Show of Hands

Thanks for swinging by!!!

ND - not sure what the current WV is on 3rd trimester abortions, but if it's aligned with the SC decisions, the same providing in the NY law apply. The NY law is lifted directly from the SC decision. Literally word for word.

At the low income employee comment...don't know what to say other than heartless. There's folks make just over minimum wage and are outsourced gov labor. They make the least amount gov workers. Mean dude. Just mean.



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This user is currently being ignored

Well. I guess you could make they arguement. Abortion is never spoken about by the Christ. Loving thy neighbor though...he calls that one out as being one of the two most important commandments that all other laws, prophets and commandments flow.

It's the keystone of Christianity.

Preventing abortion is not.


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Thou shalt not kill?

@Shazam

So your response is, oh shit pivot!

EB - No pivot at all. This Q deals directly with both the two I addressed above. To be quite frank, I'm not at all sure how you could argue they are not related though. My guess is that you have no way to defend your tribe, so you're just using this as an escape route.


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SCRLTT - that's Exodus. Not the Christ. More importantly, even the 10 Commandments are secondary in level of importance to to Love The Neighbor.

Below. Thoughts?

Although I'm against abortion, I think I'm going to need to do more research on the bill before I can answer you better.

KAY of course. Below you will find a look to the full text to the law recently passed by NY. The second link is for the first text if the Court's opinion in RvW. It's actually an interesting read, but the language in question is easier to find in section XI.

NY Law (click the link for full text PDF) www.nysenate.gov/legislation/bills/2017/s2796

RvW Supreme Court decision: caselaw.findlaw.com/us-supreme-court/410/113.html


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Thanks! I'll read later when I can!

Agreed Kay

I upvoted for ya

Whoot!

Can I get my token back?

Better. I agree with both positions. The abortion ruling is tragic, and the workers should be receiving their back pay. The GOP fumbles another chance to do the right thing. I'm not shocked. BUT to put missing a paycheck on the same level with killing a baby in the ninth month is completely missing the mark. Like comparing flunking an algebra test to failing the bar exam.

ORG - you get that there not what NY did though right? They wrote a law that uses the exact language the SCOTUS used in their opinion on RvW. It's directly lifted. They did nothing more than codify the SC's ruling.

We've had RvW since 73. We do not have an epidemic of MDs providing abortions in the third trimester. We do not have an epidemic of women seeking abortions at 7 months bc they're depressed.

All the commentary and "but what ifs" are dog whistles designed to drive outrage. Nothing more then that.

Conversely, not a single outrage producing commentary on letting poor people carry the burden for the gov's actions.


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First of all, I was a state government employee, so I would without a doubt be outraged at the idea of working without pay. So I absolutely believe they deserve their lost wages, and that more people should be upset by that injustice.
Secondly, if "all" they did was codify Roe v. Wade, that's tragic enough for me. I do not support Roe v. Wade. And to see lawmakers rejoicing after the action they took IS a sad scene, to put it mildly. And I couldn't care less about dog whistles, or the negative vibe that accompanies that expression, because it is perfectly appropriate for people to be outraged when presented with the reality of abortion. In fact, to be thoroughly disgusted at it indicates a basic level of moral sensitivity that Americans could use a lot more of, as could the entire world. Celebrating the right to kill a developing baby is a type of inhumanity that should engender outrage, whether decades ago or today.

In 2015 over 8,000 late term abortions were performed in 2015 according to the CDC. That’s a lot for a procedure for which there’s no medical indication.

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No medical indications? Really? What were the reasons listed by the CDC?

Here's one that might be a cause: severe trauma to the woman requiring resucitation following smoke inhalation, burning, chemical or other biological poisoning, electrocution, drowning, crushing from a severe auto accident, or drug overdose that left the 3rd trimester fetus brain dead once resucitation was completed. Particularly when the initial trauma would prohibit a surgical procedure under gen anethsia like a C-section. You know like what might be the case when a person is nearly burned alive or in a severe car crash?

No idea how often those sort of things happen, but I'm guessing occurring in less than 0.0016 of the 4.8M pregnancies in 2015 is realistic?

One thing is for sure. It ain't an epidemic.


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None of those are medical reasons for a third trimester abortion even if they ever happened.

Brain dead fetus. Woman will not survive surgery. You're full of crap.

““According to Abby Johnson, former director of a Planned Parenthood clinic, late term abortions are usually done for elective, rather than medical reasons.

“…it is false to say the women who choose late term abortion do so because of medical reasons. We refered hundreds of women to abort their babies after 24 weeks…not ONE was for medical reasons.”

