SAINT ANTHONY – It’s been an emotional and passionate week since the US Supreme Court overturned Roe v. Wade, paving the way for states to impose abortion bans. Two prominent San Antonio doctors are putting both aside to focus on science and exposing some legitimate health hazards.
The concern mentioned first by the two doctors was maternal mortality.
“The United States has the highest maternal mortality rate of any developed country, and Texas is near the top of the U.S. maternal mortality rate,” said Dr. Deborah McNabb, who has a private obstetrics practice in San Antonio and is now pursuing a Ph.D. D. in Bioethics and Health Care.
McNabb said the problem already disproportionately affects women of color, which will be exacerbated by unequal access and other racial disparities.
“We know that black women have a maternal mortality rate three times that of white women, and it’s not just education. College-educated black women have a higher maternal mortality rate than white women with a high school education,” McNabb said.
McNab said access, surprisingly, is not the main issue here. Even if pregnant women do reach out to doctors for care, many providers are unsure how to interpret the law’s language.
“The Texas government has said that a doctor can perform an abortion if the woman’s life is at risk or she is at risk of serious bodily harm. The problem is, where does that risk to life begin?” McNabb said.
She said that with the six-week abortion ban already in place in Texas, pregnant women who are sick enough to qualify for an abortion under the law are still waiting to cross state lines because Texas doctors don’t want to take any chances.
“To risk losing your medical license and your livelihood, to risk being locked up and separated from your family, it’s somewhat understandable that doctors might be wary because they don’t know where to stick that needle,” McNabb said.
She said gray areas can’t be cleared up by policymakers who don’t have years of medical training on how to weigh the risks against the benefits in every possible situation.
“If they mess with best medical practice, they can certainly be shut down.” If they err on the side of their own safety, in terms of the risk of incarceration, they can put a woman’s life at risk,” McNabb said.
Dr. Randall Robinson, chairman of obstetrics and gynecology at University Health and UT Health San Antonio, said he worries about people with pre-existing conditions.
“There are significant underlying medical issues that we would advise some women against conceiving,” Robinson said.
“Chronic hypertension, if a woman has cancer and needs cancer treatment, severe diabetes, women with kidney failure on dialysis — pregnancy can be an additional stress or burden on their body,” McNabb said with the same concern.
Doctors also said these complicated unwanted pregnancies can overwhelm Texas’ already strained obstetrics and gynecology system.
“Doctors in private practice can limit the number of patients they see. However, in a public system such as university health care, this is not possible. As volume increases, they will be increasingly overburdened and it is not possible to provide the standard of care if you are caring for too many patients,” McNab said.
Robinson, who works in public health at University Health System, said he will have to wait to see what type of volume increase occurs.
“It’s hard to know after this has just passed what direct effect it will have on our health care system,” Robinson said.
Until then, he said, he will continue to provide the same high level of care as always.
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