Doctors worry abortion laws will hinder treatment of patients in life-or-death situations

Amna Nawaz:

Protesters once again demonstrated in front of the U.S. Supreme Court today over abortion, three weeks after the justices overturned Roe v. Wade; 17 members of Congress were among those arrested during the protest this afternoon, after U.S. Capitol Police said they blocked traffic outside the court.

Since the court's ruling last month, doctors and states with abortion bans have struggled to figure out how to care for patients with high-risk pregnancies, including miscarriages. The Department of Health and Human Services put out new guidance last week, saying any state ban is preempted by federal law protecting abortions as part of emergency care.

But medical providers are still concerned they could be prosecuted for performing some procedures.

Joining me now is Dr. David Hackney. He is a maternal fetal medicine specialist based in Ohio.

Dr. Hackney, welcome to the "NewsHour."

I think it's fair to say the last few weeks have made clear there are a number of doctors who are confused or scared about what they can or can't do in this new reality we are — when they're caring for pregnant patients.

That federal guidance I just laid out, is that clear to you? Do you have a clear understanding of what you can and cannot do?

Dr. David Hackney, Maternal Fetal Medicine Specialist:

It does help. And we certainly appreciate everything that the department is doing in that regard.

However, it doesn't solve many of the problems that we have, which are specific to the state with which we're in now. Unfortunately, some things are very clear in the state of Ohio. We cannot perform abortions for fetal genetic anomalies, fetal birth defects, even those in which we know that the child would not survive.

And we also cannot perform abortion solely because the pregnancy was conceived by rape. That is very straightforward. In my opinion, that is very, very tragic.

The other main category in which we sometimes get involved in abortion care is cases in which it's needed to either save the mother's life or on behalf of the mother's health. And this is where there's still a lot of things which are not clear.

In Ohio, the law does call out some specific cases. So, if there's previable premature membranes breaking the bag of water, or if mom has preeclampsia, that is spelled out, but a lot of things are very much less clear.

And there's a lot of fear among OB-GYNs, who don't know when we could proceed on behalf of mothers' health or not.

Amna Nawaz:

So, what does that mean for your patients? I mean, if you have a pregnant patient come in today, you detect a lethal anomaly, what do you say to your patient? What kind of care can you provide?

Dr. David Hackney:

What I try to do first is, I try to talk to them as if the law hasn't changed, and try to come up with them with what would work the best for them.

There are patients who are diagnosed with lethal birth defects who do choose to continue to move forward. And we do certainly always support those patients, if that's what works best for them. So what my own approach has been the last couple of weeks is, I just try to talk to the patient. I say, pretend that the laws didn't change. And let's figure out first what would work best for you.

Unfortunately, for most patients, in the setting of a lethal birth defect, they choose not to move forward. And this is where I now have to tell the patient that they cannot receive an abortion in the state.

We are still allowed to speak freely. We are still allowed to refer out of state. So, we will start to try to do that. But there is the potential for a patient with a lethal birth defect who will not be able to leave the state of Ohio and would be forced to continue to term against their will, which I just cannot imagine what a nightmare that would be.

Amna Nawaz:

What's the risk for that patient in a situation like that?

Dr. David Hackney:

Well, even if the patient is completely healthy — so, sometimes, we have a case where all of the concerns are fetal. Mom is in totally good health.

Just even a completely normal, healthy pregnancy always carries risks. And the risk of the pregnancy which continues to turn is always greater than the risk of an abortion procedure in the first trimester or even the second too. In high-risk obstetrics, all the time, we see completely healthy patients where everything is going well, and then they go to deliver, and there's hemorrhage or a blood clot in the lung.

And we know that things along those lines can occur. I can't imagine if there was a patient who had a lethal fetal disorder, was forced to continue to pregnancy to term against their will, and then that something terrible would happen when they went to deliver. That would just be a tragedy with no benefits at all.

Amna Nawaz:

Dr. Hackney, let me ask you about this new landscape we're in, because it's clear that there are legal voices watching.

We have seen attorney general's weigh in on some of these cases. The attorney general in your neighboring state of Indiana even threaten to go after a doctor who did provide a legal abortion service in one case.

I'm curious what it feels like to try to do your job in this climate, what you're feeling and experiencing, what other doctors are telling you they're worried about.

Dr. David Hackney:

There is a lot of fear.

I myself was on call the very first night that the law changed. I got a text from friends on a Friday night saying that it had gone into effect, and I do high-risk obstetrics. I was going to be rounding in the hospital Saturday and Sunday. And I didn't know what to do you know, whether I came in Saturday and there was a patient who was bleeding or someone who was going into heart failure.

And there's still a lot of gray zones, where we're not exactly sure what the best thing is to do.

Amna Nawaz:

You know, it sounds, Dr. Hackney, like there's a lot you don't know. I have heard you say uncertain a lot of times. We're in a new legal landscape, and one I should mention you have argued against.

So what is it that you want to see from state leaders or from federal leaders that you think would help you to better care for and protect your patients?

Dr. David Hackney:

Well, the biggest thing I would want to see is for the Ohio state Supreme Court to stop this law, to stop S.B.23.

We're talking about raped children. We are talking about pregnancies where there's a lethal birth defect and the woman, tragically, is going to be forced to continue against her will. The Ohio Supreme Court has the potential power to stop this law. If you have children at the moment, it's very, very unclear.

The attorney general should say clearly which children who have been raped can provide abortion care and which one we cannot. I mean, it's such a horrible topic. I don't believe, to some extent, that we're having to think about this. And it shouldn't have to come from me.

As the chair of OB/GYN for the state, I'm getting a lot of calls. I'm getting a lot of questions. I'm trying to figure this out. I'm looking over the research and data on when do you have physical damage to the body of a raped child?

This whole scenario, I have to say, it's unfair.

Amna Nawaz:

That is Dr. David Hackney, a maternal fetal medicine specialist based in Ohio, joining us tonight.

Dr. Hackney, thank you for your time.

Dr. David Hackney:

Thank you.