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Friday, March 1, 2024

As doctors plead for end to state abortion ban, legislators file bills to protect in vitro fertilization from court rulings like Alabama's

Dr. Virginia Stokes, an obstetrician-gynecologist, said she’s treated many conditions that required abortion to prevent sepsis and preserve patients’ fertility. (Kentucky Lantern photo by Sarah Ladd)
By Sarah Ladd
Kentucky Lantern

In response to a ruling from the Alabama Supreme Court stating that frozen embryos are children, Kentucky state senators from both parties have filed bills aimed at protecting access to in vitro fertilization in Kentucky.

Meanwhile, nearly 300 Kentucky health-care providers and medical students signed a letter asking legislators to restore access to abortion in the state, saying its ban on abortion handicaps their ability to provide comprehensive care.

Republican Sen. Whitney Westerfield of Christian County, a staunch opponent of abortion, filed a bill Wednesday saying that any facility or “procedure related to in vitro fertilization shall not be liable” for damages “to a patient or patient’s surviving spouse or partner resulting from the loss of a human embryo, except in cases of negligence or wanton, willful, malicious or intentional misconduct.”

It also protects health care providers “performing any procedure” related to IVF from criminal charges. The day before, Sen. Cassie Chambers Armstrong, a Louisville Democrat, filed a similar bill. The Alabama Legislature passed similar legislation Thursday.

Alabama, Kentucky and at least eight other states have laws saying human life begins at conception, with the fertilization of an egg by a sperm cell; Kentucky's law speaks of the "unborn human being."

IVF is used to treat infertility, and can help other people trying to get pregnant to do so, according to the Mayo Clinic. About 2 percent of U.S. births are results of the procedure. It sometimes involves freezing embryos for future attempts at insemination; damage to frozen embryos at a fertility clinic prompted the lawsuit that led to the Alabana ruling.

Westerfield’s filing comes as he and his wife are expecting triplets, which he announced in January. He said at that time in a Senate floor speech that they adopted and transferred embryos for the pregnancy. His 6-year-old son is an “embryo adoption” baby, he said.

At a Thursday news conference, Democratic Gov. Andy Beshear said the Alabama ruling “is what happens . . . when you embrace extremism.”

He cited Kentucky’s near-total abortion ban as another example: “Women that have non-viable pregnancies still have to oftentimes carry that pregnancy to term knowing they’re going to hear their child die moments afterwards if it hasn’t already happened.”  

Kentucky bans abortion except in cases of threat to the woman's life or of serious, permanent damage to a life-sustaining organ, under a law triggered by the U.S. Supreme Court's 2022 overturn of Roe v. Wade, the 1973 decision that created a constitutional right to abortion. 

The ban causes “devastating consequences” for patients, Louisville’s Dr. Marjorie Fitzgerald said at the health-care providers' event. “We are losing obstetricians who will not practice in our state,” a nd because of the restrictions, “Doctors are violating their Hippocratic oath to do no harm.”

Fitzgerald was joined in the Capitol Annex by Democratic lawmakers, other medical providers and a second-year medical student in Frankfort to discuss the letter written by the Kentucky Physicians for Reproductive Freedom and signed by 280 providers.

They detailed the complex nature of medical decisions that lead to abortions and slammed lawmakers for restricting their ability to provide that care.

Dr. Nancy Newman, a board-certified obstetrician, said she would not now come to the state because of a “culture of fear that our legislature has created” in which providers have to decide between jail time and what their patients need. “How do you practice medicine in a culture of fear? I don’t think you can.”

Dr. Michelle Elisburg, a Louisville pediatrician, told the story of a 14-year-old patient who was raped by a 60-year-old landlord and got pregnant.

“She had the baby and then dropped out of high school to get a job” to support herself and her child, Elisburg said. “Now both mother and child have multiple risk factors for poor health, educational and vocational outcomes, requiring more financial assistance from the state.”

Elisburg said that as a Jewish physician, she’s governed not only by the Hippocratic oath to do no harm, but also a faith-based oath to act in the best interest of her patients: “As a physician in Kentucky, I am now being forced to make impossible choices that put my professional ethics and my faith in direct conflict with the law.”

Urooj Nasim, who attends the University of Louisville medical school and said she spoke only for herself, said abortion bans may keep her and her classmates from getting the hands-on training they need to become obstetrician-gyneciogists and tackle Kentucky’s high rates of maternal mortality.

“In order to make the best calls for the patients of my future, I need to receive high quality training and all of the tools and procedures available,” Nasim said. “And in a state where physicians live in fear of being prosecuted for delivering standard care, that is just not possible.”

The American College of Obstetricians and Gynecologists says “In states with abortion bans, medical students and residents are not able to receive the hands-on training they need in order to provide patients with comprehensive care.”

Nasim, who was born in St. Louis and lived in Somerset until she was 8, told the Lantern she is “undecided” on her specialty path but was “moved by that patient population” when she worked with an obstetrician previously.

“I’m a very … mission-driven medical student,” she said. “I really want to help patients with a lot of the social factors that affect their health. And OB is a really great specialty to do that in.”

Latest in a line of protests

The Thursday letter is the latest in a long line of efforts to protest Kentucky’s tight abortion bans.

In 2022, Kentucky voters defeated a constitutional amendment that would have keptt courts from finding a right to an abortion in the state constitution.

In late 2023, a Kentucky woman sued for the right to access abortion and end an unwanted pregnancy, but dropped the lawsuit when the fetus lost cardiac activity.

Republicans and Democrats have filed bills seeking to loosen or undo Kentucky’s abortion bans, to no avail.

Several anti-abortion lawmakers have focused their efforts during the 2024 session on making Kentucky a safer place to give birth and codifying support for expectant parents.

This week state Rep. Ken Fleming, R-Louisville, filed a bill seeking rape and incest exceptions to Kentucky’s abortion bans — but only in the fist six weeks of pregnancy

Newman, an obstetrician, said “Most women don’t even know that they’re pregnant by six weeks,”  an in case of assault, “The victim likely may not even tell anyone before six weeks.”

Dr. Virginia Stokes, a board-certified obstetrician-gynecologist, said she’s treated many conditions in her tenure as a physician that required abortion — placenta previa, first and second trimester ectopic pregnancies, preterm rupture of membranes, cancer, sepsis and more.

A lack of early interventions, she said, can cause “total body sepsis and death due to the sepsis. And if death is avoided, there is a frequent loss of fertility due to disruption of the uterus.”

“The fetus will not survive if the mother doesn’t survive,” Stokes said.

In such cases she’s treated, she said, these are “gut wrenching decisions with no choice to be made” involving “very much wanted and cherished pregnancies.”

“There are lots of really bad things that can happen between six and 12 weeks,” Stokes added. “and we need to have permission to take care of those patients.”

“I am pro-life,” Stokes said. “I am for saving the life of these women who have these early pregnancy complications that require, unfortunately, a cessation of the pregnancy …. As an OB-GYN, my first priority is the life of my female patient. Please don’t tie my hands.”

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