Pregnancy does not care if you are “pro-life “ or pro-choice.

If you care about anyone in her childbearing years, current or impending restrictions on pregnancy care in more than half of our States (thankfully not in New York) are alarming.

Regardless of your opinion about abortion or when life begins, those who are pregnant may be terrified of seeking timely help if common symptoms such as pain and bleeding occur. Providers may be paralyzed by the fear that, if a heartbeat is detected when the mother’s health is at risk, the best emergency care will be perceived as breaking the law.

Miscarriages occur in one-third of pregnancies, and any person experiencing a miscarriage may fear that others will suspect a self-managed abortion; they may therefore delay seeking help. Their supporters may also be terrified lest suspicion fall on them.

Ectopic pregnancies are pregnancies implanted outside the uterus, usually in the fallopian tubes, where it is impossible to develop to viability. If allowed to grow, the tubes can burst, leading to severe life-threatening hemorrhage or infertility if the woman survives. Delaying care due to the presence of a heartbeat, while the mother’s fertility, health, and life are threatened, is malpractice.

Placental abruption, the separation of the placenta from the uterus, is a catastrophe for the mother and fetus, but a heartbeat may be detectable. Doctors may be reluctant to intervene and instead will choose to wait for the heartbeat to stop which may come too late to save the mother.

Uterine rupture is also catastrophic and can occur after multiple Caesarian sections or pregnancies occurring too close together when the uterine wall becomes too thin to stay intact. A heartbeat may be detectable, and intervention may be delayed until the heartbeat stops. Again, it may be too late to save the mother. Providers terrified of being accused of breaking the law will be committing malpractice instead.

The pregnancy-related mortality rate is more than 10 times that of a safe, legal abortion. People should be able to choose when to accept that risk. The risk of a poor pregnancy outcome is highest in those without insurance, with prior medical conditions, and/or living in poverty.

Reproductive health care should not be under religious or legislative control, and no one should ever be threatened or feel terrified for making a medical decision.

Dorothy Federman, MD

Saranac Lake