The medical nonsense and dangerous precedent of Mississippi’s abortion bill HB 1390

On July 1, 2012 House Bill 1390, signed into law by Governor Phil Bryant, will take effect. This law is designed to restrict the practice of medicine at abortion clinics to such a degree that no provider or clinic can meet the requirements. HB 1390 spells out it’s purpose very clearly in the first lines:

AN ACT TO AMEND SECTION 41-75-1, MISSISSIPPI CODE OF 1972, TO REQUIRE THAT ALL PHYSICIANS WHO PERFORM ABORTIONS IN ABORTION FACILITIES MUST HAVE ADMITTING PRIVILEGES AT A LOCAL HOSPITAL AND MUST BE BOARD CERTIFIED IN OBSTETRICS AND GYNECOLOGY; AND FOR RELATED PURPOSES.

Are these restrictions good medicine?

Does the doctor doing the abortion need to have admitting privileges? In the small likelihood there is a complication of a procedure it is not necessary (or sometimes even desirable) that the doctor doing the surgery correct the problem. For example, I am a gynecologist. I cannot fix every single complication of the surgeries that I perform. If I inadvertently damage the bowel during a hysterectomy I need a general surgeon to help me. If we extended HB 1390 to all surgical procedures (and we really should if it is for safety purposes) then no surgeon could do any surgery of any kind because no surgeon is trained to fix every single complication. Why single out women getting abortions? Shouldn’t every patient at a surgical center benefit from the same law? What is required of a surgeon is to recognize the complication and then consult/get assistance as needed (medicine is a team sport).

Should the doctor doing your procedure be an OB/GYN? Many family doctors are well-trained to provide a range of abortion services. Sometimes they have done fellowships in reproductive health and as such are better trained in providing abortion than many OB/GYNs. Nurse practitioners insert IUDs and perform endometrial biopsies (taking a sample from the lining of the uterus to rule out cancer) and these procedures require the exact same skill set as a first trimester abortion. So, if you follow the logic of HB 1390, to protect women from spurious practitioners the great state of Mississippi should be regulating many more medical procedures than abortion. They should regulate IUDs, endometrial biopsies, and most definitely cosmetic procedures. Many doctors do plastic surgery, but are not board certified plastic surgeons. There are many horrendous complications and even deaths from poorly done liposuction and other cosmetic procedures, yet somehow these patients do not deserve the same level of protection?

Do abortion clinics require specific legislation? HB 1390 targets abortion clinics. That fact is spelled out in the law. However, many doctors quietly provide abortion services in their office as part of their general medical practice and this law will not protect those women. How can it be safe to perform a procedure in the office but not in an abortion clinic?

In the end, HB 1390 does nothing to make abortion safer for the women of Mississippi. It will delay access to care and result in more later term abortions as women scrape together enough funds to go out-of-state. Or take matters into their own hands.

HB 1390 is an example of how legislators know nothing about medicine and are simply abusing legislative privilege to bypass Roe vs. Wade under the guise of making abortion “safer” for women. If voters do nothing about the legislators who conceived and delivered this bill, then they are sending a message that the state should get involved with the practice of medicine, no matter how ill-informed and medically ridiculous (and even damaging) that legislation might be. Because smaller government in Mississippi means a government that gets between you and your doctor.

HB 1390 is a very dangerous precedent indeed.