From the Bedside to the State Capitol
By: Mae Winchester, MD
The exact same day that I diagnosed Trisomy 13 in a highly desired first pregnancy was the same day I learned that a dangerous piece of legislation, inappropriately known as the “Value Them Both Act,” was moving quickly through the Kansas state legislature.
The family, who I’ll call John and Jane, had asked about the fetus’ medical prognosis (extremely poor), life expectancy (average of 7-10 days if born alive), ability to connect with the outside world (probably poor), and potential quality of life (probably poor). Jane sobbed uncontrollably, in that body-shaking and gut-wrenching way that mothers do when they know that no matter what, they are going to lose their child. John asked if I could be the one to perform their abortion. Despite working in the largest hospital in Kansas, there are local and state laws, hospital bylaws, and statutes prohibiting physicians at my institution from performing abortion unless the mother’s life is immediately in danger. As I told this to John and Jane, that familiar feeling of patient abandonment washed over me. In shame, I handed them our clinic’s print-out with the names of local abortion clinics (n=2). We also discussed the arbitrary state mandated gestational age time limits in Kansas and neighboring Missouri. Our clinic’s printout also contains information for clinics in Illinois, New Mexico, and Colorado because many of our patients end up past 22 weeks gestation, the limit to access abortion care in Kansas. However, most of our patients cannot afford the travel.
Jane’s sobs were still echoing in my head when I learned that the “Value Them Both Act” was to be one of our state legislature’s first debates of the session. Essentially, this legislation paves the way to an all-out abortion ban by bringing the legality of abortion to the Kansas ballot box in an obscure primary election in 2022. While I felt like I had abandoned Jane and John, I didn’t want our elected officials to decide their health care outcomes for them.
I sheepishly called John and Jane at their home, asking if I could share their story with Kansas lawmakers, so that politicians might understand the difficulties my patients face, and how political interference makes their lives even more challenging. Jane and John’s response was immediate: “Yes. People need to know this can happen to anyone.”
Two days later, the legislature heard testimony. Many of my colleagues and I showed up to fiercely defend our patients. Patients showed up to fiercely defend their families. But the bill still passed. Our patients’ future right to abortion will now be up for debate by strangers at the voting booth.
The constant assault on reproductive rights in Kansas and Missouri is tiring and demoralizing. I focus a lot on Kansas because that’s where I work, but just five minutes across the border into Missouri, my home state, the legislators have tried to attack transgender children who want to play high school sports, criminalize physicians who provide gender-affirming care, outlaw abortion of any kind with offenders being charged with murder, ban in vitro fertilization, and restrict common forms of birth control. All introduced over the course of one month. It’s often hard to be excited for the big-ticket federal items, like Medicaid expansion and efforts to repeal the Hyde Amendment when I feel that we’re just trying to hold our head above water.
I am so grateful that our national organizations like SMFM have taken up this fight. If you live in a state like Kansas or Missouri and are not sure where to start, there are resources that will help. For Missouri specifically, SMFM has created a template letter in opposition to Abolition of Abortion in Missouri Act (SB 391). Use it to weigh in with your elected officials and share it with your colleagues. If you don’t live in Missouri, but need help with testimony or a letter at the state level, SMFM can help. Contact Helena Hernandez at hhernandez@smfm.org. We are all in this together.
