Thread by @AmyAddante

Lots of responses and inquiries about my tweet on Monday so let's review what #MOLeg requires vs what is medically necessary. I will preface this by saying I am not a lawyer. I am simply an OBGYN trying to reconcile what science teaches me and what #MOLeg requires.

I refute these requirements with information from @theNASEM report on the Safety and Quality of abortion (nap.edu/catalog/24950/…). I’ll refer to this as NASEM for this tweet.

1. So let’s start with the “licensed abortion facility” requirement.
NASEM: “When states regulate specific office-based health care procedures, the requirements are usually triggered by the level of sedation that the facility offers. Abortion services are an exception.”

2. MOLeg on Mifepristone administration: “the drug shall be administered in the same room and in the physical presence of the physician”
NASEM: “The committee could not find evidence on how this restriction impacts the safety or quality of abortions”

3. MOLeg: Physicians must provide mandated counseling including discussing the “harm to subsequent pregnancies or the ability to carry a subsequent child to term, and possible adverse psychological effects associated with the abortion”

NASEM:
- “There is no association between abortion and secondary infertility”
- “Having an abortion does not increase a woman’s risk of these mental health disorders”

- “Legally requiring providers to inform women about risks that are not supported and are even invalidated by scientific research violates the accepted standards of informed consent”

4. MoLEG: “Except in the case of medical emergency, no person shall perform or induce an abortion unless at least seventy-two hours prior thereto the physician… has conferred with the patient and discussed with her the indicators and contraindicators"

NASEM:
- “Mandatory waiting periods that require a woman to make multiple trips to the abortion facility, impact the timeliness of obtaining abortion care”
- “Delays put the patient at greater risk of an adverse event”

5. MOLeg requires abortion providers to have admitting privileges at a “hospital... located within thirty miles of the location where the abortion is performed or induced and at which the physician performing or inducing the abortion has clinical privileges”

NASEM: “The committee found no evidence indicating that clinicians that perform abortions require hospital privileges to ensure a safe outcome for the patient”

6. MOLeg: “The physician who is to perform or induce the abortion shall provide the woman with the opportunity to view… an active ultrasound of the unborn child and hear the heartbeat of the unborn child if the heartbeat is audible”

NASEM: “Ultrasound is not required, however, and there is no direct evidence that it improves the safety or effectiveness of the abortion”

7. MOLeg: “Prior to an abortion being performed or induced on an unborn child of 22 weeks gestational age or older, the physician... [must provide] printed materials... that offer information on the possibility of the abortion causing pain to the unborn child”

ACOG: “Rigorous scientific studies have found that the connections necessary to transmit signals from peripheral sensory nerves to the brain, as well as the brain structures necessary to process those signals, do not develop until at least 24 weeks of gestation”

8. MOLeg: “All information shall be presented in an objective, unbiased manner designed to convey only accurate scientific and medical information.”
I think it is safe to say we clearly aren’t doing that.

So in summary - none of these regulations improve the safety or quality of care for patients seeking abortion in Missouri so please stop using this argument to defend laws that are based on morals and ideologies. Science disagrees with you. End rant.

@DrJenGunter @staceynewman @sarahfelts @drjessigold @alidreith

@SarahUnsicker