Apparently you missed my poll on this.

You should know what you’re talking about before shooting off your mouth. Why would a woman not surviving surgery or a brain dead infant be a reason for a late term abortion? In that case the doctor would simply deliver the infant. It’s much safer and problem solved.

It seems you are the one who is full of crap 💩.


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You've never spent any time in a burn unit or level one trauma center have you? I have many many times. Ever seen a person with the left half of their pelvis crushed from a drink driver? I have. How exactly would a woman that that had happened to give birth? Wanna draw me a diagram?


If a woman received an abortion as a result of trauma, how likely do you think she'd be to ask for a referral from PP? Are you even aware that more abortions are done in hospitals that at PP's abortion providing clinics?

Tell you what. Go find the newest hospital and ask if they have ever had to do them. When they tell you yes, ask why. See how close what I'm offering is to what they say.

I don't talk out of my ass EB.


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“You've never spent any time in a burn unit or level one trauma center have you? I have many many times. Ever seen a person with the left half of their pelvis crushed from a drink driver? I have. How exactly would a woman that that had happened to give birth? Wanna draw me a diagram?”

As a matter of fact I have and I put my experience caring for such patients up against yours anytime. How many 3rd trimester trauma or burn patients have you seen that required an abortion. None I would wager. Keep in mind we are talking about 3rd trimester pregnancies. In your highly unlikely scenario the infant would be delivered by c-section.

I stand by my statement that there is no medical indication for a late term abortion and challenge you to prove me wrong.

You said that I was full of crap but, this case it is you whose mouth is in danger of overloading your ass.

You quite simply don’t know what you’re talking about.


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EB - K. in your vast experience in trauma, you've never encountered a patient who if pregnant would not survive either natural childbirth birth or general anesthesia? Without hesitation I can say I have. Did they require abortions prior to bring stabilized? I have no idea, but God I hope not.


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The answer is that even your preposterous scenario would not be a medical indication for a late term abortion. If such an event ever occurred whereby a pregnant woman’s pelvis was crushed so severely that she could not deliver the baby neither could an abortion be performed because the infant could not be delivered from the uterus due to the injuries. It would have to be delivered by c-section. Not to mention the fact that the baby would have had a good chance of being killed by the trauma. I know that you not so cleverly threw in that the mother would not survive anesthesia/surgery in which case she would be doomed anyway because she could not survive treatment of her injuries. There is NOTHING that would require an abortion.

I respect most of your opinions even when we differ but you are way over your head on this one and should just admit it and not embarrass yourself further.

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I’m probably going to bed soon but if you want to discuss this subject further go ahead and give it your best shot. I’ll get back to you on anything you propose.

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EB - since you send to have missed it, let me so this again.

In your vast experience in trauma, you've never encountered a patient who if pregnant would not survive either natural childbirth birth or general anesthesia? 

Pretty simple Y/N

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Ok. I’ll allow you to move the goalpost just this once.

Yes I have seen people who were so severely injured that they might not survive a “natural” childbirth and/or anesthesia.

Getting back to the question. Even such an unlikely scenario would not be a medical indication for a late term abortion.

Since you apparently have problems grasping simple concepts I’ll repeat it.

YOUR STATED SCENARIO WOULD NOT BE A MEDICAL INDICATION FOR A LATE TERM ABORTION!

I don’t know how much more basic I can say it.

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Now, perhaps you could explain why you think an abortion would be indicated or propose another instance where you feel it would be.

I can excuse your lack of medical knowledge but using lack of knowledge as a source of arrogance is inexcusable.


But go ahead and hit me again. I can shoot you down all day with both hands tied behind my back.

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EB I haven't moved the goal post. Not once.

Back to literally the first series of examples I gave:

Brain dead fetus. From trauma, woman will survive neither childbirth nor the general anesthesia required for c-section.


Oh, and just to be crystal clear, abortion would be medically indicated for this horrible situation regardless of which trimester the woman was in with her pregnancy. Go ask a MD EB. I actually did this today.

You have a tendency to dig your heels in the sand and blindly support your tribe no matter what. Loyalty is great. Blind loyalty is dangerous.

I'm done. Love your neighbor. Have a nice day.


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I am an MD and you’re wrong as well as whoever you asked. There is no tribe here just facts. Facts that you are too blind to see.

You have wisely chosen to drop something that you know nothing about. I’ll give you that at least.

Good day.

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EB - That's right! I actually knew but forgot you were an MD. should have said so earlier!

