Opinion: Abortion ban puts politics between doctors, patients

Dr. Kristina Tocce
For Steamboat Pilot & Today

I went into medicine to help people. I realize that’s not an earth-shattering claim coming from a doctor, but I knew it’s what I wanted to do ever since I was a little girl. I still have the picture I drew for my mother when I was five years old — me as a nurse helping people in a hospital. 

I was drawn to obstetrics and gynecology because I loved the idea of caring for patients throughout their reproductive lives. I looked forward to being part of their lives during the most joyous times, and knew that I would be there to support them as they faced the most difficult and heartbreaking decisions anyone has to make. 

I’ve seen thousands of patents in my practice over the past 19 years — everything from picture perfect pregnancies and healthy deliveries to the most unimaginable circumstances. However, I have never seen two patients — or two pregnancies — that have been the same. That’s not how pregnancy, or anything else in medicine for that matter, works. Every patient and every pregnancy are unique. 

Once again in Colorado, we’re being asked to vote on a ballot measure that would ban abortion and deny patients essential health care. Proposition 115 would force patients to continue a pregnancy with no exceptions for health or individual circumstances — even in cases of rape, incest, risks to their health, or a lethal fetal diagnosis. 

This ban is a violation of the oath I have been upholding since my medical school graduation 19 years ago. Abortion care is health care—and this ban will harm patients. 

This ban would put uncompromising politics between me and my patients. It is a one-size-fits-all approach to medical care — and a one-size-fits-all approach is never appropriate in medicine. Patients are unique, every pregnancy is different, and individualized care is required.

One of the most important things to me as a physician is for patients to be able to make their own decisions when it comes to all aspects of their health care. I want my patients to make decisions that are right for them and for their families — and as their doctor, I want to be a receptive and supportive partner as they make and carry out those decisions. I can’t imagine being forced to withhold safe, essential health care options from my patients.

The proponents of Proposition 115 want you to believe this measure is reasonable — but there is nothing reasonable about a politically motivated cut-off point after which a patient can no longer access essential medical care.

Abortion later in pregnancy represents only about one percent of all abortion care and is often sought because there is a fetal diagnosis that shows incompatibility with life. The first time many anomalies are detected is during the 20-week anatomy scan (the ultrasound that many patients look forward to). After that diagnosis, patients undergo a sequence of tests and appointments to determine fetal viability. Anyone who’s tried to make an appointment with a specialist knows that doesn’t always happen quickly. Two weeks is nothing in terms of time when you’re gathering critical medical information, meeting with high-risk specialists and pediatric surgery specialists, and undergoing additional testing. It’s an agonizing and deeply emotional process, and individuals and their families need time to consider all of their options and determine what is best for them. To mandate an arbitrary cut-off is not only cruel, it’s bad health policy. It is not medically indicated, and it will only hurt patients and their families. 

Patients have expressed profound gratitude that essential, safe abortion care is available in Colorado after 22 weeks. I simply cannot imagine a Colorado in which we deny patients their own deeply personal health care choices and decisions. 

I recently saw one of my patients, now the mother of two healthy children, whose first pregnancy was not at all how she envisioned her journey into motherhood. I’ll never forget that day she walked into my office to go over the 20-week ultrasound report, and we discussed that the fetus had an extreme cardiac anomaly. It was an agonizing experience for her and her family, and when she made the decision to have an abortion, we were able to care for her in Colorado. She then came back to me for her second pregnancy and third pregnancies — both normal, uncomplicated deliveries. At her recent appointment she asked if I heard about the latest abortion ban measure on the ballot. Over and over she said, “That is me. If this ban were in place when I went through my first pregnancy, I would have had no choice, no ability to make decisions for myself and my family and determine my path forward in life.” 

We can never possibly envision every individual’s circumstances or walk in another person’s shoes when it comes to their decision to pursue abortion care. How can I help my patients if I do not have all of the safe, medically appropriate tools at my fingertips? We need to keep all medical options on the table for patients and health care providers. Vote NO on Proposition 115. 

Dr. Kristina Tocce, M.D., MPH, is an obstetrics and gynecology specialist in Denver and has been practicing for 19 years. She serves as vice president and medical director of Planned Parenthood of the Rocky Mountains.

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