By Dr. Katrina Mitchell
“The pills were malarone, not misoprostol.” My obstetrician colleague in Tanzania, East Africa, made a chilling discovery about the drugs I had purchased from a local pharmacy to terminate a patient’s pregnancy. Malarone is a powerful anti-malarial agent that could have killed someone in the amount prescribed for misoprostol, one of the drugs used in medical abortions.
During the four years I worked as a surgeon in Tanzania – where abortion is only legal to save a mother’s life – treating patients safely was a challenge. As was my experience with a pharmacy dispensing incorrect medications, the barriers to care were often nuanced and dangerous to navigate.
In the weeks following the SCOTUS decision to overturn Roe v. Wade, I struggled to process his impact on my professional and personal life. Having lived abroad in several countries where violence against women is prevalent, it is devastating to consider that the protection within our US borders is falling apart. But we cannot tolerate this – it is not acceptable for us, nor for our future generations. I want my son to grow up in a world where a woman’s life is as valuable as his. I want him to understand that dignity, bodily autonomy and access to health care are basic human rights. I want it to reflect the sacred doctor-patient relationship and to respect my ability to protect those who entrust their lives to me.
I support the American College of Surgeons, the American Medical Association, the American College of Obstetrics and Gynecology, the American Academy of Pediatrics and all other organizations that have spoken out against this attack on medical practice and patient safety. patients. Just as SCOTUS does not have the power to compel vasectomy or vaccination, it should not play a role in forcing a woman to accept the physical and mental health risks of pregnancy and childbirth. Making abortion illegal doesn’t stop abortions – it stops safe abortions. Our country already has the highest maternal mortality rate of any Western country, and we cannot afford to lose more women.
At best, pregnancy and childbirth forever change a woman’s mind and body. At worst, it ends in death. Our leaders ignore – or choose to ignore – these facts. If they could join surgeons in a day’s work, they would have a rude awakening. I would invite them to watch us as we perform an emergency hysterectomy on a woman who is hemorrhaging in labor. Sit with us as we announce to his family that their beloved wife, sister or daughter did not survive. Hear us declare a depressed pregnant woman brain dead from a self-inflicted gunshot wound. See us place breathing and feeding tubes in a patient paralyzed by eclampsia and a hemorrhagic stroke. Smelling the stench of leaking urine and feces from a rectovaginal fistula in a teenage girl victim of incest. Hear our testimony in a child abuse case when a young mother, alone and overwhelmed, shakes her baby to death.
Our cultural idealization of motherhood leads to a complex reality for many women. During pregnancy and the postpartum period, women are at the greatest lifetime risk of developing a mood or anxiety disorder. I have cared for tens of thousands of patients who struggle in a healthcare system and culture that lacks safeguards to protect their physical, emotional and economic well-being. Women who suffer must have access to treatment, because maternal health directly affects fetal and child development. Restricting abortion further reduces women’s ability to overcome the multilevel challenges they already face.
At this time, we must raise our voices louder than ever and demand the expansion of the support we can offer to our communities in need. It’s a crisis. Our state will receive an influx of patients from elsewhere seeking reproductive health services. Planned Parenthood is the only organization in Santa Barbara that offers elective abortions, and that’s not enough. Our medical institutions must accept this call to action and begin to prioritize women’s health – all aspects of it. Change is uncomfortable, but silence is complicity.
Women of all ages, races, ethnicities, gender identities, sexual orientations and socio-economic status deserve locally available comprehensive care for their unique issues at critical times in their reproductive life cycle – from puberty through childbirth. menopause. Beyond abortion services, I propose the creation of a Santa Barbara Women’s Health Task Force, comprised of community leaders, health care providers, and stakeholders.
This working group can identify what we are currently doing well and create a plan to address the gaps, including those that impact underserved and high-risk patient populations. As exemplified in Aftershock, the powerful new documentary exposing America’s black maternal mortality epidemic, birthing centers and midwifery care for low-risk patients is a global standard. Method of delivery is significantly correlated with successful breastfeeding, and I see the effect of high intervention delivery in my lactation practice every day. We need to understand this association and ask ourselves how we can promote health-influencing outcomes for mothers and children. Safe childbirth exists both inside and outside of hospitals, and we need to help patients explore all options based on their individual circumstances.
This task force can facilitate research into the ever-changing physical and mental health needs of women in our county. It can raise funds to help build a facility that uses the latest technology and models standards of care for all facets of women’s health. Patients can receive their Papanicolaou test, mammogram, bone density test, menopause management and women’s surgical services alongside obstetrics, reproductive mental health, breastfeeding and physiotherapy. And this list is just the beginning. Many people across Santa Barbara have the vision, knowledge, and skills to build something great, but the system to support them has to be there. This system must be intentional and proactive, not myopic and reactive.
When I graduated from medical school, I committed myself to a life of service to others. The work ahead requires more dedication than ever, but I am ready. My son is too. Will you join us?
Dr. Katrina Mitchell is a breast surgeon, lactation consultant and perinatal mental health care provider. She is passionate about community education and women’s health advocacy. This article reflects her personal views and does not represent those of organizations with which she is affiliated.