Pop Quiz! Test your medical knowledge!

[Syzygy321]

Republican lawmakers like to say that their legislative onslaught against abortion clinics is motivated by a Sincere Concern for women's health. I'm talking about their demands that, for example, the clinics have wider hallways to fit stretchers, or that clinics keep a licensed anesthesiologist on staff at all times, or whatever the latest crap is in your state and mine.

The quiz question is: why is this statement (that tighter regs will protect women's safety) extreme bullshit?

I am looking for the *medical* reason that it's bullshit. The moral/ethical reasons (like, "because they shouldn't get to control other people's bodies&quot are equally true but not what I am asking.

I pose this question because, in my region, people seem really ignorant of a couple basic medical facts. I have the feeling that that pro-life propagandists have successfully convinced everyone that up is down and black is white.

[Erich Bloodaxe BSN]

1. As far as I can tell, nothing will satisfy them short of meeting the requirements for each clinic

to be a full hospital, while at the same time denying hospitals the ability to perform abortions. Ie, the requirements they come up with will ALWAYS be designed to try and end abortions through legislative loopholes.

As a medical reason they're BS? I think it's more math than medical. Go to the numbers, and I'm betting you'll find clinics that deal with abortion services day in and day out already have BETTER numbers when it comes to positive outcomes for their patients than hospitals that only infrequently perform such. Probably along the lines of any other clinic that does minor outpatient surgery, like dermatologists, for example.

It's the same as the Republican obsession with making voting harder under the pretense of virtually non-existent voter fraud. Using some incredibly minuscule number of extreme outliers to try and justify something that's a massive waste of resources in the name of ideology while pretending that it's not simply about ideology.

[Syzygy321]

3. Thanks Erich. I agree.

Especially love your last paragraph.

There's also another medical fact I had in mind, which I will post below...

[Vinca]

2. It depends on what procedures are being done in a clinic.

An abortion at 8 weeks is a whole lot different from an abortion at 20 weeks. A long time ago I worked for a doctor who performed early abortions and they were done in the office with no modifications to the office suite. It's a rather simple procedure and you don't need hospital-like facilities. At about the same time there was a movement among (non-medically trained) women to perform their own early abortions. An unwise idea, of course, but the "menstrual extraction" method they were promoting could be performed in your bathroom. If clinics performing early abortions need an anesthesiologist on staff at all time, I would say a dentist's office would also. There is no medical reason for the bullshit and closing clinics that serve women will increase unwanted pregnancies, increase undiagnosed cancers, increase untreated STDs and a host of other things. Women's clinics will also refer a patient elsewhere if they discover things like high blood pressure or notice other non-gyn symptoms of disease. I don't think closing clinics shows any concern for the health of women.

[DetlefK]

4. It all boils down to the odds of a given medical situation:

The questions are:
What medical situations will you encounter in a given environment and what are their odds?
What installation/equipment/staff is necessary to handle these situations?
Where is the balance between the odds of the medical situation and the costs of being equipped for the medical situation?
What financial value is assigned to a human life and how many saved lifes would it take to make a given investment worth its money?


For example:
Let's say, a human life were worth $1 million. Let's say, a certain upgrade to a clinic costs $100,000. If the upgrade saves at least 0.1 patients over the course of its life-time, it was worth it.
Now, how often does this emergency happen? Let's say, this emergency, that can only be handled thanks to the upgrade, happens with a probability of 0.001. That means, the upgrade was worth its money if the facility treats at least 0.1/0.001=100 patients over the course of the upgrade's life-time.

If a human life were worth $10 million, the upgrade would have to save at least 0.01 patients. But if the emergency that can only be handled thanks to the upgrade happens only once every 1,000,000 patients, the point-of-positive-return moves to 0.01/0.000,001=10,000 patients over the course of the upgrade's lifetime.

[Syzygy321]

5. Abortion is already far safer than ongoing pregnancy

That's the fact that gets shoved under the rug, under the bed, into the closet which is then triple-padlocked.

For ANY woman early in pregnancy - old or young, healthy or not, the safest thing she can do for her body is get a first-trimester abortion.

Abortion* is safer than pregnancy. By far.

Pregnancy is a forty-week burden on a woman's body. It's fraught with medical risks and those risks get greater as the fetus grows. Term pregnancy almost invariably ends in (best case) hospitalization, intensive medical care, hemorrhage, great pain, tissue damage, and short-term debility. That's BEST case. Surgery - including emergency surgery - is a common outcome.

Early abortion turns that forty-week risk into a ten or twelve-week risk. It ends with delivery of, not a 7 or 9 pound solid item, but a small clump of soft tissue.

The healthiest choice for women is pregnancy prevention (abstinence, accessible contraception, freedom from sexual coercion and rape),

early diagnosis of pregnancy and emotional support of pregnant girls and women (accessible healthcare; an end to the fear/stigma that surrounds unplanned pregnancies and makes some females stick their head in the sand as pregnancy progresses.)

and early termination for all comers: IOW a safe clean affordable clinic on every street corner.

This is such an important - and misunderstood - topic that I am going to keep kicking my own thread all day with additional abortion and pregnancy info.

*why I emphasize EARLY (first-tri) abortion: As pregnancy progresses, abortion becomes slightly more risky and the woman gets a "diminishing return" - that is, the longer she waits, the more pregnancy-risk she puts herself through.

[Orrex]

6. Are dentists, podiatrists and tattoo artists required to have admitting privileges?

These facilities, for instance, engage in practices that can easily require immediate intervention by a hospital, yet I don't hear Republicans screaming for tighter regulation of urologists. For that matter, a lot of "Urgent Care" clinics employ doctors who have no affiliation with or privileges at any nearby hospital.

In terms of "medical reasons that it's bullshit," the inconsistency is the first glaring flaw that I see. On what basis do they justify tighter scrutity of women's health centers than other medical facilities?

[Syzygy321]

7. Every pregnant woman has only two options:

1) Take on the health risks of abortion

OR

2) Take on the health risks of pregnancy-to-term and delivery.

Abortion is ALREADY the far safer option.

Laws that close clinics (or make them too expensive to run) will funnel all women into the MORE dangerous pathway of continuing their pregnancies.

[Syzygy321]

8. When they say, "But women can hemorrhage

after abortions!"

Remind them:

Women who DON'T get abortions continue on with pregnancy.

They risk placenta previa (hemorrhage) and placenta abruptio (hemorrhage). They universally hemorrhage during even normal delivery.

Estimated blood loss (vaginal delivery): 500 ml.

EBL (C section): 1000 ml.

Bleeding to death in childbirth is common in other countries. In America, it is usually prevented - but only because women get emergency surgery, emergency transfusions, and ICU care.

I delivered babies for about eight months in a mid-sized American city. Many women required transfusions. One required an emergency hysterectomy. One bled to death on the table. She was 22.

[Syzygy321]

9. When they say "but after abortion some women

have complications requiring hospitalization,"

remind them:

-- that for pregnant women who get abortions, hospitalization is very rare.

--whereas for pregnant women who DON'T get abortions, hospitalization is close to universal.