When does a med student learn to do abortions?

[f_w]

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It is not a medical emergency, but when women have to travel far to a clinic, it can mean that getting an abortion is no longer practical.

The 'excel inn' down the road is $49.99 per night.

A google search revealed a range of sources citing that 87% of US counties have no abortion providers.

Counting 'counties' can be a bit misleading as there are plenty of rural and remote counties which don't even have a county seat or administration, let alone a hospital.

So as most women not in a city will have to travel some distance to find an abortion provider, this is not that outrageous of a consideration.

That is correct, many patients in rural areas have to travel to obtain specialized healthcare services. It is a function of the geography, not necessarily part of an evil conspiracy to keep this essential basic healthcare service away from anyone.

A woman may not be able to get a baby sitter/take time off from work/miss class for a number of hours on two separate days that are that close together.

Guess how much school she's gonna miss if she has the little sucker.

a woman is completely comfortable with her decision, but most women already are by the first time they come to the doctor.

I keep repeating myself here: That doesn't matter. An ill informed decision made before coming to the office does not relieve the physician from the obligation to provide informed consent.

If a patient finds out how far along they are 2 days before the cut-off, is two days to think about it instead of three that big of a deal?

The famous cut off, what a great argument to cut off the discussion. I know I'll get yelled at for this but: If you didn't know by 7 wks that you are pregnant, a day or two more will just have to be part of the calculation.

Also frequently the price goes up after a certain day and there are cases with financial burden increases if you make a woman wait three days.

What, people charge money? I thought this was a charitable undertaking.

 

[trustwomen]

The 'excel inn' down the road is $49.99 per night.

Counting 'counties' can be a bit misleading as there are plenty of rural and remote counties which don't even have a county seat or administration, let alone a hospital.

That is correct, many patients in rural areas have to travel to obtain specialized healthcare services. It is a function of the geography, not necessarily part of an evil conspiracy to keep this essential basic healthcare service away from anyone.

Guess how much school she's gonna miss if she has the little sucker.

I keep repeating myself here: That doesn't matter. An ill informed decision made before coming to the office does not relieve the physician from the obligation to provide informed consent.

The famous cut off, what a great argument to cut off the discussion. I know I'll get yelled at for this but: If you didn't know by 7 wks that you are pregnant, a day or two more will just have to be part of the calculation.

What, people charge money? I thought this was a charitable undertaking.

Your "excel inn" statement = "let them eat cake". Babysitter, for two days, including an overnight. A day's wages (more than that, after taxes) for a hotel room. Two days off from work. Meals. And why - because the STATE doesn't think she knows what she wants? Some states, at least, let women get the information by phone or internet, and since the wait for the actual abortion is always a few days anyway that fulfills the requirement. It just becomes tricky to document that you gave the information in time (legal forms everywhere).

Y'know what, if abortion were just as available as other "specialized healthcare services", that would be fine. However, it's not. Especially annoying when you consider how common a surgery it really is. And you can bet that prenatal care and delivery are far more available! Hence, functionally, we have an access-based coercion of women's pregnancy decisions.

The physicians do provide informed consent already; spectacular informed consent, even. Why to you simply refuse to believe this? They are NOT, despite what the antis would have you believe, a "biased" source (the state, on the other hand, IS). A provider's worst nightmare is for a misinformed patient to somehow get through and have her abortion - there are lawyers, funded by anti-abortion groups, that specialize in suing abortion doctors. Clinics often also give a lot of information by phone when the patient makes an appointment, and they always answer patients' questions to the best of their ability.

Knowing (and making the decision, to boot) before reaching 7 weeks is quite the trick, by the way. It means you only missed your period three weeks ago, if you missed it at all (some women bleed during pregnancy). Half of all abortions are done before 9 weeks, which I consider quite impressive actually (when you factor in all the access barriers on top of it all).

Yes, people charge money. Stop being obnoxious on this point, please. Charging money does not mean that clinics don't ALSO display great compassion - by reducing fees, seeking abortion funding through NNAF, and accommodating their patients whenever they can. Recall that they have a very, very thin margin with which to work - because the fees are too low to begin with. Clinic people are some of the most selfless and generous people I've ever met.

 

[f_w]

Babysitter, for two days, including an overnight. A day's wages (more than that, after taxes) for a hotel room. Two days off from work. Meals.

Pack-o-rubbers: $10

Some states, at least, let women get the information by phone or internet, and since the wait for the actual abortion is always a few days anyway that fulfills the requirement.

