An abortion bill introduced in Ohio‚Äôs legislature drew scorn this week for including misinformation about a dangerous medical condition that can affect pregnant women. Some health experts see the bill‚Äôs language as another example of politicians trying to legislate women‚Äôs health without considering the medical implications.
The House bill, which was first introduced in April by Ohio state Rep. John Becker (R), seeks to limit insurance coverage for abortion procedures where the mother‚Äôs life is not endangered. It would also bar coverage for drugs or devices that prevent the implantation of a fertilized egg, which experts say could affect certain kinds of IUDs.
One provision especially worried doctors.
The latest available version of HB 182 has an exception that would allow insurance to cover a treatment that does not exist.
‚ÄúA procedure for an ectopic pregnancy, that is intended to reimplant the fertilized ovum into the pregnant woman‚Äôs uterus.”
An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, or in the wrong part of the uterus, and usually presents in the first trimester. With the exception of some very rare cases of abdominal pregnancies, ectopic pregnancies do not result in the birth of a child and can cause potentially fatal ruptures and hemorrhages.
The treatment laid out in the bill is ‚Äúscience fiction,‚ÄĚ according to Daniel Grossman, an OB/GYN and director of Advancing New Standards in Reproductive Health at the University of California at San Francisco who debunked this passage in a viral Twitter thread on Wednesday.
‚ÄúWe don‚Äôt have the technology to do that,‚ÄĚ Grossman told The Washington Post on Thursday. He said he had treated many patients with the condition who wanted children. ‚ÄúNothing can be done to continue that pregnancy.‚ÄĚ
Rather, ectopic pregnancies are treated with surgery or medication.
‚ÄúThis is one example of a much larger problem about how these abortion restrictions have nothing to do with the practice of medicine or science,‚ÄĚ Grossman said.
Several states have considered or enacted legislation known as ‚Äúheartbeat bills,‚ÄĚ which ban most abortions after six weeks into a pregnancy. Ohio‚Äôs governor signed one such bill into law in April. Critics of these bills claim that they ban abortion before a woman would likely know that she is pregnant, making it all but impossible to undergo the procedure.
HB 182‚Ä≤s flaws represent ‚Äúa new level of arrogance among legislators to think that they can practice medicine without even going to medical school,‚ÄĚ Grossman said.
The bill‚Äôs inaccuracy could create confusion about how and when a doctor would be able to treat a woman for an ectopic pregnancy, which could put her health at risk, experts say.
Anything that causes an insurance provider to consider, ‚Äúam I potentially breaking a law by providing a medical procedure or covering a medical procedure?‚ÄĚ will limit coverage for women, said Alina Salganicoff, vice president and director of women‚Äôs health policy at the Kaiser Family Foundation. Salganicoff said that such false assertions in a bill could hamper legitimate conversation around women‚Äôs health.
‚ÄúThere‚Äôs already a lot of misinformation about contraception and abortion,‚ÄĚ she said. ‚ÄúThis adds yet another element into the mix.‚ÄĚ
Ectopic pregnancy is a significant cause of mortality and morbidity among pregnant women, according to the American College of Obstetricians and Gynecologists. Ectopic pregnancies accounted for 2.7 percent of all pregnancy-related deaths in the United States between 2011 and 2013.
In an ectopic pregnancy, the fertilized egg will most commonly implant in the fallopian tube, a thin pathway where eggs are fertilized and travel from the ovary to the uterus. In rarer cases, implantation can also occur in a corner of the uterus, an ovary, cervix or abdomen.
And it can be deadly.
‚ÄúThe biggest risk for the mom is when these ectopics invade through wherever they are implanted and then they rupture,‚ÄĚ said Chris Zahn, a vice president at the American College of Obstetricians and Gynecologists. ‚ÄúThat can result in catastrophic hemorrhage and death.‚ÄĚ
Ideally, the condition is discovered and treated by doctors before it ruptures, and if the issue is in the fallopian tube, that structure can be saved to preserve future fertility.
Treating an ectopic pregnancy would not be considered terminating a pregnancy, Zahn said. ‚ÄúThe pregnancy‚Äôs never going to be viable,‚ÄĚ he said. ‚ÄúIn many of these cases, a fetus might not even develop.”
Becker, the bill‚Äôs sponsor, did not respond to a request for comment.
After facing backlash, Becker wrote on Facebook Wednesday that his detractors were ‚Äúcrazy‚ÄĚ and defended the legislation.
In an interview with the State House News Bureau on Tuesday, Becker falsely asserted the existence of a method to save an ectopic pregnancy. ‚ÄúPart of that treatment would be removing that embryo from the fallopian tube and reinserting it in the uterus so that is defined as not an abortion under this bill,‚ÄĚ he said.
Again, no such procedure exists.
He also said, despite the fact that his bill addresses such drugs and devices, ‚ÄúWhen you get into the contraception and abortifacients, that‚Äôs clearly not my area of expertise.”
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