Thursday, May 23, 2019

Dr. Jen Gunter, an influential gynecologist (and blogger) unmasks Donald Trump as a preposterous con man on the issue of abortion and infanticide

Of all the lies Donald Trump has told since entering the White House -- and CNN puts the number at about 10,000 -- perhaps the most flagrant involved the issue of abortion rights. Given that Alabama recently passed the nation's most restrictive abortion law, which is wildly unconstitutional and contrary to biological facts and proper language, this should hit home to many of our readers -- as our blog nears its 12th birthday, after receiving the breath of life in Birmingham.

What Trump lie was so fantastic that it stands out above a crowded field -- and made an influential Canadian and American gynecologist want to flip her lid, stethoscope and all? It came in late April at a rally in Green Bay, Wisconsin (See video above), and here is how HuffPost's Sanjana Karanth reported it:

President Donald Trump continued to tell dangerous lies about abortion on [April 28], this time falsely claiming to his supporters in Wisconsin that mothers and doctors conspire to commit infanticide after a baby is born.

“The baby is born, the mother meets with the doctor, they take care of the baby, they wrap the baby beautifully,” he said in an off-the-rails rally in Green Bay. “Then the doctor and mother determine whether or not they will execute the baby.”

Yep, the president of the United States claims infanticide is routinely practiced in American clinics and hospitals. The notion so outraged Dr. Jen Gunter that she did not even have to wait for Trump to speak his words in order to call b---s--t. The canard apparently had been going around in right-wing extremist circles to the point that Gunter was able to respond to it in a blog post dated March 7, 2019, titled "I'm an OB/GYN, and infanticide is not part of abortion care. Here's why" From the post:

The propaganda about infanticide and abortion is offensive and ridiculous. It insinuates that somehow abortion involves delivery of a viable infant and then that viable infant is killed.

This isn’t what is happening. At all.

A legal, non-back alley abortion does not lead to infanticide.

Anyone who says otherwise has no idea what happens at an abortion, has a forced-birth agenda and to further that goal is attempting to equate a fetus with an infant, is purposely trying to get a health-care provider hurt with inflammatory lies. Or all three.

Just like the myth of “late-term abortions,” there are a few lies layered in, so let’s unpack them so people have the right talking points. And the truth.

The first key point: A live birth is required for infanticide -- and that means the definition of a live birth, which Donald Trump almost certainly does not know, is kind of important. Writes Dr. Gunter:

I can’t believe I have to say this, but here we are.

I’m going to repeat this again.

You need a live birth for infanticide.

This is the definition that most states use for live birth:

‘Live Birth’’ means the complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of pregnancy, which, after such expulsion or extraction, breathes, or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached. Heartbeats are to be distinguished from transient cardiac contractions; respirations are to be distinguished from fleeting respiratory efforts or gasps.

That last paragraph is likely to leave many lay eyeballs glazed over -- so Dr. Gunter adds some explanation:

The key part is the last sentence: Heartbeats are to be distinguished from transient cardiac contractions; respirations are to be distinguished from fleeting respiratory efforts or gasps.

Movement or cardiac activity does not equate life, by the medical and the legal definitions.

Whether a birth is recorded as “live” in situations of extreme prematurity or fetal anomalies — the kind of situations we are talking about — is not cut and dried. . . .

The take away — a live birth does not mean a life is possible. There is a huge difference. And, the recording of a live birth can be fluid based on parental wishes.

The second key point: Most abortions can't possibly end in a live birth that can actually result in a life:
Only 1.3% of abortions are performed at or after 21 weeks and most of these happen by 24 weeks. So right off the bat, 98.7% of abortions can’t possibly end in infanticide because they are performed before any chance of viability. There can never be a live birth no matter how much bad technique or malpractice is involved in the care. 
Most states limit abortion to under 24 weeks. So it is clear there are very few places where the mythical “live birth” abortions could actually happen. Some states allow for abortions after 24 weeks when there are lethal fetal anomalies. Let’s be super clear here — lethal fetal anomalies can’t have a life.

Maternal health is a part of the equation in many states:

Some states have a maternal health exemption. Abortions for maternal health are super rare at or after 24 weeks. They are almost always a catastrophic combination of events where fetal outcome is also deemed to be not possible or very improbable. These are wanted pregnancies, so if there is any realistic chance of fetal survival a c-section or vaginal delivery is done. The ONLY time a surgical abortion would be done is when maternal health is deteriorating quickly due to the pregnancy and fetal survival is deemed to be highly unlikely or impossible — again, for those in the back, a lethal situation cannot become a live birth. And obviously if you are pro life the life of the person that should matter the most is the maternal one, even if you just consider the mother a host. A dead mother is bad for fetal life. (I can’t believe I have to write that, but again, here we are).

