January 30, 2024
by Steven A. Foley, MD
I am responding to the January 2024 article in the American Journal of Obstetrics and Gynecology entitled, “A statement on abortion by 900 professors of obstetrics and gynecology after the reversal of Roe v. Wade.” While I hesitate to denigrate the authority of medical professors, this statement is misleading and inappropriate. This statement attempts to demonize pro-life policies by asserting they go against “patient-centered, evidence-based medicine,” yet the evidence they provide can be refuted by any practicing OB/Gyn.
Further, this statement utilizes hypothetical illnesses that may occur during pregnancy to confuse and sensationalize the argument against anyone who may disagree with their opinion, citing statistics from a pro-abortion group and using conjecture to emphasize their position. As a practicing OB/Gyn, I am proof that not all physicians who specialize in this field view pregnancy as a subjective illness, rather the treatment of two patients—a mother and a baby.
Finally, in response to this statement, I would like to say that the practice of medicine is a science that requires evidence to discover better treatments and health outcomes. With that fact, why would these professors who are steeped in the academic tradition of scientific inquiry deny entirely the scientific method, which requires consideration of all suppositions—in this case the support of life? In my response I will attempt to include what they did not—a second opinion.
First, it is important to note how difficult it is to obtain accurate statistics on abortions in the U.S. For instance, some states do not require reporting on abortions performed. This makes sense, because many do not like to report complications, such as septic abortions, and may want to hide that information. So, to obtain the data, policymakers can rely on two different authorities. According to the Pew Research Center, those authorities are the Guttmacher Institute and the U.S. Centers for Disease Control and Prevention (CDC). The 900 mentioned the research from an article published by Guttmacher Institute in 2017 to highlight how onerous “state-level restrictions” are limiting progress in evidence-based medicine. While that article may make those claims, I struggle trusting the methodologies of an organization that’s purpose is to see the legalization of abortion throughout the world. This would be akin to receiving lung cancer information from a cigarette lobbyist.
That leaves any evidence-based physician or policymaker to rely on data from the CDC. According to the Pew Research Center, “The CDC compiles figures voluntarily reported by the central health agencies of the vast majority of states (including separate figures for New York City) and the District of Columbia. Its latest totals do not include figures from California, Maryland, or New Hampshire, which did not report data to the CDC.” The claim that the data shows pro-life policies as onerous without the input from three states is inappropriate.
Next, the statement from the 900 notes several times that providing patients with an alternative to abortion is going against evidence-based medicine. What evidence-based medicine are they talking about? Instead of citing actual statistics or giving analyses of existing cases they claim to have treated, the 900 provided sensationalized depictions of their patients and quoted a 2013 statement by 100 other professors that does nothing to provide any evidence that abortion provides superior healthcare for mothers and their unborn children. This is hyperbole to discourage further debate on the topic.
The statement also attempts to sensationalize the issue of the life of the mother by trying to convince their readers that healthcare professionals have no general guidance on how to proceed when pregnancy complications put the mothers’ lives in danger. State laws are clear in this regard. An ectopic pregnancy is life threatening, and saving the life of the mother is always—in every state—legal and appropriate. The things the 900 want to discuss, however, are conditions such as Down’s syndrome, which is not life threatening. The only other fact worth emphasizing is that a previable baby does not need to be killed to be delivered. The 900 imply that a dilation and evacuation is the safe way to terminate a pregnancy. It is not. In fact, most obstetricians do not perform them, because operating during the second or third trimester has increased risk—especially if an infection is involved.
This article confirms that the 900 believe abortion is healthcare. There is no statement that there should be any limitations on abortion. If they agree with the American College of Obstetricians and Gynecologists (ACOG) stance, they support abortion throughout pregnancy for any reason. ACOG’s public support of multiple state policies increasing rights to abortion has been clear. I believe they arrive at this conclusion because they framed their view of pregnancy as an illness; however, pregnancy is not an illness. It is a normal process. Healthcare is defined as prevention and treatment of illness—abortion is not healthcare.
Another negative change in the post Roe v. Wade era, according to the 900, is decreased patient autonomy. The autonomy the 900 recommends, however, eliminates any input from the physician. In his book The Way of Medicine, Dr. Farr Curlin describes the two natural conclusions that come from this form of autonomy: “First, we will call it ‘radical autonomy,’ where the practitioner is reduced to a kind of functionary whose job is to provide services to the patient, regardless of the practitioner’s considered judgement about the wisdom and the morality of doing so. This contradicts the way traditional understanding of medicine where doctor and patient work together to understand, pursue, and achieve what is genuinely good for the patient.” Dr. Curlin goes on the say, “This view then eliminates any thought of physician authority allowing the patient to decide all their care without the help of a trained professional.”
Lastly, I would mention that in previous statements on abortion, the American Journal of Obstetrics and Gynecology listed the 100 medical professors who signed on to their respective statements. Who are the 900 who signed on to this statement? It is interesting that the American Association of Medical Schools reports there are only 782 full-time medical faculty in the U.S., so I question how more than 100 percent of medical faculty members signed this statement. It could be that a number of these are part-time professors, but that was not mentioned. For their own integrity, it should be.
The authors of this article would have you believe the majority of healthcare professionals who care for pregnant women believe as these 900 medical professors do. This is not the case. More than 7,000 members of the American Association of Pro-life Obstetricians and Gynecologists (AAPLOG) and the 12,000 members of CMDA believe there are two patients when caring for a pregnant woman—the mother and the baby. The unborn baby has a separate DNA structure and separate body parts, just as any other person would. It seems that if we call an unborn person a fetus, somehow, we don’t need to treat it as a human. It has lesser value. This article implies the right to abortion is of utmost importance to these professors, and they care very little for the unborn as people.