SAN ANTONIO – It’s been a week heavy in emotion and passion since the U.S. Supreme Court overturned Roe vs. Wade, paving the way for states to impose bans on abortion. Two renowned San Antonio doctors are setting both of those aside to focus on the science and lay out some legitimate health dangers.
The concern mentioned first by both doctors was maternal mortality rates.
“The U.S. has the highest maternal mortality rate among all developed countries, and Texas is near the top of maternal mortality in the U.S.,” said Dr. Deborah McNabb, who was a private practice OBGYN in San Antonio and is now pursuing a Ph.D. in Bioethics and Health Humanity.
McNabb said the issue already disproportionately affects women of color, which would worsen with unequal access and other racial inequities.
“We know that Black women have a maternal mortality rate that’s three times white women, and that’s not just education. College-educated Black women have a higher rate of maternal mortality than high school-educated white women,” McNabb said.
McNabb said access, surprisingly, isn’t the main issue here. Even if pregnant women do make it to doctors for care, many providers are unsure how to interpret the language of the law.
“The Texas government has said that a physician may perform an abortion if the woman’s life is at risk or she’s at risk of major bodily injury. The problem is, where does that life being at risk begin?” McNabb said.
She said with the Texas six-week abortion ban already in place, pregnant women sick enough to qualify for abortion under the law are still waiting to cross state lines because Texas doctors don’t want to risk it.
“To risk losing your medical license and your livelihood, to risk being incarcerated and separated from your family, it’s kind of understandable that physicians may be cautious because they don’t know where to thread that needle,” McNabb said.
She said that gray areas could not be cleared up by politicians who don’t have years of medical training on how to weigh risks versus benefits in every possible situation.
“If they err on the side of best medical practice, they certainly could be incarcerated. If they err on the side of their own personal safety, in terms of risk of incarceration, they may put a woman’s life at risk,” McNabb said.
Dr. Randal Robinson, chairman of Obstetrics and Gynecology at University Health and UT Health San Antonio, said he worries about people with preexisting conditions.
“There are significant underlying medical issues that we would counsel some women not to conceive,” Robinson said.
“Chronic hypertension, if a woman has cancer and needs cancer treatment, severe diabetes, women in kidney failure on dialysis -- the pregnancy could be an added stressor or burden on their body,” McNabb said with equal concern.
The doctors also said those complicated unwanted pregnancies could overwhelm an already-strained OBGYN system in Texas.
“Doctors in private practice can limit the number of patients they see. However, in a public system like University Health, that is not possible. As the volume increases, they’ll be more and more overwhelmed, and it is not possible to provide the standard of care if you’re taking care of too many patients,” McNabb said.
Robinson, who works in public health at University Health System, said he will have to wait it out to see what type of volume increase occurs.
“It’s hard to know with this just having passed exactly what direct effect that will have on our health care system,” Robinson said.
Until then, he said he will continue giving the same high level of care as he always has.
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