The 'RTFM' approach to medical decision making

And you can bet that prenatal care and delivery are far more available! Hence,

Plenty of rural hospitals are withdrawing from providing delivery services due to the malpractice situation (mainly the inability of family practice docs to get affordable malpractice insurance for the coverage of deliveries).

The physicians do provide informed consent already;

So what is the fuss about ?

It means you only missed your period three weeks ago, if you missed it at all (some women bleed during pregnancy).

I noticed that married women (or more precisely women with a child wish) seem to know that they are pregnant about 2 days after they 'miss' their period. Once you are two weeks late, don't you start wondering ?

Yes, people charge money. Stop being so obnoxious on this point.

Ok, so we agree on this finally. You tried to tell me that this is a charity driven enterprise. Money changes hands, state law regulating abortions affects the amount of money that changes hands ---> loud protest.

Clinic people are some of the most selfless and generous people I've ever met.

The same could be said for the classic sicilian mafia.

 

[trustwomen]

Ok, so we agree on this finally. You tried to tell me that this is a charity driven enterprise. Money changes hands, state law regulating abortions affects the amount of money that changes hands ---> loud protest.

The state law doesn't affect the providers' money that much. Clinics see fewer patients but have to charge more to the ones they do see (two visits), so it pretty much equals out. The protest, believe it or not (for you it's "not", obviously), is actually based on concern for women's well-being. Really.

Again, just because clinics charge money doesn't mean that they aren't also charitable, compassionate, and accommodating of the patient's situation, whenever possible. They happen to provide a whole lot of free and/or deeply discounted services every year.

 

[dnw826]

I think elective abortions should widely available and legal under all circumstances, at any age of gestation, no questions asked. I also think it should be mandatory that after or during a woman's second elective abortion, she should be permanently surgically sterilized regardless of her wishes. In other words, you get to make one mistake with your reproductive life and then you have to pay the piper. This puts me simultaneously at both ends of the "freedom" spectrum. This is what life will be like under my rule.

Wow. I know people who have had more than one abortion, and they would be great parents except due to the circumstances surrounding the conception. This is a bit too drastic. I am not for enforced sterilization, though in theory, I do know some people it might've helped...

 

[dnw826]

And why are obsessive PETA supporters uniformly Pro-Choice? Never have understood this one.

Perhaps it's another variation of one poster's clever saying,

"Love the Furballs, Hate the Fetus."

No, we love the choice. I believe we have the choice. I would not force vegetarianism on someone, but I would enforce humane treatment of borne animals and humans.

 

[Songeur]

There are two arguments in favor of performing abortions which seem to be intricately tied even if it is not apparent to those who hold to them: 1)autonomy over one's body (even in light of causing or allowing another human to die) and 2)fetuses are not human beings.

I need to start with number two. I know that our laws and all the debate in the world has not allowed to us to definitively say exactly when an embryo becomes a human life. The gestational age of viablilty has been mentioned several times in this thread, 24 weeks, (as well as the fact that very, very few abortions are performed after this age), and so I am assuming that maybe 24 weeks is when the fetus becomes qualified as "human life". So I have to know something...when due to PROM my 22-weeker, not-viable baby is born and she cries and suckles and responds to my touch and lives for 8 hours and 23 minutes, did something happen to her in the minutes between living in utero and living in my arms that made her suddenly human...or are you willing to tell me that she was not human life? Or what about my 14-week son who also was born very suddenly due to PROM who still moved his arms and legs and tiny mouth as if to cry for minutes afterwards...does something just as magical happen between 14 and 22 or 14 and 24 weeks that changes the very substance of that fetus from something that is not human life to something that is? If so...what is it? I am asking this not only because I struggle with the idea that a fetus is not human life, but also because if it is the case, then I am a mother to non-human life...and that is nearly unbearable.

It was said somewhere here that even if a fetus were human life, it would still be OK to abort due to the inherent right to autonomy over one's body. It was also said (by the same poster, I think) that a person does not have to donate his/her kidney or even his/her blood to his/her own child if he/she doesn't want to...but that same person would be considered a "bag of ****"---I think it was.

