Abortion Providers In Utah Adapt To New Anesthesia Requirement

Apr 7, 2016
Originally published on April 8, 2016 3:09 pm
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ARI SHAPIRO, HOST:

Next month, Utah will put a new abortion law into effect that's the first of its kind. Doctors performing abortions will be required to administer anesthesia after 20 weeks of pregnancy. The law is based on the disputed notion that a fetus at that stage may feel pain during the procedure. Andrea Smardon of member station KUER reports.

ANDREA SMARDON, BYLINE: The author of the law is Utah State Sen. Curtis Bramble. What he really wanted to do was ban abortion after 20 weeks.

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CURTIS BRAMBLE: I believe that the life of an unborn child is worthy of protection by the state.

SMARDON: But Bramble could see that other states that had attempted to outlaw late abortions were facing legal challenges, so he found another way forward.

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BRAMBLE: If we're going to forfeit their life, then we ought to have the humanity, we ought to have the decency to protect that child from pain.

SMARDON: Utah law will soon require doctors to administer an anesthetic or analgesic to the mother when conducting an abortion after 20 weeks. It also requires the doctor to inform the mother that substantial medical evidence concludes that an unborn child who is at least 20 weeks gestational age may be capable of experiencing pain.

CARA HEUSER: From a scientific standpoint, we do not believe this is true. And by we, I mean myself and 23 of my partners, and this is what we do all day every day.

SMARDON: That's Dr. Cara Heuser, a maternal fetal medicine specialist at Intermountain Medical Center just outside Salt Lake City. In fact, a widely respected study published in the Journal of the American Medical Association concluded that fetal perception of pain is unlikely before the 27th week.

HEUSER: By having to have this discussion with patients, we are being forced to tell them something that is not accurate, and that is a grave breach of doctor-patient relationship.

SMARDON: In practice, the cases where this would come into play are rare. Among more than 2,700 abortions that occurred in Utah over a year, only 17 occurred at this late stage. The law does not apply in cases where the mother's life is in danger or the baby has a fatal diagnosis. It's targeted towards elective abortions.

But according to an obstetrician at Planned Parenthood, doctors already use general anesthesia for these procedures. The handful that are left fall into a kind of gray area that lawmakers may not have anticipated - wanted babies with serious medical problems.

ALEXANDRA ELLER: It's these rooms where these conversations happen.

SMARDON: That's Dr. Alexandra Eller standing just outside an ultrasound room at Intermountain Medical Center. She's the one who has to tell an expecting mother that her baby has a diagnosis of spina bifida or a heart that's abnormally formed.

ELLER: You know, you're going to change someone's life forever.

SMARDON: For Dr. Eller, this new law would come into play when the fetus has a debilitating condition, and a slim chance of survival.

ELLER: To have legislators who have never had that experience try to tell us how to counsel women and to give them bad information is troubling to me.

SMARDON: Some women might decide to continue the pregnancy. Some may choose to have a dilation and evacuation, which is usually conducted under general anesthesia. Some choose to have their labor induced, so that they can meet the baby and say goodbye. In this case, Dr. Cara Heuser says the mothers often bring family to the birth and take photos.

HEUSER: This is a photograph of one of my patients and her husband and their baby.

SMARDON: Dr. Heuser is holding a classic family photo, the mother and father looking down at this newborn little girl dressed in a white gown.

HEUSER: This is something that is very sacred and is something our patients need to have access to.

SMARDON: But she can't put a laboring mother under general anesthesia, so Dr. Heuser is at a loss for how to proceed in these situations, how to do what she thinks is best for patients and still comply with the law. For NPR News, I'm Andrea Smardon in Salt Lake City. Transcript provided by NPR, Copyright NPR.