Abortion almost never medically necessary to save a mother's life?

That's the perhaps startling conclusion asserted by a doctor in a letter to the editor I read in this morning's Chicago Sun-Times. I want to quote the letter in its entirety... but let me provide a little background first.

There is pending now, in Illinois, a proposed Reproductive Health and Access Act, House Bill 2354, co-sponsored by roughly 30 state legislators*, and therefore more likely to be enacted, either in this session or one in the near future, than most of the chaff that gets filed in Springfield. The Sun-Times editorialized in favor of the bill on March 30.

There are a number of controversial provisions in this bill. It would, for example, require state-funded Medicaid to pick up the tab for all abortions, not just those deemed "medically necessary." It would require that all Illinois public schools teach "medically accurate, age appropriate, comprehensive sexual health education."

(I remember when schools taught Civics. And math. It seems so long ago.)

But perhaps the most controversial provision of the bill is that it would impose obligations on health care providers who are morally opposed to abortion to nevertheless provide "timely, accurate, and complete information about the patient's [reproductive] care options in a balanced and professional manner." Noting the vehement objection of the Catholic Church, the Sun-Times said, "doctors and other medical personnel still could refuse to perform certain services that are part of the accepted standard of care in reproductive health medicine. They would be required only to provide 'accurate and unbiased information' and referrals elsewhere -- as called for by the American College of Obstetricians and Gynecologists." Under the proposed statute, a failure to do so might cost the professional his or her license to practice and subject his or her employer (a Catholic hospital, say) to damages in a lawsuit. And who will decide what is "accurate and unbiased"? Doctors? Doctors who perform abortions? Bureaucrats (some of whom may hold M.D.'s) with a certain predisposition, say, toward the desirability of abortion?

As with the administration's recent decision to permit unfettered research on embryonic stem cells, I fear that bills like the Reproductive Health and Access Act have almost nothing to do with medicine or science and everything to do with politics. But I find it hard to sift through the emotion on both sides to get at the real facts beneath. Still, I keep looking.

And today I found this letter; I read it this morning on the train. It is a side of the argument one so seldom sees... even buried in a Letters column... that I think it appropriate (and fair use) to reprint the letter in full:

I write in response to your editorial of March 30 ["Women have a right to be told of abortion option"]. As a physician practicing in the field of neonatology, I was deeply troubled by your conclusions as well as by the medical misinformation you provided to the public.

You erroneously state that women are put at risk when they are not offered "emergency" or urgent abortion as an option for their pregnancy. You use the example of rupture of membranes early in pregnancy, and state that abortion is a "recommended option." In fact, surgical abortion, which mutilates the fetus and also poses some risk to the mother, is not the best medical option in this situation. Expectant management and use of antibiotics is. The majority of time the woman will miscarry -- a far more natural event than an abortion. Furthermore, approximately 10 percent of the time the hole in the membranes can seal up and the pregnancy can continue to viability. The protocol followed in Catholic hospitals in this scenario is a legitimate, valid and safe option for premature rupture of membranes, one that is best for both mother and child.

Abortion performed to "save" a mother's life almost never -- if ever -- is necessary. Are pregnant women dying in Catholic hospitals, unable to get access to an emergency abortion? Of course not. In fact, Ireland -- a country where the unborn child is constitutionally protected -- has the lowest maternal death rate in the world. More than a decade ago, a group of Ireland's top obstetricians concluded that "there are no medical circumstances justifying direct abortion, that is, no circumstances in which the life of a mother may only be saved by directly terminating the life of her unborn child."

The United Kingdom, on the other hand, where abortion is available practically on demand, has over five times Ireland's maternal death rate.

Catholic hospitals and physicians do not offer abortion as a "treatment option," because abortion always ends the life of what medical textbooks -- used in secular medical schools -- refer to as the "second patient," namely, the unborn child.

Why does the Sun-Times advocate forcing Catholic health-care workers to participate in such a practice they -- along with those of other faiths, or of no faith tradition whatsoever -- find so immoral? Should medical schools now post notices saying, "Catholics need not apply?" Would the Sun-Times be happier with Catholic hospitals -- a third of our nation's health care -- closing down instead?

This is still the United States of America, a country founded on the principle of freedom of religion. Catholic hospitals and Catholic physicians and nurses should be able to refuse to participate -- in any way -- in a practice they consider to be immoral, unsafe and inhumane.

Colleen Malloy, M.D.,

Northwestern University

Feinberg School of Medicine

I would link to Dr. Malloy's biographical information... I went looking for it when I got to the office this morning... but there are crazy people out here on the Internet and though the doctor has necessarily exposed herself to some of that craziness by being brave enough to assert her views in print, I don't want to directly contribute to the scorn she will almost certainly have to endure.

Suffice it to say Dr. Malloy is on the faculty at the hospital; she's not a med student taking her new initials on a run around the newspaper. Her specialty is neonatology.

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* Update: Citing the blog Illinoize, the Capitol Fax Blog notes this morning that two state representatives, Jack Franks and Mark Beaubien, withdrew their co-sponsorship of the bill last Friday. Still listed as sponsors are:

House Majority Leader Barbara Flynn Currie (D-25) and chief co-sponsors Rosemary Mulligan (R-65), Naomi D. Jakobsson (D-103), Elizabeth Coulson (R-17), and Sara Feigenholtz (D-12).

Other co-sponsors -- as of now -- include:

1. Julie Hamos (D-18);
2. Elaine Nekritz (D-57);
3. Karen May (D-58);
4. Deputy Majority Leader Lou Lang (D-16);
5. Karen A. Yarbrough (D-7);
6. Greg Harris (D-13);
7. Annazette Collins (D-10);
8. Elizabeth Hernandez (D-24);
9. Mike Boland (D-71);
10. Cynthia Soto (D-4);
11. John A. Fritchey (D-11);
12. Harry Osterman (D-14);
13. Maria Antonia Berrios (D-39);
14. Kathleen A. Ryg (D-59);
15. Constance A. Howard (D-34);
16. Luis Arroyo (D-3);
17. William D. Burns (D-26);
18. Deborah Mell (D-40);
19. Deputy Majority Leader Arthur L. Turner (D-40);
20. William Davis (D-30);
21. Al Riley (D-38);
22. Kenneth Dunkin (D-5);
23. Assistant Majority Leader Charles E. Jefferson (D-67); and
24. Majority Conference Chairperson David E. Miller (D-29)