Opinion: My placenta, my choice: Why are NC women being forced to act as life support?
The recent political maneuvering to further restrict abortion access in North Carolina speaks to me of many unfair messages. As a physician who provides reproductive care, one of the most obvious subtexts is that most people really do not understand placentas.
This is not necessarily surprising. I went to medical school with someone who didn’t learn until age 25 that people with vaginas actually have three total holes below the waist, not two. (Ironically, he is now a urologist.) Even many of my most well-meaning and progressive friends refer to their children’s vulvas as vaginas, which is better than “bottom” or “privates” but still inaccurate. Education is scant and unspecific when it comes to sexual health and our own bodies, especially bodies that come with a uterus.
Placentas take a back seat to other content in sexual education, referred to sometimes as the “afterbirth” but might as well be called the “afterthought.” The more time I’ve spent delivering prenatal care, the more frustrating this is. In fact, placentas are exceptional and absolutely the most important factor in the health of a pregnancy.
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A placenta is an extensive, branching ball of blood vessels, which is the source of all nourishment and communication between a uterus and developing baby by way of the umbilical cord. It literally replaces the need for functioning lungs as it shuttles oxygen to and from the parent’s circulation. You know the “ECMO” (extracorporeal membrane oxygenation) life support we all got familiar with thanks to COVID? That is exactly what a placenta does. Also, all those IV lines people get hooked up to for fluids and nutrients in the intensive care unit? That is also what a placenta does, facilitating the baby’s development in utero.
In order to accommodate these life-building functions, the placenta demands the birthing person accommodate a huge increase in blood volume, that their body becomes more resistant to insulin, and the immune system becomes less vigilant, among other physiologic changes. In other words, when a person becomes pregnant, they become life support for a developing human. That is, in technical terms, a big freaking deal.
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Not to mention that this impressive but imperfect organ sometimes stops working properly before 40 weeks. There’s no nine month warranty on a placenta; rather, when it starts having trouble shunting blood, it sends body-wide SOS signals. These signals, which manifest as pre-eclampsia and related disorders, jeopardize the health and sometimes the life of the parent, baby, or both.
Under no circumstances can I imagine politicians mandating that a cis man become life support for another human without his explicit consent. More specifically, attach via lines and tubes his body to another person’s body for 40 weeks and demand he change multiple aspects of his habits and finances even if it might save another person’s life. And any mildly empathetic person would easily understand his choice not to take on this responsibility if becoming a human ECMO machine would worsen chronic conditions, limit his life’s aspirations, or of course risk his own life. They would even understand if after eight weeks, 12 weeks, or even more than 20 weeks, he changed his mind because the impact on his life was too great and would trust his carefully thought out decision.
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And yet here we are, with politicians who definitely did not attend medical school with me, attempting to force people to become walking life support machines. This is as illogical as requiring someone to be an organ donor against their will. The argument about when life begins, which will never be settled, is an emotive distraction to what should be the key question in debates about abortion rights: can you be forced to use your body to support another’s?
So I encourage you to learn about placentas. Learn about their functions and their flaws. Look at the photos of a placenta's branching vessels - a tree of life with a shelf life. They are exceptional, indeed, and without exception, someone risked their own well being to grow you and sustain you with one. A placenta is a choice. Now let’s elect politicians who will keep it that way.
Dr. Rachel Hines is a family physician at Lantern Health in Asheville. The perspectives expressed here are not necessarily representative of the diverse opinions of her colleagues. Hines attended medical school and residency at University of North Carolina in Chapel Hill where she first learned to deliver babies and placentas. She has since delivered hundreds of babies including three babies and placentas of her own.
This article originally appeared on Asheville Citizen Times: NC abortion ban forces women to become life support through placentas
