Testimony of Rachel Stacey, MD

Physicians for Reproductive Health

Submitted to the Senate Medical Affairs Committee

March 18, 2015

I am an obstetrician/gynecologist and have been living and practicing in Charleston, South Carolina for five years. I trained at the Medical University of South Carolina and completed my residency in 2014. I am a member of Physicians for Reproductive Health, a doctor-led national advocacy organization that uses evidence-based medicine to promote sound reproductive health policies. Our members include physicians of all specialties from across the country, including South Carolina. Physicians unites the medical community and concerned supporters to improve access to comprehensive reproductive health care, including contraception and abortion, especially to meet the health care needs of economically disadvantaged patients. I am writing to urge you to reject House Bill 3114 (H. 3114), the so-called “South Carolina Pain-Capable Unborn Child Protection Act.” This dangerous bill would deny South Carolina women access to safe and legal abortion care by interfering with the doctor-patient relationship. As physicians, our top priority is the health and safety of our patients and we strive to provide high quality care each and every day. If enacted, H. 3114 would ban most abortions at 20 weeks after fertilization, clearly before viability. The bill threatens providers with fines and/or imprisonment for providing professional and compassionate care, and is intended to intimidate and discourage doctors from providing abortion care. This bill places health care providers in a painful and untenable situation — when they are facing a complex, urgent medical situation, they must withhold treatment that would protect the health and safety of their patients in order to comply with this medically dangerous and unjust law. This bill ignores the health complications and real-life situations that women can experience in pregnancy. Every pregnant woman faces her own unique circumstances, challenges, and potential complications. She must be able to make medical decisions based on her doctor’s advice and what’s right for herself and her family. Politicians are not medical experts and should not intrude into the doctor-patient relationship in this way. Further, this bill attempts to dictate care based on inaccurate and unscientific claims. Research shows that contrary to the bills’ claims, a fetus doesn’t have the neurological structures needed to experience pain until significantly later in pregnancy.1 H. 3114 would force a doctor to deny an abortion to a woman who has determined that terminating a pregnancy is the right decision for her, including women carrying a pregnancy with severe or lethal anomalies that may not be diagnosed until after 20 weeks in pregnancy2 and women with serious medical conditions brought on or exacerbated by

1 Rigorous scientific reviews of the evidence on fetal pain in Journal of the American Medical Association (JAMA), Royal College of Obstetricians and Gynecologists, and Journal of Maternal-Fetal and Neonatal Medicine concluded as recently as 2012 that fetal perception of pain is unlikely before the third trimester. 2 These conditions can include anencephaly, renal agenesis, limb-body wall complex, neural tube defects such as encephalocele and severe hydrocephaly, limb-body wall complex, and severe heart defects.

pregnancy.3 H. 3114 contains no exception to preserve the health of the woman. Instead, it includes a vague life endangerment exception that exposes doctors to disciplinary action, limiting their options for care that is often needed in acute and complicated medical situations. Physicians for Reproductive Health, along with other leading medical organizations, strongly oppose bills like H. 3114 because they interfere with providing women the best possible medical care, interfere with the doctor-patient relationship and undermine the thoughtful decisions of women and their families.

As a doctor who takes care of women and their families every day, I know that in order to ensure their health and safety, women need access to the full range of reproductive health care, including abortion. Although most women can expect an uneventful, uncomplicated pregnancy, some situations will arise where a woman needs a safe and timely abortion. Politics and ideology should not enter into her health care decisions or the doctor-patient relationship. I most forcefully urge you to respect my medical experience, my patients, and my medical colleagues throughout South Carolina, and reject H. 3114.

3 Such conditions can include pulmonary hypertension, Marfan’s syndrome, severe valvular heart disease, Eisenmenger's syndrome, cyanotic heart defects, hormonally sensitive cancers, kidney disease, preterm premature rupture of membranes with sepsis, placenta previa, severe preeclampsia, HELLP syndrome, and ovarian hyperstimulation syndrome.