SB20 is positive step on informed consent for fetal abnormalities
S.B. 20 brings North Carolina abortion regulations in line with most European nations yet is cited by abortion supporters as “extreme.” In a sane world, such hyperbole would be used to describe New York abortion regulation, but we are through the looking glass.
As a neonatologist, I support S.B. 20, but it is somewhat disappointing. Until the 1960s, scientists acknowledged conception — new life — begins at fertilization. They also recognized that attempts to interfere with human development past this stage constituted abortion. This became an inconvenient definition when it was discovered some contraceptives prevent implantation. So, it is not up for debate when a new life begins.
What is up for debate now is when it is acceptable to end a human life and which human lives are expendable. I wish S.B. 20 could save more mothers and infants from abortion, but this bill saves many, and is unique.
One major positive aspect of the bill is that it mends the lack of informed consent for the group of mothers dealing with prenatally diagnosed life-limiting anomalies. Such conditions, previously called “lethal,” and still referred to inaccurately as such by many physicians, include trisomy 13, trisomy 18, and anencephaly.
With the regular use of maternal blood screening for fetal genetic disorders and the use of ultrasound technologies, such diagnoses are increasingly made prenatally. It is commonly reported by parents, in these very desired pregnancies, that when the news of a “lethal” condition is delivered they are then asked when they would like to schedule an abortion.
S.B. 20 permits abortion up to 24 weeks for infants with “life-limiting anomalies,” but requires proper terminology and addresses the well-described lack of informed consent for parents regarding options for continuing pregnancy. There is no medical consensus on conditions previously called “lethal.” Review of outcomes for such disorders reveals that in all prolonged survival is possible.
Publications report that in continued pregnancies with anencephalic babies, most survive to a live birth and live short, treasured lives. Infants with trisomy 13 and 18 have higher stillbirth rates but are often born alive. Literature for these babies receiving medical care reports survivals to 50% at one year for children alive at one month and 20% at 10 years. Social media support groups have made parents aware of this potential for life, even if short. Parents then begin a desperate search for supportive providers. These families deserve more than abortion appointments. They deserve non-directive counseling including options for continuing the pregnancy.
Publications show in cases of trisomy 18, many physicians know medical care is not futile, but they believe the lives that result are not meaningful. A survey of trisomy support group families found 93% were told their child’s condition was “lethal,” 61% felt pressure to abort, and 94% were told their child would die before birth. That many doctors still refer to these conditions as “lethal” speaks volumes. It reveals value judgements regarding lives of these infants.
The family experience with trisomy children paints a different picture. When asked about a future trisomy pregnancy and their child, 91% would continue the pregnancy, 97% report positive impact on their family, and 91% report their child is happy. For anencephaly, mothers who continued these pregnancies have significantly better mental health outcomes compared to those who abort. In another survey of 211 continued anencephaly pregnancies, all mothers stated they had no regrets about continuing the pregnancy. It is rare for parents to hear prenatally from doctors about the potential rewards of even a short life with such a child. They hear plenty about lethality and hardships, however, before being asked about abortion scheduling.
S.B. 20 requires physicians counseling parents adhere to American College of Obstetricians and Gynecologists recommendations, which states, “Perinatal palliative comfort care is one of several options along a spectrum of care, which includes pregnancy abortion and full neonatal resuscitation and treatment, that should be presented to pregnant patients faced with pregnancies complicated by life-limiting conditions.”
Former Vice President Hubert Humphrey said, “The moral test of government is how government treats those in the dawn of life, the children; those in the twilight of life, the elderly; and those in shadows of life, the sick, the needy, and the handicapped.”
I pray the state of North Carolina passes this test and overrides the veto of this bill.