Having an abortion is a momentous decision. And a growing number of states are expressing concern for women who are contemplating that choice.
Last month, Virginia — obviously in the interest of making abortion as safe as possible — required abortion clinics to be regulated like hospitals, even though that might put most of the state's clinics out of business. Meanwhile, Kansas — to ensure that women have full information — enhanced its abortion-counseling requirements to include warnings about even disproven risks of abortion, such as breast cancer. Elsewhere, protections have come in the form of extended waiting periods, mandatory interviews seeking evidence of coercion, and laws requiring women to have an ultrasound, and in some cases view or hear a description of the imagery, before they can have an abortion.
But while states give such solicitous attention to women planning to have an abortion, they ignore the needs of women planning to give birth. Bringing a child into the world is also a life-changing decision. Too many women have to make that choice without similar protections. It is time to demand equality and tell our legislatures to enact the Defense of Motherhood Act.
DOMA would extend existing protections, with small modifications as necessary.
In the interest of safety, DOMA would insist that all prenatal care be provided by licensed physicians (not nurses or midwives) in medical offices fully equipped to handle obstetric emergencies — even if that means having to wait longer for appointments, pay more or drive for hours.
To ensure that the decision to go through with a pregnancy is fully considered, there would be a 72-hour waiting period between the time a pregnant woman first sees a doctor and the time she can get prenatal care.
Physicians would have to inform pregnant women about the risks of childbirth and motherhood. They would have to note that childbirth, compared with abortion, is roughly 14 times more likely to result in maternal death and is more often associated with depression and other forms of mental illness. They would also have to emphasize that working women in the United States can expect to see their wages drop 9 percent to 16 percent for each child and that having a child makes it significantly less likely that an unmarried woman will ever marry.
To ensure that women are not being coerced by partners, family members or clergy into bearing a child, DOMA would require that all women be interviewed about the circumstances of conception and their motives for continuing with pregnancy. Did a husband sabotage birth control? Was a woman unable to afford contraception because her employer refused to comply with the Affordable Care Act?
And, finally, pregnant women would be required to view a two-hour video featuring a colicky newborn, a toddler having a tantrum, and a sulking teenager.
In addition to the provisions above, DOMA would remember the special needs of pregnant teenagers. Since a child's decision to have a baby represents a significant turning point in a young life, lawmakers across the country have required that parents give consent or be notified before a pregnant teen can receive an abortion.
It is hard to understand why similar protections have not been afforded to girls who plan to give birth. After all, only about half of teen moms finish high school, and they may well rely on their parents to raise and support their babies. Therefore, under DOMA, prenatal care for a minor would not be available without at least one parent signing a statement acknowledging the limited life prospects and economic opportunities for teen mothers.
All this and more has long been guaranteed to their sisters who are ending their pregnancies in abortion. It's a matter of simple fairness that we treat mothers-to-be just as lovingly.
R. Alta Charo is the Warren P. Knowles professor of law and bioethics at the University of Wisconsin law and medical schools. This column first appeared in The Washington Post.
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