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  • Title: A chill wind blows: Webster, obstetrics, and the health of women.
    Author: Chavkin W, Rosenfield A.
    Journal: Am J Obstet Gynecol; 1990 Aug; 163(2):450-2. PubMed ID: 2386130.
    Abstract:
    The Supreme Court decision in Webster v Reproductive Health Services permits states to regulate abortion in fashions that may be medically unsound and may significantly restrict access. This decision challenges the contemporary practice of obstetrics and threatens to curtail access to needed services, particularly for poor women, who are at highest risk of pregnancy-associated medical complications and death. Governmental restrictions on abortion interfere with the obstetrician's basic goal of providing optimal care for the patient. Obstetricians dedicated to providing the best care to their patients should help to ensure that safe abortion be part of a spectrum of reproductive health care that is available to all American women. The US Supreme Court decision in Webster v Reproductive Health Services permits states to regulate abortion in fashions that may be medically unsound and may significantly restrict access; provisions include prohibition on the use of public funds, facilities, and personnel for the performance of abortion, and inappropriate viability testing requirements. This decision challenges the contemporary practice of obstetrics and threatens to curtail access to needed services, particularly for poor women, who are at highest risk of pregnancy- associated medical complications and death. Thus by imposing cost and delay on women seeking abortion, such governmental regulation impose health risks. Restricted access to legal abortion for poor, high-risk women is likely to increase infant mortality rates. By enforcing governmental provisions, prenatal diagnosis would become of limited value with diagnostic capabilities far exceeding therapeutic possibilities. Future developments in reproductive medicine are likewise restricted. Progesterone antagonists and in vitro fertilization are examples of developments in reproductive research whose mode of action may cause them to be similarly threatened by the definition of conception as occurring at the time of fertilization. Governmental enforcement of particular theologic beliefs about conception and embryonic and fetal status will have a negative impact on the future of scientific advancement in reproductive medicine. If performance of abortion is not regularly included in obstetrics and gynecology training programs, it is likely that as experience decreases, procedure-associated complications will rise. These effects of governmental restrictions on abortion do indeed interfere with the obstetrician's basic goal of providing optimal care for the patient and undermine their efforts to improve maternal and infant health. Obstetricians dedicated to providing the best care to their parents should help to ensure that safe abortion be part of a spectrum of reproductive health care that is available to all American women.
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