Fast games

Ohio abortion ‘trigger’ bill could ban in vitro fertilization; increase infant and maternal mortality rates, doctors say

COLUMBUS, Ohio — An Ohio House bill that would ban abortion in Ohio under most circumstances could also criminalize in vitro fertilization, a Cincinnati fertility doctor told lawmakers Thursday morning.

The bill would also likely increase the state’s already high infant and female morbidity and mortality rates, impinge on the patient-doctor relationship and could drive doctors out of the state, obstetricians and gynecologists said. .

As the United States Supreme Court is set to overturn Roe v. Wade next month, House Bill 598, if passed, could be “triggered” or take effect after the court’s decision is released. Thursday was the third committee hearing for the bill, at which opponents testified. However, the president of the Ohio Senate said he doesn’t want a trigger bill passed until he sees the Supreme Court’s decision.

Under HB 598, doctors and others who perform abortions using drugs or instruments would be charged with criminal abortion, a fourth-degree felony. The bill clarifies that prosecutors cannot sue pregnant women, but the bill makes no exception for abortion in cases of rape or incest.

The bill would allow doctors who perform abortions to preserve a woman’s life and health to use medical records as an affirmative defense if they are sued. Another physician not professionally related to the first should certify in writing that the abortion was necessary. When the abortion occurs, another physician must be in the room to “take all reasonable steps to preserve the life and health of the unborn child,” the bill says.

Dr. Thomas Burwinkel, a Cincinnati obstetrician and gynecologist specializing in reproductive endocrinology, noted that House Bill 598 defines an “unborn child” as a Homosapien organism that has been fertilized. This definition could make IVF illegal, he said.

“HB 598 can erase many patients’ dreams of becoming parents through IVF or other reproductive technologies,” he said. “The bill defines an IVF-created embryo as an ‘unborn child,’ even though most IVF-created embryos will never survive to be implanted into a patient for a chance to develop into a pregnancy.”

In addition to embryos before they are implanted, HB 598 creates problems for fertility doctors and women after they are implanted.

Sometimes doctors do selective reductions, a procedure to stop the heart of a fetus, which is usually reabsorbed by the woman in a multifetal pregnancy. It should end in HB 598, he said.

“This practice will result in triple, quadruple, quintuple or more pregnancies,” Burwinkel said. “These patients would not have the ability under this bill to make these very high risk pregnancies safer through the use of selective reduction. This is a medical procedure used to reduce the number of embryos to a safer number for her and her fetuses.

Tim Ginter, a Republican from Columbiana County, asked Burwinkel what percentage of pregnancies result in a selective reduction in her practice.

Burwinkel said her practice helps more than 2,000 pregnancies a year through in vitro and drug treatments. Selective reductions tend to be very small since modern fertility treatments result in fewer multifetal pregnancies. The last selective reduction he remembered was four years ago. He said women with quintuplets, quadruplets and triplets are more likely to consider them.

He described a pregnant patient with triplets who did not have a complete uterus. He said it was about half the size of other women, and she opted for a selective reduction of two fetuses and delivered a baby at 33 weeks, which is still early.

“I’m pretty certain she wouldn’t have reached term or viability with triplets,” Burwinkel said.

Dr. David Hackney, a Cleveland OBGYN specialist in maternal-fetal medicine, said Ohio’s current law that bans abortions at 20 weeks is already making it difficult for doctors to practice. As a result, some fatal fetal genetic diseases and congenital disabilities are diagnosed only after the gestational age limit.

“Today we already have to tell a lot of these patients that they have to travel out of state because we are unable to provide their standard medical care in Ohio,” he said. “Those who cannot afford to do so are forced to continue. It is difficult to imagine what would happen if the termination of pregnancy for fetal or obstetrical indications were completely prohibited. Many patients will not be able to travel, and the proportion of those who must suffer through entire pregnancies will certainly be disproportionate by class, income, ethnicity and race.

Shivani Deshpande, a medical student at Ohio University, said students would not be able to receive full medical training under HB 598.

She plans to stay in the state because she grew up in Ohio, but that won’t be the case for all future doctors, she said.

“Others will leave Ohio to seek proper education and the ability to practice precise medicine,” she said. “If abortion is banned, Ohio faces a future with undereducated and underexperienced medical professionals,” she said.

Rep. Andrea White, a Dayton-area Republican, asked Dr. Amy Burkett, an OGBYN hospitalist from northeast Ohio, about the broader needs of women who will need to carry pregnancies to term.

“I wonder, from your perspective, what prenatal and postnatal supports do women in this state need that we are not currently providing? White asked.

Burkett mentioned the reversal of the state’s problem of maternal and infant morbidity and mortality and the harmful social determinants of health that influence health and quality of life outcomes, such as economic stability, access to quality education, safe housing and a clean environment.

“We have a long list of social determinants of health that I won’t detail here that women need support for,” Burkett said. “A pregnancy in someone who is already struggling adds to all of this. And so, a woman who chooses to continue with a pregnancy needs support not only during pregnancy but beyond. Beyond the 18 to 20 years that she will take care of that child, her own medical conditions and any medical conditions that child may have.

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