Wednesday, June 29, 2016

Continuity of Care - not a constitutional right according to SCOTUS


Again, I draw from my own life experiences.

In 1999 I was in labor with my fifth child. This was to be my third home birth and once again, I was blessed to have a doctor with an MD credential to attend the birth. Things were going well until the doctor went to check my dilation and discovered that my daughter's umbilical cord was coming through the cervix and we would have to transport to the hospital for an emergency cesarean section. 


Homebirth is alegal in Ohio - not illegal, but not exactly a ringing endorsement either. And while there are a few midwives who are quite active in the area, it was very rare to have a doctor to attend a homebirth. The paramedics transported me to the hospital and my doctor drove behind the ambulance. Once we got there, my doctor was treated pretty much like my husband - pushed off to the side and disregarded unless the hospital establishment wanted or needed anything. Actually, I think he was probably treated worse than my husband because at least they needed Mr. Pete to sign papers as next of kin, since I was going under general anesthesia. I had hired a trained medical professional to attend me, and they didn't consult him or his records - which is probably why at least 10 different people asked about my allergies to medications and why we lost extra time in starting the procedure.  My daughter was born with an APGAR of 1.


*****

So I guess my message is to the women of Texas, whose state was in the news this week because of the unwise and highly political decision of the Supreme Court.    One of the "burdensome" parts of the law they just struck down was the requirement that doctors who perform abortions have admitting privileges at local hospitals so that if an emergency happens that requires a medical transport, the woman can have CONTINUITY OF CARE, from the doctor who actually knows WHAT HAPPENED and can speak to it in medical terms with the other medical professionals treating the women!  This type of transfer of care can be critical to the health of the woman, her survival, and even her ability to get pregnant again in the future if she wants to.


The exact wording of the bill was:

“[a] physician performing or inducing an abortion . . . must, on the date the abortion is performed or induced, have active admitting privileges at a hospital located not further than 30 miles from the location at which the abortion is performed or induced.” Tex. Health & Safety Code Ann. §171.0031(a) (West Cum. Supp. 2015).

30 miles is about a half hour drive, give or take. If a woman is in respiratory or cardiac distress, or bleeding out, those 30 minutes are going to critical (and I can't help but think it - sometimes fatal). It seems to me that if Texas was really trying to be practical, it would have required abortion facilities have to be within may 15 miles of a nearby hospital. 30 miles seems almost ridiculous.

Nonetheless, within a 30 mile radius, a woman could have been assured that even after the surgery, if she had complications, she could go to the hospital for treatment and the hospital could consult with the physician that performed the abortion and receive her vital medical information. The doctor could also share this information without breaking HIPPA laws!

I think having privileges at the hospital would also make the abortionist and his patient feel as if they are more a part of the norms of the medical community instead of doing something outside of it. It seems to me that it would also keep doctors who perform abortions more accountable for safe practices.

Pro-choice women continue to celebrate the continued support of the high court in keeping abortion accessible. I remain baffled as to how this is any kind of a victory for women and  I certainly hope that in practice, they would demand a higher standard for their own personal medical care.
Supreme_Court_US_2010


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