First do no harm: Don’t repeal parental notification

On a Saturday evening several years ago, I was finishing up a day on call in the emergency room for obstetrical patients at a hospital in Chicago’s western suburbs. As my wife was in labor with our son at the time, I wrapped up my work for the evening. But just prior to my planned departure from the hospital, I received a call and told I was needed immediately, a young girl was in critical condition.

As an ob/gyn for more than two decades, I have had the privilege of caring for hundreds of pregnant women. My father was also an ob/gyn. Growing up in Des Moines, Iowa, my dad delivered the majority of babies in Des Moines. He was an amazing father and popular obstetrician. Growing up, my mother and we kids didn’t mind that he was sometimes called out at all hours of the day and night to help moms deliver their babies. To us, my dad was a superhero. If you work in the field of obstetrics, calls at inconvenient times of day or night – even when your wife is delivering your own child – are just part of the job description.

My dad’s example taught me that obstetricians are responsible for both lives involved in a pregnancy – and that a doctor’s duty to his or her patients extends beyond the time of any procedure or appointment.

That night at the ER, I had not been there long before I was called in to assist with a very sick patient: a 14-year-old girl with sepsis, a life-threatening condition caused by an infection which enters the bloodstream. She had arrived with running a fever, with a high heart rate and severe abdominal pain. After examining her and speaking with her mother who drove her to the hospital, an ultrasound discovered the likely cause: the remains of a 16-week-old dead fetus were in her uterus.

The girl told me she’d gone for a second-trimester abortion several days earlier. The doctor who performed the procedure had failed to remove all of the parts of the unborn child’s body, a not unheard-of complication. I explained to the girl I would need to perform surgery immediately, as her condition was worsening.

The hospital where I am on staff does not offer elective abortions; I have never performed or referred for one. I began to scrub for surgery. While in the operating room, the anesthesiologist began sedation and the OR nurse brought me over a pan and the surgical instruments I would need. I started pulling out small pieces of a little human body, first an arm, and then, a leg. I heard sniffling and looked up. The OR nurse was crying. Seeing her, the anesthesiologist also began to cry. It was all I could do to maintain my own composure until we had finished the procedure.

Angry that my patient had come to the hospital in such a condition, I called the abortion clinic where she had had her procedure and left a message for the doctor, explaining I had an emergency with one of his patients. After waiting an hour, while the girl was in recovery, I called again. And then again. Neither the clinic staff nor the doctor ever returned my calls. The patient had been completely abandoned, leaving me to guess at details that might have assisted me in her diagnosis and treatment.

As the Illinois General Assembly contemplates repealing our Parental Notification of Abortion Act, my emergency room experience with the 14-year-old came to mind. The law requires that an abortion clinic notify the parents, grandparents, or guardian of a minor girl prior to performing an abortion. The law does not require consent, just a letter or phone call from the abortion provider giving notice. It’s about as low a bar as exists in elective surgery for minors.

Complications following abortion can and do happen. If that 14-year old’s mother was not even aware that her daughter had recently had an abortion, how could she have properly monitored her? My patient was lucky – she was brought to the emergency room before her infection led to organ shutdown or death. But what about girls whose guardians think they might just have the flu? Rarely do teenage girls come to the emergency room for a fever or abdominal pain.

The Illinois Parental Notification Act is a necessary protection for minor girls. Keeping the Parental Notice requirement intact in no way affects the ability of a woman in Illinois — of any age — to obtain an abortion, at any point in her pregnancy. To repeal the current law would be reckless and irresponsible. Illinois lawmakers need to understand they will be putting young girls at risk and driving a wedge between parents and children at a time when they may need them the most.

A maxim of medical care is that doctors should, “first, do no harm.” That maxim should also apply to the General Assembly.

Robert Lawler, MD, FACOG is a board-certified obstetrician and gynecologist who practices in the Chicago area. A graduate of Creighton University Medical School, he was formerly Chief Resident at Chicago’s Mercy Hospital.

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