The most common scenario for abortion for maternal health at or after 24 weeks is severe fetal growth restriction and severe maternal hypertension (pre eclampsia). The fetus is not considered viable due to the growth restriction, even though it is past 24 weeks. The mother is very sick and needs not to be pregnant ASAP, and an abortion is deemed the fastest way to save her life. A c-section is riskier, so if there is someone skilled to do surgical abortions at this gestational age that is the recommendation.

Determinations about fetal abnormalities cannot always be made at 24 weeks:

Sometimes the conclusion about severe fetal anomalies is not reached until 25-26 weeks or later. These are typically situations where a live birth may result in a few days of life with multiple, painful interventions or perhaps a few months of abject misery due to medical interventions. These are conditions that after birth, should these anomalies have gone undetected prenatally, we would typically allow parents to withdraw care. Withdrawing care in utero or after delivery are the same thing.

Dr. Jen Gunter
In this situation, an abortion might be accomplished by induction of labor or by surgical methods. Sometimes an induction is not possible as a c-section would be needed for obstetrical indications (meaning labor is not safe medically). Many women elect for the surgical abortion as they do not want the major surgery. A surgical abortion by a skilled provider, even in the 3rd trimester, is safer for the pregnant person.

Abortions at or after 24 weeks are VERY expensive. Typically $20,000 or more. If there are no fetal anomalies or severe maternal health indications, insurance will not cover them. Even in medically indicated situations — maternal or fetal health — the amount covered can be low or non-existent. People don’t pay tens of thousands of dollars cash on a whim.

The third key point: Most abortions can’t possibly end in a live birth because they are abortions:

I can’t believe I have to spell this out either. I mean, really?

The idea that abortions at or after 23-24 weeks — the only theortically possible “live birth scenario” — are done by two methods: surgical or induction of labor.

A surgical abortion does not in any situation result in a live birth. It’s not possible. The end.

So that leaves induction of labor. Again, these are almost always severe fetal anomalies, so the live birth scenario is preposterous and, quite frankly, offensive to those patients who are living the tragedy. Many patients have a procedure to stop fetal cardiac activity before the induction, so fetal demise has already occurred. Some providers think this may shorten the time it takes for induction. And some patients prefer it. Often there is fetal demise during labor, because that is what happens with severe fetal anomalies. In the rare scenario where there is a live birth, parents hold their baby for comfort care.

The fourth key point: Most states don’t allow abortions after 20-24 weeks without extreme exceptions:

Only 7 states have no gestational age restrictions, meaning places where the mythical healthy 32 week pregnancy that results in the, “Oh my gosh I forgot to get my 8 week abortion abortion!” could happen. For all the mental masturbation from forced birthers about New York allowing abortions at term, the law applies only after 23 weeks and 6 days for situations where maternal health is in jeopardy or lethal fetal anomalies (both of which we have spelled out above and are not going to result in live births).

So there are only 7 states where this mythical infanticide could actually happen. Again in these states the scant abortions happening after 24 weeks (and most are before 26 weeks) are almost always for severe fetal anomalies or a combination of severe anomalies and maternal health. Again, no survival is possible.

Are there some abortions that happen for rape after 24 weeks? Likely a few. Maybe 1 or 2 a year? Are there a few procedures for less than lethal anomalies in these states? Perhaps. However, these will all be surgical procedures, so no infanticide is possible as a fetus isn’t an infant and a surgical abortion can’t result in a live birth.

Trump is such an ignoramus on so many topics that full-time journalists struggle to correct him. But on the subject of abortion, I would say Dr. Jen Gunter has done an outstanding job of unmasking Trump in a way that most anyone can understand. That is quite a public service. Her final thoughts on the subject:

So why the infanticide claims?

Lies and ignorance. Propaganda. Accomplished by perverting the narrative of babies born to die.

The forced birthers are trying to rename a fetus a baby or an infant or a person. This is to raise funds off the misery of women. If they cared about fetal life and the survival of newborns they would advocate for free maternity care, mandatory vaccines, gun control, and banning tobacco. This is also about power and controlling women’s bodies.

Legal, available, affordable abortion prevents back alley and clandestine procedures. If you want to prevent infanticide from predators, stop writing laws that restrict abortion.

It’s that simple.

No comments: