Health care decisions must remain protected and private | Letters to the Editor

Since the announcement of the Guam Heartbeat Bill of 2022 (Bill 291-36), there have been numerous articles opposing and supporting the bill, including a recent op-ed that claimed “it doesn’t there is no medical justification for abortion. I respectfully and professionally disagree with this statement. I urge lawmakers to look closely at this bill and be aware of the implications it has for destroying the private patient-doctor relationship and for removing a woman’s right to make decisions about her own health care. .

As a family physician specializing in women’s health and obstetrics, I see pregnant women and manage pregnancy complications every day. The fact is that there are pregnancy situations where abortion is a medically indicated option to protect the life of the mother.

For example, if a pregnancy implants outside the uterus (called an ectopic pregnancy), the growing fetus can cause the fallopian tube to burst, which is life-threatening to the mother. . Often we don’t identify where the pregnancy is until it is advanced enough to see a heartbeat. Proponents of Bill 291 claim it allows abortion for this type of situation, but how will protected health records be shared when a complaint is filed? Providers may be reluctant to manage an ectopic pregnancy as they usually would, for fear of being attacked by virtually anyone in the community for performing an abortion on a fetus with a beating heart. A woman with an ectopic rupture can bleed internally and die. With this bill, she has no choice.

There are other situations where a fetus has genetic or anatomical abnormalities that do not allow it to survive outside the womb. In these situations, a woman has the choice of terminating her pregnancy at an earlier stage or she can carry the pregnancy while it survives and then deliver either a dead fetus or a fetus that will die shortly after delivery. birth. With this bill, she has no choice.

There are also women in our island community of childbearing age who have medical conditions that make pregnancy very dangerous to their health, such as heart problems and advanced kidney failure. For these women, prevention through birth control is strongly recommended, but in the event of an unplanned pregnancy, voluntary termination of pregnancy is an option in order to protect the life of the mother. With this bill, she has no choice.

Bills like this are labeled as “pro-life” and aim to give a voice to the voiceless unborn child. But it is at the cost of silencing the mother who becomes the voiceless receptacle of this sacred life. What about his life? No woman chooses to interrupt lightly and no one is pro-abortion. As a women’s health provider, I am trained to provide women with choices to make the best decision for themselves and their families. Women deserve to continue to have this freedom of choice that will be taken away from them by Bill 291. The decisions that anyone makes about their body and their health must remain private. Physician-patient confidentiality is a right everyone deserves and should not be compromised by law or policy.

And to say something so definitive that there is never a medical indication for termination of pregnancy is wrong. Obstetrics and pregnancy care has so many moving elements and factors that go into our medical decision making. If laws like Bill 291 are to force providers to question the standard of care we have been taught in our more than 12 years of training, then every person on this island will be at risk.

Let’s focus on the facts and not on the feelings. What our community needs is proactive legislation based on our current statistics. We need to focus more on safer sex and birth control prevention education because Guam has one of the highest incidences of gonorrhea and chlamydia infections in the country. We need to focus more on sexual consent education because the highest number of sexual assault cases in Guam involve girls between the ages of 12 and 14.

We need better funding and better access to contraception for our most vulnerable populations. We need more effort to recruit obstetrics, neonatology and pediatrics providers, as Guam was recently identified as having one of the highest infant mortality rates in the country.

These are the needs of our island. These are areas where legislators should focus their efforts. These are areas that will improve the life of every individual in Guam. Bill 291 is not the answer and should not be passed.


Mariana Cook-Huynh, MD, is a family practice obstetrician and is originally from Guam.

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