Column: NH abortion ban puts politics ahead of health care

I read with interest your article on the pregnancy termination issue in the New Hampshire budget (“Doctors urge budget veto over abortion ban,” June 16). Your article is factual, but in my estimation misses the real points that need to be emphasized.

When the term “abortion” is mentioned, many people have a knee-jerk reaction one way or the other without thinking about health care for women and children and, in the case of this issue, the women and children of New Hampshire and Vermont. This whole discussion, and the proposed actions, are putting politics ahead of the best health care of our citizens.

The provision proposes to criminalize abortions after 24 weeks, which is a rare in New Hampshire and Vermont except when the life of the mother is threatened. It makes a certain group of politicians look good in the view of other abortion opponents across the country while failing to show any understanding of how we have achieved, for the women and newborns of our area, the best outcomes in the U.S. over many years by developing a system of prenatal and neonatal care with the collaboration of Dartmouth-Hitchcock Medical Center, the University of Vermont, and all the hospitals with obstetric services in the Twin States.

The success of this excellent but fragile system depends on the ability to recruit and retain experts in the subspeciality fields of maternal fetal medicine and neonatology and, to a large extent, well-trained general OB/GYN physicians, nurse practitioners and nurse midwives. We are already short in numbers in those two subspeciality fields, and recruitment would in the future be made much more difficult with the introduction of the draconian measures threatened for health care providers dealing with some of the most difficult medical decisions there can be.

So, the provision accomplishes nothing while creating real challenges to our ability to maintain our excellent medical outcomes into the future.

Also, for clarification, “viability” and “24 weeks gestation” are not synonymous terms. The 24-week timeline presumes a perfect 28-day menstrual cycle for all women, which is not the case. Add to that the fact that many older women are attempting pregnancy either with or without in vitro fertilization, which complicates the issue even further. Every intensive care nursery keeps its own data as to its success in saving these very immature infants. These are difficult decisions for specially trained medical experts. These are not decisions for politicians looking to score points and get votes.

Another factor to keep in mind is that it is becoming difficult to recruit general OB/GYN physicians across the country who will practice obstetrics long into their careers. Most new residency graduates will not consider going to smaller rural hospitals and most want the availability of subspecialty trained maternal fetal medicine physicians and neonatologists in the area where they practice.

New Hampshire is supposed to be a smart and independent state. I hope the governor, who claims to support reproductive rights and is reportedly considering running for national office, will have the strength to show his independence by considering the health care benefits of all women and children by vetoing a budget that contains this dangerous provision.

Barry D. Smith, of Norwich, is an emeritus professor of obstetrics and gynecology and chairman emeritus of Dartmouth’s Geisel School of Medicine.