Personhood amendments are on the ballot again, this time in Colorado (again, hoping 3rd time isn’t a charm as voters rejected personhood amendments in 2008 and 2010), North Dakota, and Tennessee.
For those unfamiliar with exactly what a personhood amendment entails, it is a ballot measure that if passed would change the state constitution to give a fetus, including a fertilized egg, the exact same legal rights as a woman.
As an OB/GYN I think a lot about what that could mean health wise. Here are nine reasons personhood measures are not only troubling, but could harm and even kill women:
Prevent the management of an ectopic pregnancy, which is a when a fertilized egg implants outside of the uterus (in the Fallopian tube, on the ovary or cervix, or rarely in the abdomen). This happens in 1-2% of all pregnancies pregnancies and if not managed correctly is potentially fatal condition. I have seen women almost bleed to death from a ruptured ectopic pregnancy. Before modern medicine it is estimated about 50% of women with ectopic pregnancies died (some abort or resolve on their own). With advanced medical care (close monitoring to see if the pregnancy is aborting or treating the ectopic pregnancy with a medicine called methotrexate or surgery) the mortality rate has dropped to less than 5 per 10, 000. Even with modern medical care approximately 3-4% of pregnancy-related deaths are from ectopic pregnancies. Lets’ be clear, it is malpractice to fail to intervene at the appropriate time Think personhood amendments won’t change that? Some Catholic hospitals already mismanage/refuse to treat ectopic pregnancies under the guise of personhood and seem to be getting away without being sued, so the precedent is set. If personhood amendments pass doctors could be charged with murder if they treat an ectopic pregnancy appropriately. A personhood amendment views an ectopic pregnancy as an exploding gift from God that could kill and 0.5-1% of all pregnant women.
Delay treatment of serious infections in early pregnancy. If the membranes rupture prematurely potentially harmful bacteria can get into the uterus. While often this triggers labor, sometimes it does not. Regardless of what the body does an infected uterus means one thing medically, delivery. It doesn’t matter if a woman is 16 weeks or 36 weeks. If the baby is viable delivery means inducing labor or a c-section (depending on the situation) and with a pre-viable pregnancy this means abortion. The sad case of Savita Halappanavar in Ireland shows us what happens when a woman has an infected uterus, is pre-viable but the fetus has a heartbeat, and the law is of the land is personhood…the woman dies. Think this could only happen in Ireland? It has already happened at a Mercy Health Partners, a Catholic hospital in Michigan, it’s just the four women there were lucky they didn’t die because they were able to get appropriate care elsewhere. With a personhood amendment there would be no other hospital in the state where they could go to get standard of care.
Prevent access to birth control. While medical professionals understand that IUDs, birth control pills, and the morning after pill don’t destroy fertilized eggs the Supreme Court has demonstrated that science matters little when it comes to reproductive rights and medicine. If IUDs can be excluded from health plans become someone believes they cause abortion (note, belief being part of religion and not science) then many forms of birth control could clearly be at risk with personhood amendments pass. This could potentially leave diaphragms, condoms, sterilization, and periodic abstinence as the only methods of contraception.
Increase unsafe abortion. Obviously the point of personhood amendments is to outlaw abortion. However, we already know what happens when women are desperate, they buy potentially unsafe medications online and do it themselves at home (or their desperate mother buys the medications for them). There are already several well-documented cases, but these are only the ones we know about. Women who buy drugs online to cause abortion might be getting dangerous drugs or could bleed to death or have other complications, especially if they are further along than they think. Consider for a minute that some states have banned doctors prescribing medical abortions remotely (telemedicine) under the misguided assumption that it is unsafe (studies say it isn’t with an abortion provider and the right medication and instructions) , yet these very laws have driven women to do medical abortions in the most unsafe way possible, undergound with unknown drugs. Eventually women will start to die from home abortions. If a woman does survive it is possible she could be charged with murder.
Criminalize suicide attempts in pregnancy. Sometimes pregnant women try to kill themselves. This is a tragedy, but if they survive and their fetus doesn’t they could be charged with murder. This has already happened in Indiana. Instead of helping women suffering from severe depression or schizophrenia the state will be charging this at risk and vulnerable population with murder.
Criminalize medical decisions in pregnancy. Sometimes OB/GYNs make medical recommendations, such as c-sections or antibiotics, and sometimes women disagree and decline. That is autonomy. What if a woman declines and then her baby dies? Sadly, some doctors have already started this slippery slope of forced c-sections (likely driven by malpractice issues), but with personhood amendments women could be criminalized for making decisions about what happens to their body and when.
Putting an end to in vitro fertilization (IVF). During this infertility therapy the egg is fertilized outside of the uterus and then the most robust one or two are implanted back into the uterus. In the process some fertilized eggs are frozen for potential use at a later date and others that are clearly abnormal are discarded. Almost always there are more fertilized eggs than can be used and almost always there are abnormal ones. It will be impossible to practice IVF with the constraints of personhood and it is likely the practice will stop or be severely restricted . Many women who suffer from infertility will not be able to have the pregnancy they want.
Forced birth of babies with genetic abnormalities. Many women who find themselves pregnant with a fetus with a serious birth defect make the agonizing decision to end their pregnancy. No one can understand what that is like. Many of these pregnancies will result in a baby who requires 24/7 care until they eventually succumb to their myriad of medical issues. In addition to the heartbreak and the physical pain of a short life of highly invasive medical care, who will pay for this care?
Forced resuscitation of extremely premature babies. Many parents, myself included, are forced with the agonizing decision of declining resuscitation of an extremely premature baby knowing that survival without severe neurological compromise is highly unlikely. At 22 1/2 weeks my son had a 1% chance of surviving without severe neurological impairment. Will parents be able to decline resuscitation in the delivery room or will they be forced to watch their baby who they had hoped would pass a peacefully as possible be traumatized by invasive medical care only to die days or even weeks later in the neonatal intensive care unit?
Personhood amendments have serious medical repercussions and in a misguided attempt to end abortion (FYI the way to reduce abortion is free and available access to long acting reversible contraception) forced birth advocates are sending reproductive care for women back to the 19th Century.
If you don’t want women to die, if you want to have sex and want more reliable options for contraception than condoms, if you want the option to try all forms of assisted reproduction if you have infertility, if you want autonomy to include the reproductive tract then you will vote against personhood amendments.
In fact, given how personhood amendments unfairly and dangerously and unconstitutionally target women wouldn’t it be nice if we could vote to make the idea of personhood amendments unconstitutional?