Sunday, April 13, 2008

State Protects Women From Postpartum Depression

As a result of the recent CDC report that [a]s many as one in five women in the United States suffers from postpartum depressive symptoms, the State does its duty and exercises its right to step in and protect pregnant women from themselves:

An Act to Protect the Families, and the Interests and Health of Pregnant Mothers, by Prohibiting Discouraging Carrying a Pregnancy to Term Except in Cases Where the Mother’s Life or Health Isn't at Risk of Anything

(a) Findings- Congress makes the following findings:

(1) Women who become pregnant should be protected from endangering their health by being coerced into carrying the pregnancy to term. Informed consent is a critical component of all decisions to continue the pregnancy.

(2) A recent report from the CDC found that [a]s many as one in five women in the United States suffers from postpartum depressive symptoms.

Part Z of title III of the Public Health Service Act (42 U.S.C. 280g et seq.) is amended by adding at the end the following:

(b) I. Requires the viewing of an abortion techniques video prior to a woman receiving prenatal care, with an explicit provision that allows a woman to avert her eyes.

II. Requires any "private office, freestanding outpatient clinic, or other facility or clinic or hospital" in which prenatal care is provided to "conspicuously" post a sign that is "at least three-quarters of an inch boldfaced type" in each patient waiting room and patient consultation room used by prenatal patients. The sign must state that it is "against the law for anyone, regardless of his or her relationship to you, to force you to carry the pregnancy to term."

III. A physician must inform a pregnant female minor that "no one can force her to carry the pregnancy to term" and that prenatal care cannot be provided "unless she provides her freely given, voluntary and informed consent"

IV. Requires minors seeking to carry the pregnancy to term to obtain parental consent before undergoing the pregnancy.

V. It is a felony for a physician to deliver prenatal care to a minor who does not have parental consent or a judicial waiver.

VI. Allows siblings, parents, grandparents or the husband of a pregnant woman to go to court to stop her from continuing the pregnancy post-21 weeks if they can argue the procedure might violate state law.

VII. Requires a physician to meet privately with a woman 30 minutes before the start of the prenatal visit and that the woman provide a written reason for the pregnancy.

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8 Comments:

At 3:44 PM, Blogger Frances said...

Thank you so much for writing this...As a Floridian, I am mightily pissed off that my legislators are actually considering making pregnant women seeking an abortion get an ultrasound that they have to pay for. Not only does it discriminate against the poor (women who already have limited access to birth control and prenatal care), but it works by attempting to one-sidedly guilt trip the woman. This is awesome, and oh-so-sane.

 
At 6:08 PM, Blogger aimai said...

I love this. I'd like to suggest that the new "informed consent" for pregnancy include the showing of an unmedicated labor and warnings that remind the woman, as "What to expect when you are expecting" does, that after a while in your pregnancy the Dr. is considered to have a duty to the fetus equal to his duty to you and may and will make decisions during the labor that are against your medical interest if he or she thinks it necessary on behalf of the baby. In other words, at any point in time you may cease to be the official "patient" and some other person's rights will be privilieged over yours.

aimai

 
At 8:41 PM, Blogger ema said...

frances,

As am I. Also:

Not only does it discriminate against the poor (women who already have limited access to birth control and prenatal care), but it works by attempting to one-sidedly guilt trip the woman.

And it does sooo much more: 1) it poofs away the presumption, granted to every other patient, that pregnant patients who need/desire an abx are capable of consent.

Like so--the only medical reason to do an U/S before an abx is to diagnose a pregnancy. Except, other than very specific cases (when you're not sure of dates; to r/o an ectopic; etc.), a pregnancy test is all that's needed to confirm a pregnancy. But since the patient needs/wants to abort, she's not considered capable of understanding what a pregnancy actually is [or that an abortion entails the termination of a pregnancy] and so she must be subjected to a medical test WITHOUT AN INDICATION. [Doing this to any other patient = malpractice.]

And 2) it mandates that the MD provide substandard care. Both the Ob/Gyn and the Radiology specialty boards specifically mention that performing an U/S just too look at the fetus does not constitute a medical indication.

Oh, and have I mentioned that when you do a medical U/S, you have an indication; that means there are certain criteria you have to observe/abide by. For example, if you do an U/S to determine EGA, you have to make certain measurements, view specific landmarks, etc.

When you do an U/S just to show the dimwitted patient that a pregnancy entails a fetal component there are no standards. What if it's a molar pregnancy (more or less a placental problem) and you miss it, since all you're mandated to do is to show the patient the fetus and, I take it, giggle and coo like a school girl?

aimai,

I'd like to suggest that the new "informed consent" for pregnancy include the showing of an unmedicated labor and warnings....

He, good one. Let's face it, the possibilities are endless. I was going for the most absurd of all: showing a pregnant patient who's decided to carry to term anything about an abortion. You know, as absurd as showing a patient before an abortion prenatal/delivery material.

 
At 9:27 PM, Anonymous Anonymous said...

Something else that I've been wondering about the whole ultrasound thing and you might be in a position to answer: in the early stages of pregnancy, isn't a transvaginal ultrasound pretty much the only way of getting a decent picture? Having goo smeared on your belly is one thing, having a probe inserted is totally different in its invasiveness. Which kind of ultrasound is required? Also, at the faux crisis pregnancy centres, what kind of ultrasound do they use?

 
At 11:20 PM, Blogger ema said...

Intransigentia,

That's correct. The problem during the first trim (~12 wks) is that the uterus is still small enough to be hidden behind the symphysis pubis.

Which kind of ultrasound is required?

If you need to do an U/S, a transvaginal one. The point is, there's no need to do one. 1st trim U/S are *not* routine/required. [The main indication for one would be to establish EGA if the woman is unsure of her dates, or if there's a discrepancy in uterine size when you do the pelvic exam.]

Also, at the faux crisis pregnancy centres, what kind of ultrasound do they use?

I'm not sure. If I were to speculate, I'd say they probably use delay tactics with 1st trim patients and have them return in a few weeks for a transabdominal one.

That's because a TV U/S 1) is, technically, more difficult to do (you'd have to have qualified personnel available to figure out what you're looking at), and 2) is more invasive and less conducive to gushing over.

If your goal is to coerce women into a forced pregnancy, I should think you'd want the process to be as noninvasive and "rainbows and fluffy bunnies" as possible.

 
At 6:48 AM, Blogger Margaret Polaneczky, MD (aka TBTAM) said...

The mainstream media is talking som little about all this. It's frightening. Glad to see the conversation going at least in the blogosphere.

On a lighter note, you've been tagged.

http://theblogthatatemanhattan.blogspot.com/2008/04/6-words-meme.html

 
At 11:21 AM, Anonymous Anonymous said...

This blog is perfect! Thanks for the antidote to the craziness that surrounds us.

I AM pregnant and since PPD is really a serious risk, I'm following the advice in this article to try and stay healthy. I think we should provide all the support needed by those of us who WANT to be pregnant and stop trying to push the desires of a few on all women. I wasn't ready for pregnancy until now and would have been horrified to be deprived of my right to appropriate birth control.

Anyway, thanks for your comments!You're right on track.

 
At 7:07 PM, Anonymous Anonymous said...

TBTAM,

My sentiments, exactly!

Sam White,

Thank you.

 

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