Abortion is a highly controversial and politicized topic that often sparks heated debates and protests. However, beyond the moral and ethical arguments, there are also medical reasons why some people may need or choose to have an abortion.
In this blog post, we will explore some of the conditions that make abortion medically necessary, as well as the legal and social implications of restricting access to this essential healthcare service.
What is a Medically Necessary Abortion?
A medically necessary abortion is one that is performed to preserve the life or health of the pregnant person or to prevent the birth of a fetus with severe or lethal abnormalities. According to the American College of Obstetricians and Gynecologists (ACOG), “induced abortion is an essential component of women’s health care”.
ACOG also states that “restricting access to abortion care jeopardizes women’s health, interferes with sound medical decision making, and compromises patient-centered care”.
A medically necessary abortion is determined by a physician or health care professional, not by the state, and there are multiple medical conditions that could result in a medically necessary abortion. Some of these conditions include:
Pulmonary Hypertension
This is a condition where the blood pressure in the lungs is abnormally high, which can cause heart failure, stroke, or death. Pregnancy can worsen pulmonary hypertension by increasing the blood volume and cardiac output, putting more strain on the heart and lungs. ACOG recommends that people with pulmonary hypertension avoid pregnancy, and if they become pregnant, they should be offered termination as an option.
Ectopic Pregnancy
This is a condition where the fertilized egg implants outside of the uterus, usually in one of the fallopian tubes. Ectopic pregnancies cannot result in a viable fetus and can cause life-threatening bleeding or rupture of the tube. Ectopic pregnancies require immediate treatment, which usually involves removing the tube or using medication to end the pregnancy.
Preeclampsia
This is a condition where high blood pressure and protein in the urine develop during pregnancy, which can lead to serious complications such as seizures, organ damage, or death. Preeclampsia can also affect the growth and development of the fetus, causing low birth weight, premature birth, or stillbirth. The only cure for preeclampsia is delivery of the baby and placenta, which may require inducing labor or performing a cesarean section before the due date.
Placenta Previa
This is a condition where the placenta covers part or all of the opening of the cervix, which can cause severe bleeding during pregnancy or delivery. Placenta previa can also prevent the baby from moving into the correct position for birth, requiring a cesarean section. In some cases, placenta previa may resolve on its own as the pregnancy progresses, but in others, it may persist and require termination of the pregnancy to avoid hemorrhage or infection.
Fetal Anomalies
These are conditions where the fetus has physical or genetic defects that affect its development or survival. Some fetal anomalies are incompatible with life, meaning that the fetus will die before or shortly after birth. Examples of such anomalies include anencephaly (absence of brain), trisomy 13 (extra chromosome 13), trisomy 18 (extra chromosome 18), and hydrops fetalis (severe fluid accumulation).
Other fetal anomalies may cause severe disability or suffering for the child after birth, such as spina bifida (open spine), cystic fibrosis (lung disease), or Tay-Sachs disease (neurological disorder). In these cases, some people may opt for termination of the pregnancy after receiving counseling and information about their options.
What are the legal and social barriers to accessing medically necessary abortions?
Despite the medical evidence and professional guidelines that support abortion as a vital health care service, many people face legal and social barriers to accessing medically necessary abortions. Some of these barriers include:
Restrictive Laws
Many states have enacted laws that ban abortions after a certain gestational age (such as 15 weeks in Mississippi) or for specific reasons (such as fetal sex or diagnosis in Ohio), except in cases of “medical emergency” or “severe fetal abnormality”.
However, these laws often do not define what constitutes a medical emergency or a severe fetal abnormality, leaving room for interpretation and potential prosecution of providers and patients who seek abortions for valid medical reasons. Moreover, these laws may force people to delay or forego abortions that could save their lives or health, or spare them from emotional trauma and financial hardship.
Lack of Access
Even in states where abortion is legal, many people face difficulties in accessing abortion services due to the lack of providers, clinics, or hospitals that offer them. According to the Guttmacher Institute, 90% of U.S. counties had no clinics that provided abortions in 2017, and 38% of women of reproductive age lived in those counties.
Additionally, some people may have to travel long distances, pay high costs, or endure mandatory waiting periods, counseling, or ultrasounds before obtaining an abortion, which can pose significant barriers for low-income, rural, or marginalized populations.
Stigma and Misinformation
Many people who seek abortions for medical reasons face stigma and misinformation from their families, communities, or healthcare providers, who may judge them for their decisions, question their motives, or pressure them to continue their pregnancies.
Some people may also encounter false or misleading information about the risks and benefits of abortion, such as the myths that abortion causes breast cancer, infertility, or mental illness. These factors can affect the mental and emotional well-being of people who need or choose to have an abortion, as well as their ability to access accurate and supportive care.
Conclusion
Abortion is sometimes medically necessary to save the life or health of the pregnant person or to prevent the birth of a fetus with severe or lethal abnormalities. Abortion is an essential component of women’s health care that should be available and accessible to all who need it.
Restricting access to abortion care jeopardizes women’s health, interferes with sound medical decision-making, and compromises patient-centered care. People who seek abortions for medical reasons deserve respect, compassion, and evidence-based information and support from their healthcare providers and communities.
