Scott Walker's 'reasonable' abortion ban could force women to undergo unnecessary surgery

Wisconsin Gov. Scott Walker signed a measure on Monday that bans abortion at 20 weeks except in narrowly-defined cases of medical emergency. Walker called the bill—which makes it a felony for a doctor to perform the procedure and contains no exceptions for rape, incest, or severe fetal anomalies—a “reasonable standard.”

“For people, regardless of where they might stand, when an unborn child can feel pain I think most people feel it’s appropriate to protect that child,” Walker said.

But Walker’s claim about fetal pain—which is the basis of the new law—doesn’t hold up against the overwhelming medical consensus:  A review of the scientific evidence published by the Journal of the American Medical Association, as well as studies out of Harvard University and University College London, found that pain perception doesn’t develop until later in gestation.

Being on the wrong side of the evidence hasn’t stopped anti-abortion politicians from banning the procedure: Fourteen other states have approved similar bans since 2010; a 20-week ban passed the House back in May; and a Senate version is expected to come up for a vote soon.

In addition to rejecting overwhelming medical evidence on fetal pain, Wisconsin lawmakers took the 20-week ban one step further and laid out restrictions on how physicians are supposed to perform the procedure in emergency situations: In the narrow cases in which abortion at 20 weeks is still permissible, the law requires doctors to terminate the pregnancy “in the manner that, in reasonable medical judgment, provides the best opportunity for the unborn child to survive.”

Physicians say this amounts to dangerous medical interference.
“The language [of the law] is contrary to what constitutes an abortion,” Vicki Saporta, president of the National Abortion Federation, told Fusion. “So women will be forced to travel outside of Wisconsin to obtain the medical care they need, even, apparently, in medical emergencies. Which would, and could in fact, endanger the lives and health of women.”

In an interview with Wisconsin Public Radio, Dr. Douglas Laube, a professor with the Department of Obstetrics and Gynecology at the University of Wisconsin and a former president of the American College of Obstetricians and Gynecologists (ACOG) said the “[provision] could mean in certain cases is that cesarean section—which really is a concept applicable much later in pregnancy—a cesarean delivery would need to be done.”

In addition to a letter of opposition signed by 99 physicians from ACOG, a statement from Dr. Kathy D. Hartke, chair of the Wisconsin chapter, criticized the bill for getting between patients and doctors:

The clear consensus by leading medical groups is that a 20-week ban on abortion would interfere with the physician-patient relationship at a time when women are in need of empathetic, respectful care. These medical decisions should be made solely by each individual woman in consultation with those she trusts the most, including her obstetrician-gynecologist—not state politicians.

And this is, weirdly enough, a sentiment Walker expressed less than a year ago. While his opposition to abortion rights is well-documented, Walker attempted to strike a moderate tone during his reelection campaign.

In an ad released in October 2014, Walker called himself “pro-life,” but defended a Wisconsin law forcing women to undergo an ultrasound before having an abortion by saying that, ultimately, the bill “leaves the final decision to a woman and her doctor.”

But the 20-week ban, like other restrictions in place in Wisconsin, leaves the final decision about terminating a pregnancy to, well, Scott Walker. It’s a dangerous precedent that ignores the medical realities women face at this stage in a pregnancy, according to Hartke:

As an obstetrician-gynecologist, I have firsthand experience treating women who are confronting the potential need for a second trimester abortion. I have witnessed the many heartbreaking, painful and frightening reasons why women need abortion care after 20 weeks.

Yet this ban would force physicians to deny services even to women who have made the difficult decision to end pregnancies for reasons including fetal anomalies diagnosed only later in pregnancy or threat to a mother’s life. Because many of these problems emerge or worsen later in pregnancy, a 20-week ban would leave almost all women without appropriate treatment options.

Abortions performed at 20 weeks account for less than 1 percent of abortions performed in Wisconsin, according to data from the state’s health department. That’s about on par with national numbers.

But as restrictions on abortion overall—like Wisconsin’s ultrasound requirement, its 24 hour waiting period, and state limitations on public and private insurance for the procedure—make it more difficult for women to access the procedure early in their pregnancies, the need for later abortion goes up.

And bans on abortion at 20 weeks hit low-income women and young women hardest, according to a study published in 2013 in a journal called Perspectives on Sexual and Reproductive Health.

After conducting interviews with nearly 300 women who had second-trimester abortions, the study concluded that women who access the procedure later in their pregnancies often experienced “logistical delays,” like trouble with finding a provider and raising enough money to pay for the procedure and other costs, like travel and time off work.

These are precisely the kinds of delays caused by Wisconsin’s existing abortion restrictions, and now, with a ban on the procedure at 20 weeks in place, women in already financially strapped or medically agonizing situations (or both) are left with fewer options than ever.

Walker, whose office has not returned Fusion’s request for comment, called the law a “reasonable standard.”

Physicians with the Wisconsin Medical Society, American College of Obstetricians and Gynecologists, the Wisconsin Academy of Family Physicians and the Wisconsin chapter of the American Academy of Pediatrics disagree. But Walker was holding the pen Monday morning.