The XX Factor

New Utah Law Mandates Anesthesia in Certain Abortions, Defying Medical Ethics

Sen. Curt Bramble, an accountant and state legislator, is telling Utah doctors what to do.

Kirstenfrankly/Wikimedia

A new law in Utah will compel doctors to administer anesthesia to patients getting abortions at and beyond 20 weeks of gestation. Gov. Gary Herbert signed the bill, the first of its kind to become law in the U.S., on Monday, defying testimony from medical experts who warned that it would force women to take unnecessary health risks to satisfy the political whims of conservative legislators.

The law, sponsored by Republican Sen. Curt Bramble of Provo, states that anesthesia will “eliminate or alleviate organic pain to the unborn child.” Anti-choice advocates maintain that a fetus feels pain after 20 weeks gestation, though that claim has not been proven by any scientific research. Utah law previously allowed abortion-seeking women to choose whether they wanted anesthesia. The Salt Lake Tribune reports that, though there’s no way to tell if and how fetuses register pain, Herbert signed the law to “err on the side of caution.”

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That’s caution for the fetus, not the patient. Many abortion providers already recommend IV sedation or general anesthesia for second-trimester abortions, especially ones as late as 20 weeks, making this new law a purely political gambit. But that’s beside the point. Legislating doctors’ medical decisions is a reckless, dangerous game that puts women’s lives at risk. Anesthetic drugs increase the likelihood of complications and negative health outcomes of a very safe procedure; subjecting women to anesthesia against their wishes or their doctors’ recommendations is cruel. “You’re now mandating [women] take that risk, based on inconclusive and biased evidence. You don’t understand what you’re legislating,” Utah doctor Sean Esplin testified on the bill earlier this month.

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Conservatives have long invoked specters of death panels and government-controlled robot doctors in their sustained protests against the Affordable Care Act. Just last year, Utah House Republicans tried to block the ACA Medicaid expansion in the state on ideological grounds. Now, they’ve literally told doctors what drugs they must administer to women during a specific medical procedure. Bramble himself admitted that he didn’t know whether his bill would require an anesthesiologist or whether special drugs or medical equipment were needed to comply with the new law. Of course he didn’t—he’s not a doctor!

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The executive director of Planned Parenthood of Utah, Karrie Galloway, trusts people who’ve gone to medical school more than she trusts a cabal of power-tripping legislators when it comes to powerful analgesic drugs. “You’re talking to a woman who is being told that Curt Bramble, a CPA, is better at practicing medicine than the physician I have chosen,” she said. “I mean, we have fetal medical specialists speaking, and they were discounted by a citizen who said, ‘I read it on the Internet and therefore it must be true.’ That’s how we do policy here in Utah.”

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Unfortunately, lack of medical knowledge is no injunction against passing dangerous medical legislation. Lawmakers already force doctors to lie to abortion-seeking patients in some states. They make laws for and against medical marijuana, legislate how painkillers and other prescription drugs are distributed, and decide whether physicians can assist patients who wish to die. The best bulwark against bad medical laws is testimony from medical experts, and Utah’s legislators heard—and ignored—plenty. The American College of Obstetricians and Gynecologists said this kind of legislation runs counter to medical ethics. Republican Utah Sen. Brian Shiozawa, an emergency-room doctor, warned Bramble that the law would also mandate anesthesia for women giving birth vaginally, because fetuses would probably feel pain as they were squeezed down the birth canal.

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The law probably won’t affect too many women seeking abortions in Utah—the Tribune reported that just 17 women received abortions at or after 20 weeks gestation in 2014, and the state bans abortions after fetal viability, between 22 and 24 weeks. But David Turok, an associate professor in the University of Utah’s obstetrics and gynecology department, says the law could also apply to other common procedures usually performed without anesthesia, like inducing labor when a woman is past her due date or when a pregnancy complication warrants an early delivery. “You never give those [anesthetic] medicines if you don’t have to,” Turok told the Associated Press.

Forcing doctors to use anesthesia in Utah could make it even more difficult for them to serve their patients safely and expediently, too. As heightened anti-abortion restrictions crop up around the country, it’s getting harder for abortion providers to fund full-time positions and attract employees willing to take a job that might be legislated out of existence at a moment’s notice. Trapped, a recent film about the effects of such laws at abortion clinics in the South, showed one Whole Woman’s Health employee in tears as she was forced to turn away a 13-year-old rape survivor, who was 20 weeks and five days pregnant, because the organization’s single nurse anesthetist in the entire state of Texas couldn’t travel to the clinic in time. Getting an abortion in Utah is already a hassle: More than half of Utah women live in a county without an abortion provider; they must make two in-person visits to a clinic and wait at least 72 hours in between visits.

Utah’s new law will exempt a woman from the anesthetic mandate if she’s getting an abortion because her life is at risk or because the fetus has a developmental defect that would keep it from surviving outside the womb. This exemption only underscores the hypocrisy of the law. If legislators truly believed that fetuses felt pain, and if this law was truly a measure to protect them, there would be no exception. As it stands, it’s nothing more than risky medical meddling and a punishment and shaming tactic against women who have elective abortions.

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