Reading through the transcripts of the oral arguments heard by the Supreme Court in Gonzales v. Carhart and Gonzales v. Planned Parenthood on Wednesday, I couldn't shake the sneaking sensation of absurdity. Who knew Justice Kennedy was so knowledgeable about preeclampsia? As Scott rightfully points out, Wednesday's discourse left me wishing that the U.S. government were as intent on drawing a "bright line" between medical expertise and ideology-fueled congressional "findings" as it is on the one between abortion and infanticide.
Meanwhile, here in Nicaragua, where the National Assembly voted to ban therapeutic abortion (abortion to save a woman's life) on October 26, we're beginning to see what happens when politicians play doctor. Nicaraguan lame duck president Enrique Bolaños has yet to approve the ban on therapeutic abortion, but the medical community has already begun to panic – and, I'm sorry to report, women have already begun to die.
On the evening of October 31st, Yasmina Bojorge, 19 years old and 19 weeks pregnant, was admitted to Hospital Velez Pais in Managua with a high fever and painful uterine contractions. Her symptoms suggested that she was in the midst of a dangerous miscarriage, but the Ultrasound machine in Velez Pais was out of order, and given the pending abortion law's strict penalties for doctors, the medical team was too nervous to treat Yasmina without first confirming the status of her 19-week-old fetus. So, instead of providing her with emergency care, they sent her to Hospital Roberto Calderón on the morning of November 1st, where it was established that the fetus was still viable, though Yasmina's life was at risk. Yasmina was transferred to the high-risk obstetric unit, where her contractions persisted. Her family pleaded with the doctors to operate in order to save her life, but the doctors refused to treat her until it had been confirmed, 15 hours later, that her fetus was dead. At that point, the doctors attempted to induce a normal vaginal delivery, but Yasmina had already gone into shock. At 8am on the morning of November 2nd, she was transferred to the intensive care unit of Hospital Bertha Calderón, where the doctors finally decided to operate, attempting a last-minute removal of her uterus, which had by that point filled with blood.
Yasmina died of internal hemorrhaging on the operating table, 39 hours after she had first sought emergency medical care. Her fetus had been dead for hours. Her 2-year-old son is now an orphan. Meanwhile, another young Nicaraguan woman with a high-risk pregnancy is currently lying in a hospital in Masaya, denied urgent treatment by another group of doctors who are too afraid of breaking the law to do their jobs. These are not isolated cases: Mercedes Calderon, head of the Integrated Adolescent Care Program, reports that roughly 10 percent of all pregnancies in Nicaragua are high-risk, usually occurring among women who are under 14 or over 40.
It's hard to imagine a scenario where doctors would stand by and watch a living, breathing, suffering woman die – after all, we trust that when called upon, doctors will do everything in their power to save our lives. But what if the law prevents them from doing so? Fear has already settled over the medical community in Nicaragua and the therapeutic abortion ban has yet to be signed into law. Back in the United States, the proposed abortion ban on which the Court will likely rule this July does include an exception in cases of life-threatening pregnancy, but it fails to include any real discussion of women's personhood. And when you take women out of the equation like that, they start to become invisible: even if they're lying right in front of you.