Members of the Senate Judiciary Committee.
I am sending this simplistic summary about the need to repeal the recently passed bill regarding so called 24 week pregnancy terminations now since I am far away and unable to testify. I expect the hearing to be a very emotional one, and the facts I try to explain here are in my view far more important to the citizens you represent now and into the future if you hope to maintain the very high quality Obstetrical and neonatal care we now are able to provide the citizens of NH. In fact if I were putting a title on the bill it would be, "The preservation of NH's outstanding medical Care in Obstetrics and Neonatology". Some told me last year "we had to do something". Why was that since pregnancy terminations in NH any time even close to viability is such a rare occurrence, and to the best of my knowledge only done for medical reasons. Simply stated this bill puts providing this excellent care in grave danger and also will create a situation where women or even infants with difficult medical problems could be forced to get their care in our surrounding states where the needed expertise will then be located. That would be very sad indeed.
1.NH currently has excellent Obstetrical outcomes with the main problem today being drugs in Pregnancy that is being addressed by many at DHMC and others. It is a National problem. We along with VT are best in the US in outcomes for Obstetrics and Neonatal care year after year. This collaborative system has evolved over the past 50 years because of the hard work of many dedicated people in NH and VT.
2. This new law solved no current NH problems.
3. This law creates a severe problem in that it will be very difficult if not impossible to recruit new Maternal Fetal Medicine MDs and Neonatologist MDs when our current small group retire or leave because of the new law.
4. Without these sub specialists it would then be much more difficult to recruit and retain General OB/GYN MDs who already are very difficult to recruit to our smaller hospitals.
5. The Governor lied about how the new law was the same as the laws in MA and NY where there specifically by law are no civil or criminal penalties for these special MDs and other health care providers who use their hard earned knowledge and expertise appropriately.
6. In my view all the women and the men who care about them should be scared that NH Obstetrical care could go from best in the nation to one of the worst without these specially trained physicians.
7. The Ultra sound issue is just an added burden and expense put in by some who thought it would discourage women from having an abortion. Ultrasounds are already done when medically indicated.
8. The concern about the 24 week so called viability is in my view a smoke screen. Viability dating varies from NICU to NICU across the country. The Ultrasounds done around 20 weeks are not very accurate for dating, plus or minus 10-14 days. In the rare case that a difficult, abnormal pregnancy is not detected until around this time of pregnancy we need all the experience of these special MDs to not be influenced by a law written by people with no medical training and a political agenda.These are very difficult and important discussions and decisions that should be made in private by the woman and her family, and they are few in number in NH.
As the former long time Chair of OB/GYN at DHMC and as a person with two adopted children and three adopted grand children I believe I have a balanced view on these issues. If one would never have a pregnancy termination based on their moral or religious beliefs I fully respect that personal choice. However, in a country that is supposed to separate Church and state I believe it is absolutely wrong for laws to be written that force the beliefs of a group of non medical legislators on the entire population. This is especially true in this situation when the law likely will result in very negative health care results for the entire population of NH in future years.
At my age and with my experience in the 60's and early seventies I can tell you that laws like this will not reduce the number of abortions at any stage. The wealthy always found a place to go to get safe procedures and the poor had back ally terminations often resulting in severe illness and some in death leaving young children without a mother. What will reduce abortions as proven in several states is good sex education and affordable access to contraception. This is a difficult pill for some to swallow, but the facts are very clear.
In this current discussion I believe the main concern of our legislature should be the preservation of the best health care for the citizens of NH and the Draconian penalties in the new law are a huge step in the wrong direction.This must be reversed now. SB 399 should be passed.
Barry D. Smith, MD
Barry D Smith, MD Professor Emeritus, Chair Emeritus OB/GYN Dartmouth's Geisel School of Medicine