Your Obstetrician (and Trump) Will See You Now

U.S. President-Elect Trump’s words at a presidential debate about late-term abortion felt like a punch to my gut. “[I]n the ninth month,” he said to the crowd, “you can take the baby and rip the baby out of the womb of the mother just prior to the birth of the baby.”

I am a high-risk pregnancy doctor. A large part of my job involves diagnosing and counseling families about conditions anomalies in their fetuses. The same week that Donald Trump said those horrific words, I had the sad task of telling a patient and her husband that the ultrasound we were doing at 30 weeks showed a massive tumor essentially replacing their child’s brain. I could only imagine how hurtful words like Trump’s would be to my already devastated and grieving patient.

Such ill-informed rhetoric has reduced the debate around late-term abortions to a yes or no, a wrong or right—when the reality is far more nuanced than that. Why have we allowed, as a consequence of this oversimplification, for the law to dictate management rather than allowing women to make these personal decisions with their doctors?

PROWilliam Murphy / Creative Commons
PROWilliam Murphy / Creative Commons

Laws broaching the topic also demonstrate a lack of understanding of how fetal development can be disrupted throughout gestation. The Zika virus brought this issue to the forefront. Nearly every day there are news pieces detailing the terrible things that Zika can do to the brain accompanied by images of infants with underdeveloped sloping heads. Unfortunately, most of the signs of infection in the fetus don’t show up until the third trimester of pregnancy—at which point, due to restrictions on pregnancy terminations, the only option that we as providers have to offer our patients is inadequate condolences.

These prohibitory laws fail to acknowledge the personhood of the woman, diminishing her solely to a greenhouse for the fetus to grow in. They are inherently paternalistic and imply that a woman cannot be trusted to make a decision that most directly affects not just her body but her entire life. I am not aware of any similar laws prohibiting how men treat their own bodies.

Less than one percent of pregnancy terminations are performed in the third trimester. And this is not just because the law prohibits it. It is because, in my experience, patients do not take the decision to end their pregnancies lightly and have in fact agonized over what is the right thing to do. To argue that allowing women freedom of choice would result in an epidemic of cavalier pregnancy terminations discounts women’s morality and humanity—and it’s out of step with reality.

I’m not the villain. I am advocating for my patient. I am respecting the choice she made and helping her to achieve it in the safest way possible. And more importantly, my patient is not a monster.  She is heartbroken and struggling to adjust to the new reality that has been thrown to her.

Neither I nor any legislator knows what is best for every person or family. Rather, there needs to be space for every woman to make the correct decisions for herself.

Pregnancy termination is a reality that will continue regardless of how many laws restrict it. Before Roe v. Wade, up to 1.2 million illegal abortions occurred each year. While abortion rates have been declining, in 2011 an estimated 1.06 million abortions took place. What will result from prohibiting abortion is an increase in the morbidity and mortality associated with the procedure, not the procedure itself. Prior to Roe, almost 20 percent of pregnancy-related deaths were due to complications from abortion.

Our President-Elect has a deep misunderstanding of women’s bodies and the importance and magnitude of their choices—and we must ensure that he and all of our elected representatives know how imperative it is that such decisions remain between a woman and her physician.



Dr. Priya Rajan is a Maternal-Fetal Medicine physician, an assistant professor at Northwestern University and a Public Voices Fellow.