Sunday, February 12, 2012

Abortions and the Consequences of Not Doing Them

Abortion has become a hot button issue. I will not indulge in the medical reasons for doing
them, but instead will focus on the arguments made by the opponents of abortion and
the consequences that will occur if they are successful in making abortion illegal.
No one I know of, even on the choice side of the debate, likes abortions. I as a physician have not
done abortions, but have referred patients to abortion clinics after explaining different options to the patient; it is up to the woman and her conscience. I have no right to intrude my biases or
beliefs into another’s at such a stressful and vulnerable time.
The abortion opponents make the following arguments for denying the procedure.
“Life begins at conception.” My response is then to ask: is not the egg and sperm alive? At
conception the fertilized egg is a/or potentially a human being. But with the advent of cloning then every cell in the human body is potentially a human being. So every time you scratch your nose you commit a holocaust. It has been estimated that 70-75% of all fertilized eggs or conceptions are eliminated from the body, most with the woman not even knowing she was pregnant. If one says God decides which eggs survive, then does that make God a serial killer of those hundreds of eggs per women that did not please him. Another argument is that abortion
causes pain and suffering to the embryo/fetus. When a conception product reaches the level of blastula it is nothing more than a glob of cells that doesn’t even have the differentiated nerves to recognize noxious stimuli. Later in development when nerve cells are forming, the myelination that will allow for proper function, including pain perception for the central nervous
system is far from complete until long after birth. Another controversial topic highlights this
dilemma, circumcision. This procedure has been carried out for years in newborn baby boys without anesthesia. Now, it is still done in some regions without anesthesia. Studies have shown increases in heart rate, blood pressure and respirations with the procedure. But the infant is also tied down and restrictinga baby from moving also causes these same responses. I have done circumcisions on unanesthizedinfants and have had them fall asleep while I was doing the procedure. Now authorities recommend anesthesia to prevent pain and suffering, which they say will cause deep underlying psychological scars in the child. If you ask a grown male if he remembers his circumcision, he will say no. If you ask him if he thinks he was psychologically damaged by doing the procedure without anesthesia, he will look confused at first and then call you crazy. This discussion is not to condone circumcision, but to highlight the question of does the fetus feel pain during an abortion. Odds are not, but we really don’t know.
Now we come to religious arguments, which is really where the opponents are coming from. They say the soul is started or instilled at conception. What is the soul? It is a rather nebulous term that everyone seems to understand, but no one can define adequately. I can
find no place in the bible where it says the soul is put into a fertilized egg. If one likens it to personality, then that really doesn’t start to develop until one has been long born. Genetics may have some effect on it, but so does environment as the child grows up. Is it consciousness? A little homunculus inside your head that is aware. Consciousness is hard to define, but neuroscience is getting closer. It seems to be a byproduct of 100 billion neurons with 100 trillion synapses as an emerging property of complexity of the brain. Can you remember when you first became self aware? God forbids murder. But God in the bible has killed enormous numbers of innocent people including children. Flood of Noah, if it occurred at all, must have killed untold numbers of children. The first born in Egypt were killed and I wager that by far the largest number of them were innocent. He commanded the Hebrews to kill the Midianites, Ammonites, Moabites and other tribes occupying Canaan before the Hebrew invasion of Joshua including
the children, but to save the virgin women for themselves.
The World Health Organization (WHO) in 2010 reported that every minute one woman dies from complications related to pregnancy or childbirth, or approximately 529,000 per
year. For every woman that dies in childbirth twenty more suffer injury, infection or disease, that
is equivalent to about ten million per year. Five direct complications account for greater than 70% of maternal deaths; they are hemorrhage 25%, infection 15%, unsafe abortion 13%, clampsia 12% and obstructed labor 8%. There are one million children left motherless per year and they are ten times more likely to die within two years of their mother’s death. An unsafe abortion as defined by the WHO is a “procedure for terminating an unwanted pregnancy either by persons lacking the necessary skills or in an environment lacking the minimal medical standards or
