Thread by @Bec_Shrader

I just read through the entire bill. I have many thoughts. For now, I’m walking in to my high risk OB NC clinic knowing my career will entirely change after this is passed.

Follow the thread below as I add my concerns and surprises after reading this bill 🧵

https://twitter.com/cakitchener/status/1653725624794529794

The TL;DR version is:

•12 weeks abortion legal for any reason
•Abortion legal up to 20 wks for rape/incest
•Abortion legal up to 24 weeks for “life limiting diagnoses”
•Abortion legal at any stage for mother’s life.

We should know by now it’s not that simple.

I work in high risk OB. We do not perform abortions, but we do refer. There are ab clinics around that have to stay hidden so their patients aren’t attacked nor bombarded with protestors. This is not an “abortion tolerant” state, yet NC has become a southern “sanctuary city”.

Many people come from southern states that have total abortion bans (6 weeks) to find care here. That will be no longer.

My main takeaway is that NC healthcare is struggling with staffing and funding. This bill helps with one, but hurts the other.

3.5M in funding to HHS for each year 23-25 in the form of grants to local health departments nonprofits (crisis pregnancy centers?) that provide contraception. As of right now CPCs do not provide contraception. I’m shocked they actually included reforms to reduce mortality.

My concern with staffing is this. They require a BUNCH of paperwork >12 weeks to be sent to HHS to be processed. There are annual inspections for every clinic by HHS and many requirements with fines for these facilities. OB care and HHS right now is understaffed in NC.

We already have a 72 hour consent here for a surgical abortion (not sure if there’s one for medication). I believe they tried to make it required that only a MD can give a patient miso/mife in person, but it didn’t pass. This bills states the pills have to be given in person.

So that means no telemedicine appointments for abortion pills, no mailing abortion pills, no even advertising for this-there is a $5K fine for doctors/providers that do.

After 12 wks every physician is required to report the measurements of a fetus/US image, methodology, and reason within the law after an abortion. If 1 in 4 women get an abortion in a lifetime-this will be a MOUNTAIN of paperwork for the clinic and HHS. Who has the staff?

Partial birth ab and “infants born alive” (aka after attempted abortion) are mentioned again here. Partial birth abortion is illegal on a national level. Infants born alive are also already protected but this bill add a $250K fine for doctors that “intentionally withhold” care.

Now…on to the exceptions. Rape/incest reasons for abortion are allowed until 20 wks (no documentation necessary to prove rape). That’s a good thing. However, they do require 72 hr counseling, an ultrasound and an offer to hear the heartbeat/look at the screen for every abortion.

Life limiting conditions. This is the piece I was most interested in, as I myself went through this situation twice.

Read about that here: scarymommy.com/crisis-pregnan…

This is the wording for the life limiting anomaly exception. It is left up to the discretion of the physician (aka no list of anomalies). You can have an abortion up to 24 wks (later than current law).

Here are my concerns: they require counseling to include statements on the exceptions to the norm for that anomaly (“some babies have lived up to 1 year, etc), referral for palliative care consultations (not common for hospitals to have this service)…

And a report stating the stats of the woman: age, race (?), how many abortions the woman has had before, etc and documentation the woman has been invited to watch/hear an ultrasound and shown facts abt fetal development. This is all while a very wanted pregnancy dream is dashed.

However, there is explicit language that eugenic abortions (due to race/sex) are not exceptions to the law. This includes Trisomy 21-Down Syndrome. So you cannot abort your pregnancy post 12 weeks if the reason is Down Syndrome.

I want to add this to the thread: there are 350 perinatal palliative care services in the US. 10 in NC. If every patient given a life limiting diagnosis > 12 wks (most ppl if they didn’t have genetic testing) is required to be referred to these services, it will buckle the system

Now to the surprising elements: they actually put language in this bill to reduce maternal and infant mortality. Real, implementable policies with funding that could make change. FINALLY.

🎉🎉

Paid leave for state employees (8 wks full time, 4 part time), expanding access to child care, increased Medicare/Medicaid funding for obstetrics care, kinship foster care monthly stipend, increased foster care family monthly stipend, etc. Good on @NCGOP…seriously.

I truly have to give bare minimum kudos where it is due. Good on @NCGOP that didn’t listen to the extremists in their party that wanted a ban at 6 weeks. It feels more permissive bc other states have asinine bans that will harm women.

#NCAbortionBan #ncpol #smfm #NCGOP #NCDem #AbortionBan

newsobserver.com/news/politics-…

There are colleagues of mine-experts in MFM (specialized OB) that can’t give their expert opinion on this bill. @NCGOP are trying to pass this quickly and without public comment.

@GarlandPierceNC I hear you are one of the Dems that could vote for this ban. Please consider the concerns I have here.

This bill will turn residents away from many of our amazing and wonderful teaching hospitals that provide OB and MFM care. Duke ranks #8 in the nation in OB residency. This bill will affect EVERYONE’S OB care-because who wants to be train somewhere with a strict abortion ban?

This is a comprehensive 10 page summary of the bill that was just sent through health systems of NC.

files.constantcontact.com/14aa1a1c601/be…

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