Abortion rights panel: State 'hostile' to women, doctors

The panelists, including a physician, state senator and lawyer, painted a bleak picture: a growing healthcare desert statewide as doctors who treat women and refuse to risk prosecution leave the state or their practices; delays in treating women with complicated pregnancies that can lead to infertility or death; an estimated 11% increase in the number of babies born in the state, including unwanted children who could lack basic needs and have to endure domestic violence; a soaring maternal death rate, especially among women of color and those living in poverty; and a growing demand for permanent sterilization operations by young men and women now that abortion as a medical safety net is not a legal option in Tennessee and 12 other states.

The sponsors of the virtual panel discussion on “The Impact of Overturning Roe v. Wade on the People of Tennessee” were the League of Women Voters of Oak Ridge, the American Association of University Women of Oak Ridge, the Tennessee Health Care Campaign and Women’s Interfaith Dialogue of Oak Ridge.

The moderator of the panel was Carole Myers, professor of nursing at the University of Tennessee at Knoxville and co-host of “Health Connections” on WUOT-FM radio. The panelists included Corrinne Rovetti, a family nurse practitioner who worked at the now-closed Knoxville Center for Reproductive Health; state Sen. London Lamar of Shelby County, whose platform includes providing women of color with reproductive health services to prevent maternal mortality and morbidity; Nikki Zite, a physician and professor and vice chair of education and advocacy at the UT Medical Center, and Chloe Akers, a criminal defense attorney and founder and board chair of Standing Together Tennessee, which was established in response to Tennessee’s trigger ban on abortion.

Tennessee has moved from having one of America’s most liberal constitutions “that honored and upheld the right to freedom of choice to one of the most hostile states in this country” with respect to abortion rights, Rovetti said. In her review of the state’s constitutional history, she noted that in 2014 when the Republicans took charge of the governorship and both chambers of the Tennessee General Assembly, Amendment 1 was approved by voters in a referendum. Its first sentence: “Nothing in this constitution secures or protects a right to abortion or requires the funding of an abortion.”

In 2019, the Republican-controlled state legislature passed the Human Life Protection Act, also called the trigger ban. “It stated clearly that if Roe v. Wade was overturned by the Supreme Court (as happened on June 24), abortion will become illegal in Tennessee,” Rovetti said. “So, the trigger law passed with no exceptions for rape, incest and sexual abuse, and the law criminalizes providers of abortion as felons and provides an affirmative defense in court for providers who do perform abortions to save the life of the pregnant person.”

Calling the Tennessee General Assembly “an extreme body” of legislators, Rovetti said a handful of legislators are trying “to make the voices” of abortion rights proponents heard. One of those legislators is Lamar, a Democrat from Memphis and a panelist, who said she has told her pro-life legislative colleagues that “Tennessee is not doing a good job of taking care of the children we already have.” Noting that Tennessee ranks ninth in the country in maternal deaths related to or associated with pregnancy, she said, “We are expecting maternal mortality to increase in proportion to the anticipated 11% increase in births in the state.”

As the youngest legislator in the state’s House of Representatives, she lost her son and almost died herself as a result of undiagnosed pre-eclampsia during her pregnancy. Pre-eclampsia, similar to a stroke, can damage a woman’s organs, including her brain.

The senator, who previously worked in reproductive justice for women of color and women in poverty, said Memphis has the highest ratio of pregnancy-associated deaths among women, with 135.4 deaths per 100,000 live births. She added that “89% of these pregnancy-related deaths were deemed preventable.”

The leading underlying causes of pregnancy-related deaths in Tennessee from 2017 through 2020 were cardiovascular disease, hemorrhage and mental health conditions (caused largely by postpartum depression, domestic violence and acute overdoses).

In Tennessee’s 2022 Maternal Mortality Report, it was revealed that one-third of women dying from pregnancy-related causes lost their lives during the postpartum period ranging from 43 to 365 days after the baby was born. The senator noted that Gov. Bill Lee recently expanded healthcare coverage of women for up to a year after they have given birth.

Lamar has introduced numerous bills, some which have been enacted into laws. Stating that 17 rural hospitals have closed in Tennessee since 2012, she said, “People in rural Tennessee cannot access a doctor within a decent distance to get the healthcare they need. So, I have been advocating for certified doulas in rural areas because they are trained to assist in the birthing process.”

Zite, who applauded the numerous healthcare organizations that have opposed legislative interference in safe and essential abortion healthcare for women, noted that the 1973 Roe v. Wade decision addressed the public health crisis in which women were dying from unsafe, self-induced abortions. In addition, she said, the Supreme Court “balanced the right to abortion with the right to protect prenatal life," yet in the past 50 years, the states have enacted 1,336 abortion restrictions.

She cited a number of studies that contradict anti-abortionists' claims. For example, the number of abortions performed has declined over 50 years because of the increased availability and use of birth control measures, not because of restrictions; as a result, the U.S. birth rate has fallen.

She said evidence shows that abortions do not increase the risk of future infertility, pre-term birth, hypertensive disorders or breast cancer, as pro-life advocates claim. A 2018 report by the National Academies of Science, Engineering and Medicine indicates that abortion is safer than childbirth by eight times.

“Abortion is also safer than a colonoscopy, a dental procedure, plastic surgery or a tonsillectomy,” she added.

“The Turnaway Study” by Diane Greene Foster found that “women who were denied abortions that they wanted were more likely to have serious complications, including eclampsia and death, stay with abusive partners, suffer anxiety, endure chronic pain and loss of self-esteem, and be unable to make plans for their future life,” the doctor said. In addition, she noted, “they were five times more likely to not be able to pay for their children’s basic needs.”

Zite said physicians are concerned that the use of IUDs and emergency contraceptives like Plan B will be criminalized.

“We have seen a huge increase in demand for permanent contraception options, both female and male,” she added. “There is a social media Reddit list of healthcare providers who will perform permanent sterilizations for women who have no children or very young children.”

Zite noted that Tennessee’s abortion ban causes her “moral distress” because it “threatens a doctor’s ability to provide abortion care for ectopic pregnancies, miscarriages or conditions in which a pregnant patient’s health and safety are endangered.”

She said Tennessee women now must try to carry to term, at risk to their own health, fetuses that doctors say will die from their inability to develop a skull, brain, heart or kidney. She advises pregnant women who have life-threatening cancer to go out of state for an abortion and life-saving chemotherapy.

“These tragic cases we would have been able to treat legally before June 24 without being worried about committing a felony,” she said. “I am worried that we are going to have trouble recruiting and keeping physicians because they are becoming terrified of being criminalized in our state for providing lifesaving care.”

Akers, an attorney, said the Alabama abortion ban is more liberal than Tennessee’s law in that the Alabama law does not apply “in the case of a medical emergency – a situation that prevents a serious health risk to the mother.”

She represents “a handful of Tennessee doctors. One doctor, who she described as an incredible, smart and compassionate physician from Chattanooga, has left Tennessee and taken a job in Colorado.

“She treated the worst cases of fetal anomaly (life-threatening abnormalities in the unborn child) in women that required termination of the pregnancy to save the mother’s life. Another client of mine is leaving critical medical practice to do research.

“If you think these doctors are going to stay here and risk prosecution, you are out of your mind. And we already have a health care desert in rural areas of the state," she said.

This article originally appeared on Oakridger: Abortion rights panel: State 'hostile' to women, doctors