Posted by February 13, 2014 at 2:01 PM
Written by Bich-May Nguyen, MD, MPH, a family physician practicing in Houston, TX and a 2013 NPA Copello Health Advocacy Fellow.
As a woman and a family physician in Texas, I have found this past year disappointing. The state legislature continues to disrupt families’ lives with efforts to insert political ideology into the physician-patient relationship. When I read about the National Physicians Alliance’s Copello Health Advocacy Fellowship and how one of the program’s objectives this year was to advocate for women’s health, I knew I needed to get involved.
After the NPA national meeting, one of my first activities was giving a lecture about abortion to family medicine residents. This one-hour session will be the extent of their residency education on this topic. Because of my interest in evidence-based medicine, I included strengths of recommendation for medical abortion regimens and surgical abortion techniques. Additionally, I highlighted areas of uncertainty for which little data currently exists. Furthermore, I included information about Texas abortion regulations and pointed out the lack of medical indications for all of these regulations, which include a twenty-week abortion ban; the requirement that abortion providers to have admitting privileges at a local hospital; and that abortion facilities must be renovated to meet the same standards as ambulatory surgical centers.
Giving this presentation was a cathartic experience for me. I feel that one of my responsibilities in medical education is to teach physicians-in-training how to assess data critically. The lack of scientific evidence supporting these imposing regulations is alarming. In my talk, I reviewed the process and data behind the FDA’s approval of the first abortion medications, as well as subsequent studies to determine an effective regimen on a decreased dose thus reducing medication and cost.1 I reviewed the poor evidence for fetal pain and the twenty-week abortion ban.2 I reviewed the lack of evidence for requiring abortion providers to have admitting privileges at a local hospital and for requiring renovating abortion facilities to meet the same standards as ambulatory surgical centers.3
Unfortunately, the state of Texas is not using evidence-based medicine to guide its regulations. Instead, the state is targeting abortion providers to regulate abortion out of existence and is making it harder for women to access this legal procedure. The anti-choice advocates claim that these regulations are in the name of “safety” and “protecting women’s health.” Yet, abortion is a much safer procedure than childbirth. The risk of death from childbirth is about 14 times higher than that from abortion. The “safety” claims are merely pretense.
Pro-choice supporters need to continue to draw attention to these injustices. Recently, I went to a talk by Planned Parenthood national president Cecile Richards. One of her main points was that this new generation of activists may not be out in the streets burning their bras, but instead taking the protest to social media. I hope physicians will be braver about speaking out in person and online in support of keeping abortion legal, affordable, and accessible.
- Mifepristone/Misoprostol Abortion Protocol. Reprod Heal Access Proj. 2012. Available at: http://www.reproductiveaccess.org/med_ab/mife_protocol.htm#printer. Accessed November 7, 2013.
- Lee SJ, Ralston HJP, Drey EA, Partridge JC, Rosen MA. Fetal Pain. JAMA J Am Med Assoc. 2005;294(8):947–954. Available at: http://jama.jamanetwork.com/article.aspx?articleid=201429.
- Gold RB, Nash E. TRAP Laws Gain Political Traction While Abortion Clinics—And the Women They Serve—Pay the Price. Guttmacher Policy Rev. 2013;16(2):7–12. Available at: http://www.guttmacher.org/pubs/gpr/16/2/gpr160207.html.