm Humanitarianism: If you want some tales that will chill your bones, read the NoLongerQuivering blog, Vickie’s story. She risked death trying to have alllllll the babbies God wanted, without medical intervention. The crazy leaders of this cult are the really scary ones. Psychopaths is not to strong a word.

  110. 110
    Another Halocene Human says:

    @liberal: This one?

    http://www.ncbi.nlm.nih.gov/pubmed/23124825

    That is pretty extraordinary. I can’t believe they made it to 34 weeks. I’ve been told organs would start failing. Hmm. Maybe those mpreg stories are as ridiculous as they seem.

    Advanced abdominal pregnancy is a very rare extrauterine pregnancy, which results in serious maternal and fetal morbidity.

    Or not.

    Okay, you win. I did not know this was possible. Wacky.

  111. 111
    Pinkamena Panic says:

    H@Another Halocene Human: Oh thank god, I thought I was the only one who got sick of the self-important cult of no personality lurking in the Pharyngula commentariat. Someone ought to tell them to drop the high school clique mindset and realize that people might – gasp! shock! – be able to disagree with them without being subhuman!

    The sad part is that PZ is better than his followers, but they pretty much run the show there.

  112. 112
    EL says:

    @liberal:

    @liberal: One biological fact which I’ve never been able to understand—-there really have been cases where human “abdominal pregnancy” has produced a viable infant.

    It’s extremely rare, but it has occurred. The case I learned about in medical school was where the tube ruptured and the embryo implanted in the abdominal cavity. Everyone though it was a normally progressing pregnancy until at about 6 months when her blood pressure dropped like a stone. The woman nearly died but the doctors were able to save mother and baby. Very rare for these to have a good outcome.

  113. 113
    EL says:

    @Another Halocene Human: extremely rare, but there are cases, like this one.

  114. 114
    Mnemosyne says:

    @CA Doc:

    Unfortunately, that is the problem. Even if you can point to cases like this one, most people assume that it will never affect them or anyone they know, so they’re fine with putting more and more restrictions on abortion because, hey, it’s never going to affect them.

  115. 115
    Sister Rail Gun of Warm Humanitarianism says:

    @Another Halocene Human: I’m a walkaway. I grew up among fundies and got out alive and (mostly) sane. I can’t read things like that without risking being triggered.

    Yes, they’re raving psychopaths.

  116. 116
    fuckwit says:

    @Felanius Kootea: The whole goal of the wingnuts is to have that happen here, all the time.

  117. 117
    PurpleGirl says:

    @Another Halocene Human:

    Is anyone left wondering why so many Catholic women used to become nuns?!

    Think about it: You’re one of 4 sisters of a farm family or factory worker. There is no one to marry. Your options are to live with your parents and family until you die or become a nun and learn something to do (maybe teach) and have a roof over your head and meals every day (mostly, except for special days). A lot of women choose to become a nun.

  118. 118
    J R in WV says:

    It sounds like Catholic hospitals should all have their license to operate revoked, as they aren’t willing to provide care to pregnant women.

    If they aren’t willing to provide the standard of care to pregnant women, then by providing spurious hospital care in a location, they prevent real hospitals from being able to provide real care to everyone in that locale.

    This is obviously immoral…

    The catholic pederasty church should have their property confiscated, as they are a conspiracy to protect pederasts from discovery and prosecution. If they can continue their religious activity without churches, rectories, abbeys, etc, then good on. But all those facilities should be confiscated and used as small colleges, high schools, etc.

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