I do not believe the two arguments can be separated. If you believe abortion to be OK based on autonomy over one's own body, but believe a fetus is human life, then you must also believe those who have abortions (perform abortions?) are "bags of ****". So, it seems, for the autonomy argument to hold water, then you cannot consider fetuses to be human life (at least not without also considering yourself to be a bag of ****). I know that Trustwomen does hold to both arguments, but she also claims that they are separate arguments. They are not. If you accept one, you have to accept both.

I know that there are terrible, terrible situations with no easy answers. There are many situations where I can understand why a person would have an abortion. I believe that (for the most part) people who perform abortions are doing so because they believe they are helping and are showing compassion.

The rub comes in for me here: I do not believe it is right to kill human life. And I cannot understand how a fetus is not human life.

(Just an aside...I know that the procedure for d&c and d&e are similar if not identical to most abortions...the difference is that the fetus in those cases is already dead. I thought I read someone muddying the water there...)

 

[Shredder]

Eugenic abortion and sterilization are the greatest services doctors can provide IMO

 

[velo]

Eugenic abortion and sterilization are the greatest services doctors can provide IMO

wow, you'll say anything! You don't care how controversal it is! Shedder, you're so cool! 🙄

 

[LizzyM]

Eugenic abortion and sterilization are the greatest services doctors can provide IMO

Did you mention this at your interviews? Write it in your secondaries or PS?

 

[Shredder]

Most wouldn't understand. It's the nature of paradigm shifting

 

[LizzyM]

Most wouldn't understand. It's the nature of paradigm shifting

You were born 100 years too late.

 

[stoic]

or possibly 100 years too early

here's to the future being more ****ed than the present!

 

[CatsandCradles]

Eugenic abortion and sterilization are the greatest services doctors can provide IMO

Hey Shredder, just curious, what medical school do you attend?

 

[Shredder]

Depends on your motive; anonymity can be valuable for outspoken folks like myself. pm if you want

 

[Squad51]

I need to start with number two. I know that our laws and all the debate in the world has not allowed to us to definitively say exactly when an embryo becomes a human life. The gestational age of viablilty has been mentioned several times in this thread, 24 weeks, (as well as the fact that very, very few abortions are performed after this age), and so I am assuming that maybe 24 weeks is when the fetus becomes qualified as "human life". So I have to know something...when due to PROM my 22-weeker, not-viable baby is born and she cries and suckles and responds to my touch and lives for 8 hours and 23 minutes, did something happen to her in the minutes between living in utero and living in my arms that made her suddenly human...or are you willing to tell me that she was not human life? Or what about my 14-week son who also was born very suddenly due to PROM who still moved his arms and legs and tiny mouth as if to cry for minutes afterwards...does something just as magical happen between 14 and 22 or 14 and 24 weeks that changes the very substance of that fetus from something that is not human life to something that is? If so...what is it? I am asking this not only because I struggle with the idea that a fetus is not human life, but also because if it is the case, then I am a mother to non-human life...and that is nearly unbearable.

First of all, sorry for your losses. Those events must have been very difficult and I hope this finds you and your family well.

On to the point. The point (in a timing sense) of "humanity" is, at base, a religious argument. For ancient Jews, the first breath in life was said to impart the soul, for some modern Christians, life begins at conception. St. Thomas Aquinas wrote on the fetal brain achieving enough "complexity" to accept a human soul (which he believed occurred around the 24th week) but the modern Catholic Church has chosen an approach similar to yours, i.e., the point of "humanity" is unknown, so it is better to assume it is at conception than risk being "wrong" in the eyes of God.

But there is some science that goes "against" this, in a fashion. We know, with scientific certainty, that the majority of conceptions do not go on to a viable pregnancy. Many fail to implant, and others are lost too early to be detectable, or mistaken for a simply "late period". Should we mourn each of these? Should we provide burial and religious ceremony to the products of each woman's menstrual cycle each month to be certain not to ignore the loss of a human life? Certainly not. So the question remains, when is a human human? We all agree that the infant, born and breathing on its own is human, and we all agree that the unfertilized egg in a woman's ovary is not uniquely human of itself, so when does the change occur?

The answer cannot be established without faith, because the central component of the question (the definition of humanity) is faith based. And, in this country, we have fought and died for the right to make decisions of faith on an individual basis. I think there exists a middle ground in the abortion debate that is not often discussed. That is, the personal belief that abortion is wrong, but the acknowledgment that this belief is personal, and a matter of faith, and therefore each woman should have the right to decide for herself. Until abortions are mandated or forced onto a woman against their will, that is, in fact, what this debate boils down to. Is an individual in our society allowed to make a decision of faith of their own accord?

