Why Do You Vote? Healthcare Autonomy

Dr. Karen Ilika has given me permission to share her essays concerning the upcoming election.  Because she is a retired physician, I feel it’s especially important to share her comments regarding healthcare.  While I’ve edited the headings and made slight changes in formatting, the commentary is all hers.  You can read her other political posts by going to her FB page:  http://facebook.com/karen.ilika.

Carolyn Hayek

 

Support Women Making Their Own Healthcare Decisions

 Day #99 - Why I Vote by Dr. Karen Ilika

 I vote to trust women to make their own decisions about reproductive healthcare and keep government out of it.

 

As an OBGyn I cared for women for decades through some of the most consequential and emotionally impactful times of their lives. My patients included those who sought contraception, those who were unable to become pregnant and those who were both happily and unhappily pregnant, some with very serious complications. The situations were often complex and beyond the understanding of the government officials who now are attempting to keep the decision-making for themselves.

 

Women deserve to be able to control whether they become pregnant or not. There is ironclad evidence that having access to affordable contraception is key to women’s success in education, career and financial security. Women are sometimes required to make heart wrenching decisions about pregnancy, both wanted and unwanted, based on a multitude of factors. They need to have the privacy and freedom to include their clergy, medical providers and family in decision-making rather than the government.

 

The Democrat platform will support freedom of reproductive healthcare choice, as has been the law of the land for the past 50 years. I support a federal law to solidify women’s rights nationwide.

 

DJT said he is “looking into” restricting contraceptive choices last month before reversing himself. He brags about having overturned Roe v. Wade. The Republican platform says States will be free to restrict abortion access from conception onward, and without exception, at their option. The national rhetoric has changed this year with only 1 mention of abortion in the 2024 platform vs 35 references in the last one. This reflects the recognition that extreme positions are not an election-winning strategy. But... the Republicans have made it very clear where they stand on this issue.

 

The message has not been lost on physicians who recognize that abortion bans are putting other standard health care at risk for patients experiencing miscarriage or other complications. Qualified physicians are choosing to not attend residency training or work in the 22 states with restrictive laws that criminalize physicians for practicing the standard of care.

 

Vote Blue to give women the rights they deserve as equal human beings to have bodily autonomy.

 

Support Doctors’ Expertise Re Maternity Care

 Why I Vote by Dr. Karen Ilika

51 days to the General Election

I vote in response to the presidential debate

DJT: "Her vice presidential pick says abortion in the ninth month is absolutely fine. He also says execution after birth — it's execution, no longer abortion, because the baby is born — is OK," Trump said.

 

Horrible, right? And a lot of nonsense!! Murder is of course illegal everywhere in the US. (Unless carried out by a President with immunity apparently, but that’s another topic.) I truly can’t figure out if he does not have the ability to understand this issue or if he thinks voters aren’t smart enough to comprehend it and so he can distort it at will for political purposes without regard for facts.

 

As an Obstetrician I delivered thousands of babies in my career. I explained complex medical issues to patients for 40 years. I think I can give this some context that might help. More than once, I had an expectant mother come to the hospital at 20-22 weeks of pregnancy in labor following the unfortunate experience of her water breaking. There is no successful treatment for this, no way to achieve a good outcome. Called “preterm premature rupture of membranes” when it happens at less than 36 weeks, ruptured membranes is a complication of about 3% of pregnancies. The earlier in pregnancy this occurs, the less likely it is that the baby will survive. At 22 weeks, the very premature infant has less than a 10% chance of surviving the birth process. The brain, lungs and heart are all very immature and these fragile surviving babies suffer extreme long-term complications.

 

An article in the Guardian explores the experience of one family that faced survival after a very premature birth. "You hear about 'miracle babies' or 'little fighters' and people have such a romantic view about premature babies – 'Oh, there's an incubator for a little while and then they go home and everything is rosy'. It's not.”

 

Very premature birth presents a complex situation medically, morally, ethically, and emotionally. The parents are faced with making a decision about resuscitation efforts if the baby is not breathing, nearly lifeless. If resuscitation is unsuccessful or is not done, care is focused on keeping the baby comfortable and supporting the family. The desires of the family along with the medical assessment of the baby play a part in decision making. What legislators think should not have to be a consideration.

 

Another scenario involves a pregnancy near term but the baby has genetic abnormalities that are known to be lethal. One such abnormality is anencephaly, or absence of the skull. While most pregnancies with this abnormality will end in miscarriage or stillbirth long before term, I delivered such a baby who survived the pregnancy and delivery. All of these babies die within hours following birth.

 

My patient, “Sue”, found out that her baby had this abnormality fairly early in her pregnancy. She and her husband, family and priest considered the options and Sue chose to continue to carry this baby she knew would not survive long, even if born alive. Other women might have made a different decision. My role was to provide her with the best obstetrical care possible while supporting her in whatever choice she made. I remember Sue at an office visit in the 9th month, tearfully saying she didn’t want to go into labor because she knew birth meant an inevitable quick death for her baby boy. As long as he remained in her uterus he was alive and she felt able to protect him. When the baby was born we wrapped him in a baby blanket, put a little knit hat over his exposed brain, and placed him in her arms. We didn’t carry out any extraordinary resuscitation and allowed mom and dad to peacefully love on their son for the hour or two that he lived.

 

This was not “they put the baby aside and decide what to do with him, execute him”. This was appropriate, compassionate care for a family in an impossibly difficult situation. The intentional ignorance that is expressed by DJT and others is maddening. These uneducated politicians cannot possibly write an abortion law to cover the multitude of obstetrical situations that they don’t even understand.

 

The focus shouldn’t be on “at how many weeks” should we draw the line for allowing women to choose legal termination of a pregnancy, but rather on WHO should be making that decision in the first place. Women in consultation with their family, doctor, and clergy, if desired, are the ones that I trust to decide.

I vote to reject DJT’s misogyny and his position on reproductive health care.