Daniel Grossman is a professor of obstetrics, gynecology and reproductive sciences at the University of California at San Francisco and director of Advancing New Standards in Reproductive Health. Robyn Schickler is a practicing obstetrician-gynecologist and a fellow of Physicians for Reproductive Health.
As practicing obstetricians, we know how miraculously wonderful pregnancy can be. Having the privilege of caring for a woman during such an important and incredible time in her life is one of the reasons we chose to pursue careers in OB/GYN. And unfortunately, we also know how things can go tragically wrong during pregnancy. Sometimes when tragedy strikes, the best medical treatment involves abortion, because that’s the fastest and safest way to save the pregnant woman’s life.
But nowadays, even these basic facts are highly politicized — so much so that a company such as Facebook has become unwilling to stand up to those pushing misinformation on the subject. This is a dangerous development.
Last month, the anti-abortion group Live Action posted a video to the Facebook page of its founder Lila Rose, claiming abortion was never medically necessary, and Facebook asked the fact-checking site Health Feedback to review it. Health Feedback reached out to us as medical professionals, and we both commented that the video was inaccurate.
What happened next seems less shocking in an era when politicians routinely dismiss fact as fiction: Republican Sens. Josh Hawley (Mo.), Ted Cruz (Tex.), Kevin Cramer (N.D.), and Mike Braun (Ind.) sent a letter to Facebook complaining that the fact-check was biased, and Facebook responded by removing our assessment. Rose’s inaccurate video remains posted.
This is wrong. Ask any obstetrician and they will surely have a tale to recount: A woman’s water breaks at 20 weeks, and she develops signs of infection — not only in her uterus but in her blood; a patient with a placenta previa, where the placenta covers the uterine opening, begins to have heavy bleeding at 19 weeks; a woman pregnant at 21 weeks develops severe preeclampsia, characterized by high blood pressure, that affects her liver. These babies cannot survive outside the uterus, and an abortion is medically indicated to save the woman’s life.
These are rare, challenging situations that progress quickly, and we do our best to save as many lives as possible. But Caesarean delivery is risky to the pregnant woman and might increase the chance of complications in subsequent pregnancies. That’s why we provide the full spectrum of reproductive health care, including abortion, to our patients, which is consistent with the recommendations of the American College of Obstetricians and Gynecologists, the leading professional organization of U.S. OB/GYNs. That doesn’t make us biased; it makes us good doctors.
If a video had been posted claiming that a life-saving treatment for heart disease was unnecessary, the process for fact-checking it might have been less controversial. Cardiologists who are experts in this area of medicine would have been consulted, including those who conduct research on the topic. Perhaps the American Heart Association would have been asked to comment. Why is medical treatment involving abortion any different?
Everyone is entitled to his or her views of abortion, but promulgating misinformation about when abortion is medically necessary is dangerous. In many cases in which termination of pregnancy is necessary, the parents strongly desire the pregnancy, and they are devastated to learn that they have a complication that will result in the loss of their baby. There is a risk that patients may choose to delay necessary care because they have heard conflicting information from advocates, which may put women’s lives at risk. For those who have survived this kind of complication in pregnancy and lost their baby, it is traumatizing to be told what they did was medically unnecessary. Given that we are in the middle of a crisis of rising maternal mortality, which disproportionately affects black women, it is concerning that some are calling for the restriction of life-saving care during pregnancy.
Neither of us is interested in having a shouting match with Lila Rose or Republican senators or any other advocate making claims about when abortion should or should not be performed. This is a question about the practice of medicine and the real-life needs of patients, and those with medical expertise are the ones best suited to answer it. When every major medical group agrees that abortion is sometimes medically necessary, it’s time to recognize that as fact.
This isn’t about getting more Facebook likes, followers or campaign contributions; it’s about the lives of pregnant women. Medical misinformation harms our patients, and it’s our duty as doctors to stand up for them.