both.” 95% of the maternal deaths globally occur in developing countries. Those numbers of deaths are equivalent to six jumbo jets crashing per day, each carrying 250 childbearing age women.
When one tries to get accurate information of legal and illegal abortion rates in the United States and other countries with associated mortality and morbidity, one has to be
careful of the sources because of biases found in Pro Life sites. Truly academic, fact based, neutral sites are swamped by an ocean of propaganda sites. Books and articles can be found, but propaganda sites spin the data from them also.
According to a study by Moos et.
Al., from the Dept of OB/Gyn at the University of North Carolina at Chapel Hill in 2003, the world wide unintended pregnancy rate approaches 50% of all pregnancies. Also, “Virtually no experimental or observational literature reliably answers questions about the effectiveness of counseling in the clinical setting to reduce the rates of unintended (unwanted, mistimed) pregnancies in this country.” Yes, abstinence is the only way to delay or prohibit unwanted
pregnancies, however, humans being what they are, means to rely on that is folly. Studies
have shown that religious kids have as much sex and get pregnant like any other and in some studies more; case in point is certain religious politicians, who represent family values,
whose daughter had out of wedlock sexual encounters with a child being produced. That is not to mention other recent popular religious family value politicians having affairs that
resulted in children out of wedlock. Almost half of unintended pregnancies end in abortion. According to JB. Smith et.al. the “primary benefit of increased contraceptive prevalence is a reduction in the number of unwanted pregnancies and thus abortions.” Indeed, studies by the WHO, Guttmacher Institute and others have found that the rate of unintended pregnancy and subsequent abortions decline. And the death rate due to abortion complications fell by more than 50% in five years following liberalization and legalization of contraception and abortion.
The WHO also has research that shows that in countries that outlaw abortion, after it being legal, the practice and subsequently illegal abortion rates skyrocket, and needless to
say the death rates. We have experience with trying to legislate morals that failed miserably, it was called Prohibition. Are we doomed to repeat this mistake? There are approximately six million pregnancies per year in the U.S., half are unintended. The mortality rate from a legal abortion performed during the first trimester is approximately 0.6/100000. The risk of dying from the abortion doubles for every two week delay after eight weeks gestational age. In 1975, according to Williams Textbook of Obstetrics, 16th edition, 25% of terminated pregnancies occurred by legal abortion, 2/3 in unmarried women and ½ occurring in teens. It has been estimated that 70% of current legal abortions if not available would have occurred illegally
then. In 1990 there were 1,200,000 abortions per year in the U.S. and it has been decreasing.
In 1996 there were 314 abortions for every 1000 live births for a national rate of 20/1000
for 15-44 year old women. How many died per year before Roe v Wade? In the 1940’s greater than 1000 women died per year secondary to abortion complications. Several studies from a
book titled “When Abortion was Illegal” cite a study in 1932 that estimated the death rate from illegal abortions at 15,000 each year. More conservative estimates calculate 5,000 to 10,000 per year. These abortions death rates primarily reflect women who tried to do the abortion
themselves or had untrained opportunists perform the procedure. In the 1960’s in New York 42% of the maternal mortality rate was due to illegal abortions.
So when or if abortion again becomes illegal, what will be the consequences?
It should be obvious by now that the death rate will climb. The cost to the tax payer will increase to take care of the sick and injured. More prisons will be needed and to be paid for to house the new criminals. Some will give their children up for adoption, around 5%, but the numbers vary. Some will keep the babies, but a lot will be stuck at the poverty level because they cannot afford to leave their unwanted children alone and go back to school or work. It has been shown in other countries by WHO and other international agencies, if you give women the right to control their own bodies that automatically translates into more opportunities economically and the country then begins to prosper. Margaret Sanger said in 1920; “No woman can call herself free who does not control her own body.” Then there is the cost of raising a child. A minimum is $118,590 that will also ultimately have to be carried by the taxpayer.
Pro Life then means Pro Death and can best be exemplified by the true believer who guns down a physician who is simply trying to provide a safe and economical service to the
individual women, who knows that she cannot carry this child to term
for whatever reason.

Peace Skeptical DoDo

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