I write this as the former longtime chair of obstetrics and gynecology at Dartmouth-Hitchcock Medical Center, as a person with two adopted children and three adopted grandchildren, and as someone who has worked for almost 50 years, along with many others, to help New Hampshire and our region achieve the best medical outcomes for pregnant women and newborn babies. I am also someone who sadly remembers the terrible situations I dealt with while a resident at Cornell Medical Center in New York City in the 1960s, when rich women went elsewhere to get safe pregnancy terminations and poor women had unsafe back alley terminations, which often led to severe illness or death.
New Hampshire’s new abortion law, which goes into effect on Jan. 1 and will ban abortions after 24 weeks’ gestation, will have damaging side effects.
The ultrasound required by the law to determine the gestational age of a fetus is cruel to many, especially the poor, adds unnecessary expense, and interferes with private decision-making between patients and their health care providers. But focusing on the ultrasound issue is a case of gaslighting — it distracts from the real danger of this new law, which is the severe damage it will do to the excellent obstetrical and neonatal care that is now being provided to the citizens of New Hampshire and the region.
A small but determined minority of “one-issue” legislators and citizens have now put that care at risk. The medical decisions they are now imposing on everyone should rightly be made by patients in consultation with their health care providers. They should not be made by a small band of untrained, ideologically driven lawmakers who do not appreciate the risk this new law poses for New Hampshire’s excellent obstetric and neonatal outcomes.
The citizens of New Hampshire — and those from the surrounding region who depend on New Hampshire medical facilities such as DHMC — need to understand that this new law, with its draconian penalties for health care providers, will needlessly complicate the already difficult effort to recruit and retain obstetricians, gynecologists, neonatologists and maternal-fetal medicine specialists. These specially trained professionals — already limited in number nationwide and especially challenging to attract to a rural state like ours — are the core group that has enabled our region to have the best medical outcomes for pregnant women and babies. That’s because they have been willing to work long hours and share their expertise at other hospitals in order to make these excellent outcomes a reality. Now, however, health care providers in New Hampshire face civil and even criminal penalties for making the best medical decisions based on their knowledge, experience and their discussions with patients and families.
And why does New Hampshire Gov. Chris Sununu continue to say that New Hampshire’s new abortion law is basically the same as the laws in Massachusetts and New York? That is simply not true. Massachusetts and New York both allow for much more effective medical decision-making, and much better medical care. Both allow terminations when the fetus has anomalies incompatible with life after birth. New Hampshire’s law includes no such exception. New York allows terminations when “necessary to protect the patient’s life or health.” Massachusetts allows terminations “to preserve the patient’s physical or mental health.” New Hampshire’s much narrower law requires providers to determine that the mother faces a “medical emergency.” Both Massachusetts and New York specifically state that there will be no legal penalties for health care providers. Health care providers who violate New Hampshire’s new law face felony charges, prison time and fines up to $100,000. Gov. Sununu owes the people of New Hampshire an apology.
In a 2004 interview with Bill Moyers, Sister Joan Daugherty Chittister, a Benedictine nun, theologian and author, discussed the so-called “pro-life” movement: “I do not believe that just because you are opposed to abortion, that that makes you pro-life,” she said. “In fact, I think in many cases, your morality is deeply lacking if all you want is a child born but not a child fed, not a child educated, not a child housed. And why would I think that you don’t? Because you don’t want any tax money to go there. That’s not pro-life. That’s pro-birth. We need a much broader conversation on what the morality of pro-life is.”
It is time for New Hampshire’s legislators to rethink the ramifications of this new law from the perspective of what is best for all New Hampshire citizens.
Barry D. Smith, of Norwich, is chairman emeritus of the Department of Obstetrics and Gynecology at Dartmouth-Hitchcock Medical Center and emeritus professor of obstetrics and gynecology at Dartmouth’s Geisel School of Medicine. He is member of the New Hampshire Medical Society’s legislative task force and a trustee of the Hitchcock Foundation.