[*This post has been updated with additional material and to clarify a quote from Dr. John Mission]
There's legislation pending in the Pennsylvania state House and Senate that, if it were ever signed into law, would impose some of the toughest restrictions on a woman's access to abortion of any state in the country.
The House and Senate bills, respectively sponsored by Rep. Kathy Rap and Sen. Michele Brooks, two northwestern Pennsylvania Republicans, would:
- Limit abortions to cases of medical necessity after 20 weeks of pregnancy rather than the current 24-week ceiling.
- Sharply curtail the use of a common, second trimester abortion procedure known as dilation and evacuation, in which the fetus is extracted with tools, their bodies often torn apart in the process.
Brooks' bill cleared the Senate in February, on a 32-18 vote, where opponents garnered just enough votes to sustain an expected gubernatorial veto. It's now in the House where it, and Rapp's proposal, are before the House Health Committee.
Brooks' bill angered physicians, who complained that they hadn't been consulted about the legislation, which sailed through the Senate Judiciary Committee without a public hearing.
On Monday, a group of eight obstetrician/gynecologists from across Pennsylvania, working together, arrived in Harrisburg to urge lawmakers to oppose legislation that would punish them with a third-degree felony for providing a rarely needed, but no less critical, medical service for some women.
"I couldn't not be here," said Dr. Lisa Perriera of Philadelphia. "What this [bill] proposes would impact on what I do every day. We decided we were going [to Harrisburg]. They were going to hear from us."
Only 1,588 of the 31,818 abortions performed in 2015, or less than 5 percent, were done by the dilation and evacuation procedure. But those procedures do represent more than 60 percent of all abortions completed after the fifth month of a pregnancy.
And just 380 abortions, or 1.2 percent, were performed after 20 weeks of pregnancy.
Based on interviews with mothers and experts, they are not undertaken freely. These are parents who are decorating nurseries, buying clothes and picking out names, only to learn, tragically, that the child they're expecting has a medical condition or suffers from an abnormality that would doom it to a short, painful life if the pregnancy were brought to term.
Talk to some of these women - and I have - and the pain is palpable months and years after it happens. It's a trauma that none would have undergone willingly. But they also know it's a deeply private choice that some parents - free of state interferences - may someday have to make.
Three physicians interviewed Monday: Perriera, Dr. Catherine Chappell and Dr. John Mission, both of Pittsburgh, said they found receptive audiences among lawmakers, even as they corrected what they described as misconceptions about their work.
*"We generally counsel people that a fetus begins to be able to survive outside of the womb sometime between 23 and 25 weeks of pregnancy," Mission said. "There were some who thought they could survive a month earlier than that."
The fetus's ability to survive outside the womb, known as "viability" has been a key issue in debates over abortion over the years. And the current Pennsylvania bills are no exception.
In Roe v. Wade, the 1973 U.S. Supreme Court decision that legalized abortion nationwide, the ruling hewed to medical knowledge at the time, declaring that a fetus was viable between the 24th and 28th weeks of pregnancy.
Proponents of the Pennsylvania ban say the court's decision is no longer in keeping with current medical knowledge, and say a fetus can survive much earlier outside the womb.
Right now, 19 states have passed laws that ban abortion at 20 weeks of pregnancy, with laws in effect in 16 of those states.
Seven states have laws similar to the procedural ban proposed in the Brooks bill, according to the Guttmacher Institute, a Washington D.C.-based reproductive health rights organization.
In most of those states, the D&E bans are either still facing court challenges or haven't taken effect yet.
"They put restrictions on our practice after 20 weeks of pregnancy," Chappell said, arguing that the Legislature's intrusion into the doctor/patient relationship was unacceptable.
"This is the craziest piece of legislation I've ever seen," she said, adding later, "the risk of [violation] is a felony charge, which really ups the ante."
What's really, crazy, and Chappell is too reserved to bring it up, is the fact that these very busy doctors had to schlep into Harrisburg to lobby lawmakers against this solution in search of a problem in the first place.
You'd think that they, like lawmakers, would have other, more important things to do with their time.
For the 253 members of the General Assembly, there's the small matter of the state budget to take care of. But, this being Harrisburg, rank-and-filers like Rapp and Brooks are mere bit players until the grown-ups descend from on high with a completed spending plan and tell them how to vote for it.
But they can't do that unless conservatives like Brooks and Rapp are on side. Thus they allow votes on their pet causes, even as those close to the leaders hold their noses, brace against the inevitable embarrassing star turn in the national spotlight, and hope against hope that the GOP-controlled chambers don't actually do something as dumb as actually pass these bills.
Republicans pushed a similar bill in last year's legislative session, only to see it fall short of the goal line. Opponents say the test vote in the Senate, which garnered one more vote than needed to sustain Gov. Tom Wolf's promised veto, was a critical win.
Even still, doctors like the trio I spoke with Monday are sweating the Legislature's vote. And they're warning couples, who might have to make the gut-wrenching decision to end a pregnancy because of some life-ending fetal abnormality, that busybodies in Harrisburg may soon take that option away from them.
Craziest thing she's ever seen?
Chappell's being polite.