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Christopher Estes

Florida bills burden women's health

In medical school, we learn that the patient comes first. Our Legislature is trying to gut this principle. The House passed six bills meant to separate women from medical care they need; the Senate approved four. I appeal to Gov. Rick Scott: Veto all four bills. They are meant to hurt, not help, Florida's patients and their families. • All of this legislation targets abortion and abortion only. I am an obstetrician/gynecologist who specializes in medically complex abortions. I treat women who would be harmed if one or more of these bills became law.

I think of Karen: a 37-year-old married woman with a 6-year-old daughter. Karen and her husband wanted another child, and their daughter was excited about a little brother or sister.

Because of her age, Karen had an amniocentesis. The test showed that her baby had trisomy 18: a lethal condition. The baby was going to die in the uterus, during labor or shortly after birth.

Devastated, Karen and her husband visited specialists for second opinions, but the prognosis was the same. They decided, painfully, on abortion.

When she came to me, Karen had had multiple ultrasounds from nearly a month of testing. I didn't need to do another ultrasound. Karen understood very well what was happening and had thought long and hard about her decision. After discussing her options for how to proceed, she underwent an uncomplicated surgical abortion procedure. She was relieved and finally able to grieve.

One of the bills on the governor's desk would mandate ultrasounds before abortions. If that bill had been in effect when Karen was pregnant, I would have been required to perform yet another ultrasound. I would have had to offer Karen the opportunity to hear me describe and explain her baby's appearance during the ultrasound, as well as a chance to see the ultrasound images.

I'm sure Karen would have said no to both; her baby's deformities were all too familiar. To top it off, Karen would have had to sign a form from the state indicating that she had declined "of her own free will" — as if she didn't know her own heart and mind.

Nothing in these requirements would change my patients' minds about abortion. We don't yet have conclusive evidence on the impact of ultrasound mandates, but some other states have passed similar bills. My colleagues there say that so far, their patients haven't changed course after viewing or hearing about their ultrasounds.

If Karen's story has a bright side, it is that her health insurance covered her prenatal care, testing, the specialists and her abortion. Karen and her husband could choose abortion without worrying about how to pay for it — a procedure for a pregnancy like Karen's can cost thousands of dollars.

But our Legislature has determined that Floridians don't deserve abortion coverage. The House and Senate passed a bill to prohibit any insurance plan available on the coming state health insurance exchange from covering abortion.

I had a patient, Marie, who carried a doomed pregnancy to term because she didn't have abortion coverage and couldn't afford the procedure. Marie's trauma was exacerbated every day when strangers saw her pregnant belly and made cheerful inquiries about her baby.

The state of Florida must allow women to obtain abortion care when they need it. Like everything I studied in medical school and residency, abortion is safe, legal, rigorously researched, and vital to human health. The governor must not punish the women who need this procedure. I urge him to veto the exchange ban, the mandatory ultrasound requirements and the other pointless burdens on women's ability to stay healthy.

Christopher Estes is an obstetrician/ gynecologist and a member of Physicians for Reproductive Choice and Health. He is an assistant professor of Clinical Obstetrics and Gynecology at the University of Miami Miller School of Medicine and practices at University of Miami Hospital.

Florida bills burden women's health 05/09/11 [Last modified: Monday, May 9, 2011 7:05pm]

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