Response to Dr Val

I was reading Dr Val’s blog over at the Better Health Network. She has linked to an essay by a third year medical student discussing why she will perform abortions as a physician.

She voices her own opinion on the subject. I highly recommend going over and reading it yourself, I suspect I could not pick a quote that is a good summary, or summarize it myself without losing the nuance of her position.

As I mentioned in my previous piece, these are complicated issues. When we reduce them to one word ideological arguments, we oversimplify human lives. Below is my response to her post. I’ve attempted to post my reply there, but I’m not sure if it didn’t work, or if it’s being held in moderation. Let me preface this by saying I’m currently a third year medical student on my OB-GYN rotation. I’ve seen and assisted on a significant number of abortions by D/C (for the sake of discussion let’s leave it at double digits but not triple digits), I’ve also seen (watched, but did not scrub) a small number of D&E, and D&X procedures.

I have had the rare-for-a-med-student (at least at my institution) of following a patient from clinic, to abortion, to followup visit at clinic, as well as seeing a number of clinic patients before, or after abortion.

It is absolutely an emotionally complicated issue. This goes for the physician, the patient, and any staff involved.

Still, I think seeing a snapshot of a patient in preop is perhaps a biasing experience. Seeing your patient agonize of the decision in clinic changes things as well. Seeing someone unsure what to do, making decisions that alter the course of their life no matter what choice they make. It is it’s own complicated, chaotic situation.

Seeing your patient in followup provides yet another perspective. Some patients agonize. Some patients are relieved (this an understatement, but I lack a concise way to summarize their feelings). Some rationalize, intellectualize, and otherwise grieve. But few of the women I’ve talked to regret the decision they made – whether it was to carry to term or to abort.

Whether that is after the fact, with cognitive dissonance making the decision for them or not, I don’t know.

I’m not criticizing the perspective you offer, just pointing out that the issue is often much more nuanced than an explanation that a patient can give in a short time in preop/postop.

I agree that adoption should be offered more often, with more explanation. I think though, that is a failing of some training programs, which don’t teach enough about adoption as an option.

I came into medical school with a pro-choice perspective to begin with. My experience on this rotation has reinforced this for me personally. I know other people have reacted differently, with some horrified pro-choice individuals moving towards pro life, and some pro-life moving towards pro choice.

What can’t be denied is that this discussion is much more complex than those on the far right or far left would have us believe.

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6 Comments on “Response to Dr Val”

  1. Dr. Val Says:

    Thanks for your thoughtful response. It is a VERY complex issue indeed. 🙂

  2. Sarah P. Says:

    It’s not simple.

    It is sad.

    I agree with your comment in a previous post – arguing from evidence is far superior to arguing from ignorance. And the evidence points to illegal abortion as a far greater horror.

    Education, excellent availability of birth control, and real choices for all should reduce the number of abortions. But adoption is an incredibly difficult choice too – I can’t imagine telling people for the 6 months of visible pregnancy that yes, I’m having a baby, yes, I’m married, and no, I’m not keeping it. An abortion would be easier, although I like to think I’d be strong enough to make the adoption choice. Hopefully my spouse’s vasectomy remains effective!

  3. Shana S. Says:

    I’ve thought a lot about the ethical and moral issues involved in abortion, and I know there are a lot of complicated issues involved. It’s upsetting when people on either side of the issue try to pare it down, and make it black-and-white.

    I think too often when people discuss abortion, they talk about adoption as another choice while forgetting there is also a considerable stigma attached to adoption, too, along with emotional fallout for the birth mother (and father) and that of the adoptive family. Finding families willing to adopt children can be difficult, especially for children with developmental or other disorders. I have nothing but admiration for adoptive parents, willing to take children into their homes and their hearts.

    I, personally am anti-abortion and pro-choice. Making abortions illegal does not stop abortions, only makes them unsafe. People need to realize that the only way to end abortion is to end unwanted pregnancies; making comprehensive sex ed the norm and creating access to cheap and effective birth control methods would be a big step in reducing the number of unplanned pregnancies.

  4. Amit Says:

    I agree with Shana on the above article. Making abortions illegal makes them unsafe and will not stop them from happening.

    Ultimately I believe it is the woman’s choice for what happens to a baby’s life as they are the ones responsible for nurturing it.


  5. I’m not sure how to react to any of the comments and blogs I’ve read about abortion. Since I personally don’t think that living things are endowed with souls or anything magical, I always have found the abortion argument to center on religion rather than medicine or science. Again, for me personally, nothing about early abortions concern me either ethically or medically (other than the usual risks of any elective procedure).

    Descriptions of late-term abortions have always bothered me viscerally. Dr. Val’s blog confirms that feeling.

    But, in the end, it’s a matter of conscience for both the patient and the healthcare workers. And that itself is complex beyond all explanation.


  6. Abortion is a very complex issue. I had it out with a few people who share the pro-life point a view and seem to think that they have science on their side.

    Unfortunately, they seem to feel like the science actually takes sides and actively supports their case.

    It was an exercise in talking past each other for the most part.

    The thread is here:
    http://deadwildroses.wordpress.com/2009/06/16/abortion-an-argument-from-self-ownership/

    I’m happy to see that a more moderate conversation on the topic is possible.


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