2 + Abortions Worldwide

View Original

"It just wasn’t right—this young woman shouldn’t have died from a botched abortion."

This story is one in the Faithful Providers series published by Lauren Barbato in Conscience Magazine.

Albert G. Thomas, MD OB-GYN & Associate Professor of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Medical Center, New York

I was already performing abortions when I converted to Catholicism. My wife’s family was Catholic—her father almost entered the priesthood—and we wanted to keep the faith and raise the kids Catholic. We got married in a Catholic church in Yonkers. No one at the parish knew I performed abortions. I never felt like I had to keep it secret, though. Catholicism encourages discussion, debate and openness. My father-in-law taught me that.

My family is from Jamaica, and I was born here in New York City. First generation. My parents were Episcopalian, but they weren’t that religious. I served as an altar boy in the Episcopal church, but my parents didn’t attend Mass with me.

Growing up on the Lower East Side, I had terrible asthma as a kid. I was hospitalized a lot, and my parents even sent me to stay with family in Jamaica for six months, hoping the clean air would cure my condition. Not long after I returned, my father, who worked as a customs inspector at Idlewild Airport (now known as JFK), moved us to Westchester County.

Maybe it was my numerous experiences with hospitals and physicians, but I knew early on that I wanted to be a doctor. I’ve always been compelled to take care of others. My father died young from leukemia, so I thought I would be a cancer doctor. That’s usually how it happens; it’s something personal that leads you one way and then another.

As a medical student at Mount Sinai, I made several mission trips to Sierra Leone and Ghana. The first time I traveled to Ghana, I saw a patient who had performed an abortion on herself. This was 1985. The young woman developed clostridium; she had lockjaw. She was dying. There were no medicines or vaccines there to treat her. This was not the way anybody’s life should end.

I already knew that I wanted to work in gynecology and obstetrics, but from that point on, my advocacy for women’s healthcare really solidified. It just wasn’t right—this young woman shouldn’t have died from a botched abortion.

And I could see how much generalists were needed in healthcare. I’ve been given opportunities over the years to specialize in maternal-fetal medicine, but I turned them down. I wanted to do everything for everybody. I wanted to take care of others, just like the selfless physicians who took care of me as a child.

For 20 years, I ran the abortion clinic at Mount Sinai Medical Center in New York City. When I started in 1987, I ran the whole thing myself. There would sometimes be private physicians performing terminations of pregnancies for their own patients, but I did all terminations otherwise.

We provided abortions up until the 24th week. We have considerable abortion access in New York, but we also served other populations. I would frequently see patients who had traveled from areas that didn’t have any providers. Some of these patients traveled 100 miles, maybe more. Back in the 1980s and early 1990s, I had five or six patients each week traveling from Pennsylvania.

While running the Mount Sinai clinic, I treated many Catholic patients—many of whom were burdened spiritually. As a physician, I’m there to provide patient-centered care, not to shine a light on myself. We work in the background. We have our faith, but it’s a private matter; we do what’s best for others. But when it helps to let my patients know that I’m a person of faith, I share my Catholic background with them. I will minister to them right then and there.

A few patients even asked me to bless the baby afterwards. That’s really one of the most honored things I can do for somebody. These particular individuals were really torn about undergoing the procedure, but they either had a medical reason or a very strong social reason for why they needed an abortion. They didn’t need me to be pompous or to judge them. They needed someone who could hold their hand and tell them it was going to be okay.

Maybe if I had grown up Catholic, rather than Episcopal, I would have been more conflicted about abortion. I didn’t grow up thinking abortion was the worst thing; I didn’t believe that it was evil. But who knows? Maybe I still would have thought, “You know, letting women have the choice to terminate a pregnancy is best for everybody.”

I didn’t see any problem with practicing evidence-based medicine and being a Catholic. I like to think that if I were told it is wrong to do certain things in medicine because of some religious objection, I would rise above that and be the person I am now, advocating for everyone to receive the same standard of healthcare.

I don’t call myself an abortion provider; I’m a comprehensive health provider. And as a comprehensive health provider, I serve all patients—those who want to terminate a pregnancy and those who want to continue their pregnancies. My job is not to convince patients to have a termination. My job is to help them make a decision that’s well informed. I think that’s what God would want us to do—to practice the best medicine. Not to consider ourselves in terms of what’s best for our patients, but to consider what our patients’ needs are. If I’m so concerned about my own salvation, then how can I help others?

I always say to patients, regardless of whether it’s for a termination of pregnancy or a hysterectomy: “How are you going to feel about this later? Are you going to hate your decision a year from now?” There will be patients who feel better. Patients will tell me, “I came to you because I was told this was something I should consider, and you’ve convinced me that this is a decision I’m making based on information that’s current and updated.” And some patients are going to say, “I’m not going to do this, but I needed to hear this from you, because I needed to know this information.”

By not having doctors who provide everything from contraception to terminations to deliveries and hysterectomies, the American healthcare system is putting women at risk. We have patients who have healthcare paid for by a company, but they don’t have any providers in the area. This delays them from getting prenatal or abortion care.

A lot of things can happen in just a few weeks to someone who wants to keep their baby. And if a woman wants an abortion but can’t get one in the first trimester, either because there are no providers in her area or because her doctor refuses to provide abortion, then she’s forced to carry the pregnancy to term or have a second-trimester abortion, which is more costly and carries more health risks. (Article continues below image.)

I always say to patients, regardless of whether it’s for a termination of pregnancy or a hysterectomy: “How are you going to feel about this later? Are you going to hate your decision a year from now?” There will be patients who feel better. Patients will tell me, “I came to you because I was told this was something I should consider, and you’ve convinced me that this is a decision I’m making based on information that’s current and updated.” And some patients are going to say, “I’m not going to do this, but I needed to hear this from you, because I needed to know this information.”

By not having doctors who provide everything from contraception to terminations to deliveries and hysterectomies, the American healthcare system is putting women at risk. We have patients who have healthcare paid for by a company, but they don’t have any providers in the area. This delays them from getting prenatal or abortion care.

A lot of things can happen in just a few weeks to someone who wants to keep their baby. And if a woman wants an abortion but can’t get one in the first trimester, either because there are no providers in her area or because her doctor refuses to provide abortion, then she’s forced to carry the pregnancy to term or have a second-trimester abortion, which is more costly and carries more health risks. (Article continues below image.)

The Catholic church understands how important it is to have universal healthcare for everybody. But when you pick and choose what counts as healthcare and what doesn’t, you get inconsistencies and poor outcomes.

Anything that prevents mortality is healthcare. Birth control pills prevent cancer, specifically, ovarian cancer and endometrial cancer, so they can be used off-label for these diseases. Unintended pregnancies have a higher morbidity and mortality rate, but long-acting reversible contraception, which is being used in countries that are stalwarts in universal healthcare, has significantly decreased maternal mortality. A lot of people think carrying a pregnancy to term is all fun and games, but it’s not.

Just a few days ago, I had a patient suffer a postpartum hemorrhage after I delivered her fifth baby. We had to perform a hysterectomy. She had one foot in the grave. What if she’d had a tubal ligation after her fourth pregnancy, or better access to contraception? She wouldn’t have been in this near-death situation in which she needed three units of blood and a hysterectomy.

We really are trying to save lives. We’re not glossing over women. We’re saying, “No, you have to be able to give free birth control pills because they’re life-saving.” We’re not saying that because we are anti-religion. We are people of faith. We’re truly prolife. We’re pro-women’s life. We’re pro-children’s life. You can’t take that moniker away from us.