OPINION: Forcing women to deliver a dead fetus is anything but dignified

Photo Courtesy Associated Press/ Photographer: Ross D. Franklin

By Gloria Frank, Linda Spar

May 15, 2024

This is part five in a series on the increase in violence against women since the US Supreme Court overturned Roe v. Wade, and the future of abortion care and emergency medical treatment in the United States.

Read part one here.

In these states and others in red America, where abortion is now illegal, deciding to even become pregnant is a fraught experience.

Families are struggling. Men are struggling. Every gendered and non-gendered person who can get pregnant is struggling. Potential surrogates are struggling. Partners, husbands, wives, and significant others are playing an uneasy game of baby roulette:

“If we get pregnant, but the fetus develops a genetic abnormality and will not survive, I will need to flee the state.

“Could we afford it?”

“Can I find childcare?”

“Get time off from work?”

“Will our neighbors or family ‘snitch’ on us? Call the police?”

“What if I miscarry and am accused of ending the pregnancy on purpose? Or what if I require chemotherapy or another teratogenic drug treatment to save my own life and need to end the pregnancy? Will my own obstetrician even be permitted to give me medical advice? “

There are many women who—having already been pregnant but forced under their state laws to wait until they were almost dead, or forced to wait extra weeks or months to find a hospital with a place for them in another state to get an abortion and save their lives—are physically or emotionally (or both) unable to get pregnant again.

Because of the damage to their bodies from being terrorized by their state legislators or other government officials.

This is not “pro-life.”

Dr. Kara Shain, an OB/GYN in New Mexico, explains that forcing a woman to remain pregnant to deliver a dead or dying infant “intact” can be viewed by the layperson as a more “dignified” exit for the fetus than an abortion later in pregnancy.

“One common argument against abortion is that dilation and evacuation (a method for performing an abortion later in pregnancy) is a brutal procedure that strips the fetus of compassion and dignity,” said Shain. “As someone who has trained for 13 years to provide care to women and their pregnancies, I can promise the grey area regarding abortion is vast.

“Consider the story of a patient of mine who had a baby with anencephaly. This is a severe neural tube defect, causing the infant to have little to no brain and skull tissue. The patient had wanted an earlier termination for this condition (which is not compatible with life) but was unable to access this care. She carried her pregnancy to term and underwent an induction to deliver the baby.

“Herein lies the grey area. Because there is limited cephalic (head) tissue, there is minimal pressure applied to the cervix to dilate it. In a typical labor and delivery, the cervix dilates to 10 centimeters, mostly due to fetal head pressure. Also, the fetal neural (nerve) pathways assist in the successful labor process.

“These brain pathways are limited to absent in a fetus with anencephaly. This all leads to a very prolonged induction (labor, during which the fetus did not survive). A lengthy induction largely increases risk of hemorrhage and increases the risk of maternal blood clot among other medical risks.

“The reason to dive into the medical weeds with this case is to highlight that while the fetus delivered intact, this prolonged, medically risky, and traumatic term delivery was anything but dignifying and compassionate. The woman’s safety and experience would have been largely benefited by having the abortion as soon as the diagnosis was made.”

This is clearly another example of domestic terrorism. Women and families are now being terrorized in conservative, Republican-led states.

Women living in states that ban abortion actually repeat the same phrase: they are terrorized to live in such a place.

Unbelievably, this is happening right here, right now. In 2024.

There should be MUCH more outrage in America right now. From every person in every political party. Every single federal lawmaker takes a solemn oath of office, in which they declare they will defend the Constitution of the United States against all enemies, foreign and domestic.

But it is the Republican lawmakers and others now who are the domestic enemies. They are enemies against women. By threatening the sale of contraception and the morning-after pill, and halting abortions, they are domestic terrorists. Women are being terrorized across our land.

And the poor are, sadly, suffering more terror than anybody.

Authors

  • Gloria Frank

    Gloria retired in 2021 after a 36-year legal career, including leading Medicare’s EMTALA enforcement program in the late-1990s. She co-wrote the OIG Special Advisory Bulletin on EMTALA and assisted the Department of Justice in the Roberts v. Galen of Virginia EMTALA case before the U.S. Supreme Court.

  • Linda Spar

    Linda is a former Presidential Management Fellow who wrote the EMTALA enforcement regulations while she was lead on the Medicare EMTALA enforcement program in the mid-1990s. She is the co-author of “EMTALA in the 90’s – Enforcement Challenges,” in Health Matrix: Journal of Law-Medicine, Case Western Reserve University.

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