Planned Parenthood recently released its 2022-2023 annual report and the data are telling. The nation’s largest abortion business reported 392,715 “abortion procedures” while the Guttmacher Institute estimates a total of 1,026,690 abortions performed in the United States in 2023, 63% of which were chemically induced.
In his classic American novel, Moby Dick, Herman Melville wrote, “In this world, shipmates, sin that pays its way can travel freely and without a passport; whereas Virtue, if a pauper, is stopped at all frontiers.”
And of course, what makes Moby Dick a classic – aside from the 173 years since its publication – is that this nugget of insight is still relevant. This is particularly so if one considers the current state of abortion and the abortion industry in America today.
It’s been written that the white whale represents an unknowable God and all that is good in the world, while Captain Ahab obsesses over the destruction of the whale as he travels the world “freely” seeking the annihilation of the white whale, which is “stopped at all frontiers.”
But the allegory goes beyond the obvious as Melville’s quotation applies to the entire abortion industry. Clearly, the sins of the abortion industry have traveled freely for decades since the passage of Roe v. Wade. There is much more than what’s on the surface. A lot more.
A physician practicing at any hospital in this country has a moral and ethical obligation to his or her patients to either attend to the patients’ present and future needs, or in the event of a planned absence, make arrangements for adequate coverage.
Hospitals must have a policy in place whereby all basic services are covered for emergency coverage. For instance, if a patient were to sustain a fractured leg, the hospital and emergency room must make arrangements for that patient to be seen by an orthopedic specialist or have follow-up with one. This is the law. It applies to all medical and surgical services, including gynecologic.
Even abortion facilities have rules and guidelines – sort of.
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The World Health Organization (WHO) has policies and recommendations as it relates to post-abortion care in the outpatient setting. In the WHO document entitled Clinical Practice Handbook for Safe Abortions, appropriate guidelines are presented for facilities and providers to follow such as stabilization and referral; however, what is not mentioned is the concept of continuity of care for the patient.
Abortion facilities do require their providers to either have admitting privileges at a local hospital or a written agreement with a local hospital to accept patients in transfer that might need further evaluation or intervention at the time of their abortion.
These policies are also outlined in the book published by the National Academy of Sciences, Engineering, and Medicine, Safety and Quality of Abortion Care in the United States. Interestingly, but not surprisingly, this document also fails to address continuity of care by abortion providers.
Who, then, is responsible for the patient who is discharged but then experiences problems a few hours or days later?
If a gynecologist performs out-patient surgery on a woman on a Wednesday and the patient is discharged the same afternoon her surgeon leaves town on vacation, the surgeon is obligated to have someone take call for him or her. If a patient were to experience a post-operative complication or emergency while their surgeon was out-of-town and arrangements were not made for proper coverage by a responsible provider, the surgeon could be held liable for abandonment. This just isn’t theoretical, it’s the standard of care. To breach this tenet of medical care can lead to sanctions by a state board of medical examiners – unless of course, the provider in question is performing abortions. In this instance, it’s a two-tiered system of accountability.
Over the course of my career as an OB/GYN, I attended numerous female patients who sought care following an abortion. Never – not once – was I able to reach the provider who performed the procedure and ask them to assume care of the possible complication they most likely contributed to.
Admittedly, complications following an abortion are rare. The state of Minnesota maintains a state-mandated registry of abortions and complications performed at five different facilities. In 2021 a total of 10,136 abortions were performed between five different facilities and there were 87 (0.87%) reported complications that required follow-up care. This number is consistent with other published data, however, others have reported up to 40% of women undergoing an abortion seek emergency department care within six weeks of the initial abortion procedure. And I would opine that the vast majority of these women were cared for by someone other than the provider who performed the abortion in the first place.
In visiting with an old friend – a residency-trained and board-certified emergency medicine specialist – about this very topic, he affirmed that in his 40 years of practice in a large metropolitan city, he cared for numerous women who presented to the emergency room with complications following an abortion. Not once was he able to contact the provider who had performed the abortion. He went on to state, “After so many years, I just gave up trying to reach them for follow-up care.”
To further test my hypothesis, I reached out to the head of a large urban emergency department with years of clinical experience and posed the question: “Have you ever had a post-abortion patient present to your ER for care related to her abortion and have the responsible individual who performed the abortion notify the ED of the patient’s pending arrival or been able to contact the abortion provider personally to discuss their patient with them.” “No, never,” was the simple response.
These experiences are the rule, not the exception.
How is it that the concept of abandonment does not apply to providers of abortions?
Why do they get a pass when one of their patients suffers a complication and they – or a designated provider in their stead – are unavailable and therefore unaccountable?
A better question might be, why is it they don’t care?
Why, indeed?
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Editor’s note: Dr. Lloyd Holm is a retired OB/GYN and former President of the Iowa State Board of Health who is currently the Executive Director of Options for Women/River Falls, a pregnancy resource center in western Wisconsin. A previous contributor to Pregnancy Help News, his writings have also appeared in The Federalist, The Omaha World- Herald, Obstetrics and Gynecology, the American Journal of Obstetrics and Gynecology, Iowa Medicine, The Female Patient, and the on-line networking platform for medical professionals, Doximity.