Ok. Let me try it this way:

This is Mrs. T, a 38 year old woman, admitted yesterday with 3rd-4th degree burns to face and femoral/groin region. 3rd degree burns also present on medial dosal and ventral abdomin. Patient was found in a burning apartment by local FD. Patient was not breathing and no pulse detected on discovery, but successfully resuscitated and intubated by EMS enroute to the ED. Soot deposits observed by EMS in the nares and oropharynx. Stage 3 laceration to distal coaxal area with partial severing of both external illiac structures also found by EMS and stabilized enroute. Laceration closed in ED without surgical consult. Additional acute ETI suspected but not confirmed as determination was made to leave intubation in place by ED attending.

Ctd


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Upon admission, patient was hypotensive with a pulse range 50-60, BP 40-50/15-35; abnormal respiratory pattern, hypoxic with arterial lactate of 11mM and a O2 sat of 60%. CBC, lytes, and other labs pending. Smoke inhalation and shock protocols initiated, 2L crystoloids pushed, 1 bag B+ whole blood and Vasopressin 0.04/min administered. . Chest xray positive for bilateral particulates. Following ED resuscitation, patient briefly regained consciousness, and subsequently sedated.

Patient is 28 weeks pregnant and Peds attending present at admission. Ultrasound at presentation revealed weak fetal heartbeat, no fetal movement and umbilical cord artery blood gas analysis showed pH 7.3, PaO2 30 mmHg and PaCO2 35 mmHg. EFM put in place resulting in negative fetal movent detection since admission. Dx from Pediatric chief is that brain death occurred prior to admission and administration of broad spectrum Abx initiated with both his and patient's family member's consent.


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Goal on admission was to stabilize mother and then review treatment options.

Heartbeat irregularity is now being detected by her RN, who reports they are growing in both frequency/duration and there are accompanying spikes in mother's BP/PR. Additional 1L crystolid bolus and vassopressin were ordered and administered but without effect.

She's a fighter, but we're afraid we're going to lose her. We have full consent from her medical POA to do what we need to to save his wife.

Dr. Ebola, What should we do?



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Please excuse any wacky labs. Pretty sure I'm close to what would be expected, but I'm doing this from home by memory without any access to literature.


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Is this a hypothetical case?

Yep.

This patient will likely not survive no matter what the treatment. Per your description (despite the wacky labs and VS;)) she has extensive burns and probably lung damage. She is not stable and is at high risk for any procedure including a late term abortion.

If the dead infant is considered a threat to her life the safest option would be to deliver the infant by induction. I assume you feel the burns and her condition would preclude surgical removal. Correct?

The only other option would be a d&c involving dilation of the cervix and dismemberment of the infant with removal of all products of conception including the placenta. In her condition this could cause massive hemorrhage, DIC, and other complications that might hasten her demise.

Ctd

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In other words, their is no easy answer to this extremely unlikely scenario. If her cervix can be dilated the infant could be delivered intact.

In summary, IF it was felt for some reason that the infant had to be removed on an emergency basis to save the mothers life a d&c (abortion) could be considered with the understanding that the abortion might also kill her.

Does that answer your question?

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EB - yes it does, and yes. I tried to craft this in a way that trauma would prevent surgical removal. Totally agree she's got slim to no chance at surviving.

Yeah, figured the labs were wacked with the exception of the umbilical cord abg. That I had copied in my notes from a journal source a few days ago. Don't remember the source though.

My point in writing this "case" though was to make one point. The "health of the mother" provision isn't included to provide a willy nilly way of doing late term abortions. It's to maintain all available options on the table for an MD fighting to save a women's life. I think that often gets lost in this debate.

Should it be used as a first resort? Nope. Should the MD face criminal charges or loss of license if s/he decides that's the best course for the patient. I personally don't think so.

Hope that makes sense?


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One other error in your reasoning is that when a late term abortion is performed the mother would be put under general anesthesia.

I agree with your last paragraph except no one is proposing that a doctor be imprisoned if the doctor and patient decide to do a late term abortion. The question is whether there is a medical indication to do one and the answer is no.

Hopefully that makes sense.


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28 weeks requires gen anaesthesia? Didn't know that. Actually, WV and AL are pushing for imprisonment of MDs who perform any abortions, AR, OH, FL, IA all are pushing for criminal prosecution of MDs after 6 weeks.

As far as I'm aware none of these bills have a "except for the health of the women" clause. I know WV, AL, and OH do not. Also no viability clause for first trimester. No clue how MDs will handle this, but to me, it seems frigging insane to force a woman to continue carrying a fetus for weeks knowing it will not survive to term. Incredibly Heartless too.


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I disagree that it’s insane and heartless to act in the best interests of the woman.