Before someone responds to this post with some drivel about how murder is against most religions but it is also against the law, realize that argument is false on two fronts. First, murder is against the societal good, so there are reasons beyond faith to prohibit it. No one has yet made a non-faith based argument as to the societal detriment to abortion. And this leaves out the fact almost every major faith (with some exceptions) allows for killing another person under conditions that would be illegal under U.S. law, so our laws against murder are not based on religious faith. Second, some religions hold very different (and some would say abhorrent) views regarding other major crimes that we would never accept as law here (e.g., the rape of a child is o.k. as long as her attacker marries her and pays her father a dowry) so why legally settle the matter of abortion on a faith basis? If we were to begin legislating on faith, we would live in a very different society...

😎

 

[CatsandCradles]

Squad 51,

This is a very thought provoking post you have written here. It reminds me of Chapter 2 of John Stuart Mill's On Liberty.

In that chapter, he tries to show that it is perhaps naive for us to allow one group to make decisions for society and argues that people should cultivate their minds so that they may arrive at a conclusion - rather than one group, imposing their views without any retoric for the counter argument.

Of course you all might be saying, "Common Cats, that's old stuff we all know that," but I still couldn't help pointing out the similarity 👍

Sorry about going off tangent!

 

[Songeur]

First of all, sorry for your losses. Those events must have been very difficult and I hope this finds you and your family well.

On to the point. The point (in a timing sense) of "humanity" is, at base, a religious argument. For ancient Jews, the first breath in life was said to impart the soul, for some modern Christians, life begins at conception. St. Thomas Aquinas wrote on the fetal brain achieving enough "complexity" to accept a human soul (which he believed occurred around the 24th week) but the modern Catholic Church has chosen an approach similar to yours, i.e., the point of "humanity" is unknown, so it is better to assume it is at conception than risk being "wrong" in the eyes of God.

But there is some science that goes "against" this, in a fashion. We know, with scientific certainty, that the majority of conceptions do not go on to a viable pregnancy. Many fail to implant, and others are lost too early to be detectable, or mistaken for a simply "late period". Should we mourn each of these? Should we provide burial and religious ceremony to the products of each woman's menstrual cycle each month to be certain not to ignore the loss of a human life? Certainly not. So the question remains, when is a human human? We all agree that the infant, born and breathing on its own is human, and we all agree that the unfertilized egg in a woman's ovary is not uniquely human of itself, so when does the change occur?

The answer cannot be established without faith, because the central component of the question (the definition of humanity) is faith based. And, in this country, we have fought and died for the right to make decisions of faith on an individual basis. I think there exists a middle ground in the abortion debate that is not often discussed. That is, the personal belief that abortion is wrong, but the acknowledgment that this belief is personal, and a matter of faith, and therefore each woman should have the right to decide for herself. Until abortions are mandated or forced onto a woman against their will, that is, in fact, what this debate boils down to. Is an individual in our society allowed to make a decision of faith of their own accord?

Before someone responds to this post with some drivel about how murder is against most religions but it is also against the law, realize that argument is false on two fronts. First, murder is against the societal good, so there are reasons beyond faith to prohibit it. No one has yet made a non-faith based argument as to the societal detriment to abortion. And this leaves out the fact almost every major faith (with some exceptions) allows for killing another person under conditions that would be illegal under U.S. law, so our laws against murder are not based on religious faith. Second, some religions hold very different (and some would say abhorrent) views regarding other major crimes that we would never accept as law here (e.g., the rape of a child is o.k. as long as her attacker marries her and pays her father a dowry) so why legally settle the matter of abortion on a faith basis? If we were to begin legislating on faith, we would live in a very different society...

😎

First of all, thank you for your acknowledgement of our losses.

I started to write something here, but I can't seemto get it said in a cohesive manner. The bottom line is that I struggle with this issue. I don't believe it is right to kill human babies, and with what I have seen, I cannot help but believe that a fetus is indeed a human baby much earlier than 24 weeks. All of that being said, I know that there are some really, really awful situations out there that have no easy answers. I will not be a physician who performs elective abortions. But I will extend compassion to those who do and to those who end up having them.

 

[velo]

Most wouldn't understand. It's the nature of paradigm shifting

You're right, it takes time. People forget that Adolf failed in his first coup attempt and failed out of art school. Just goes to show you can do anything you put your mind to, good luck!