Women’s Stories: Dr. Chasen


“New York must ensure that all pregnant women receive the care they need, when they need it, right here.”

Opponents have caricatured the Women’s Equality Agenda as a radical liberal expansion of abortion rights in a state that already has far more abortions than the national average.

As a doctor who specializes in maternal-fetal health, I need to explain why they’re wrong — and why we need to update New York abortion law to make it consistent with federal law and current medical standards.

Some women experience serious health complications during pregnancy and, when faced with such medical crises, are forced to make hard decisions that no New Yorker should be forced to confront. I frequently see patients with serious obstetric complications and medical illnesses, or women who are carrying fetuses with severe and/or lethal abnormalities. Their stories are heartbreaking.

Not long ago, I saw a woman, who was excited to have a baby, learn that her fetus had Alpha-thalassemia, a fatal blood disorder, at 25 weeks into the pregnancy. At this stage, it was considered too risky under New York law to legally — not medically — perform an abortion.

This is because New York law only allows abortion care later in pregnancy in cases when a woman’s life is at risk — not when a woman’s health is at risk or the baby is not viable.

At 30 weeks, this woman became critically ill due to severe hypertension — a common occurrence when a fetus is deteriorating. She hemorrhaged during labor, required multiple transfusions, and nearly required a hysterectomy.

If she could have had her labor induced at 25 weeks when she learned that the fetus would never survive, this would have been avoided. But because this wasn’t an option under our laws, she could have lost her life or her ability to have healthy children in the future.

While almost all abortions are performed in the first trimester, sometimes, as this case illustrates, women learn later that they are carrying a fetus with devastating anomalies or experience pregnancy complications that place their life or health at risk. Many of these complications are simply not detectable until later in pregnancy.

Even though federal law requires that a doctor always be able to protect the health of a woman, New York law as written appears to prohibit that unless a woman’s life is in danger. As a result, doctors often believe incorrectly that they cannot provide the care that a patient needs.

Women who can afford to travel are frequently referred out of state to get the care they need. And women who can’t afford to travel are simply out of luck. This is deeply unfair; it hurts real people and their families.

That is where the Reproductive Health provisions of the Women’s Equality Agenda come in. By ensuring that providers will not be subject to criminal sanctions for providing constitutionally-guaranteed care, the revisions to our law would ensure that if something goes terribly wrong at any point during a woman’s pregnancy, she will be able to access the care she needs here in New York.

And by aligning state law with federal law, women and their doctors will know that women’s health is a medical issue that will be managed in accordance with medical standards. It will not be subject to political or ideological games.

Doctors need to be able to provide the best care possible. Too often around our country, we see how the politicization of abortion-related care ties doctors’ hands. New York must ensure that all pregnant women receive the care they need, when they need it, right here.

Chasen is an associate professor of obstetrics and gynecology and director of high-risk obstetrics at Weill Cornell Medical College.

 

The above has been adapted from a NY Daily News op-ed published on March 15, 2013 and approved by the author.