New Orleans health director fears state’s abortion bans will hurt patients, discourage doctors

Published: Jul. 11, 2022 at 6:37 PM CDT
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NEW ORLEANS (WVUE) - New Orleans Health Department chief Dr. Jennifer Avegno said Louisiana’s anti-abortion trigger laws will hurt patient care and worsen the doctor shortage in the state. And, Avegno thinks the state legislature could make the situation better.

Physicians said the bans on most abortions impact more than just that procedure. They said the bans are jeopardizing other health care, and that women will suffer as a result.

“There’s a lot of physicians out there who have worked very hard to not get to this point,” Avegno said. “And, I have to say, we’re incredibly disheartened and frustrated at what we’ve seen.”

The three trigger bans took effect immediately after the U.S. Supreme Court on June 24 overturned the landmark 1973 Roe v. Wade decision, which gave women federal abortion rights.

“With the trigger bans now in place, that makes it even more difficult, more confusing to not only our patients but also our doctors, who now face criminal time if they do something trying to care for a woman that gets interpreted as being illegal,” Avegno said. “All of that is going to lead to delays in care, which is only going to make things worse for our patients.”

Louisiana law includes the possibility of jail time for physicians who violate abortion prohibitions.

“Whether you’re an OBGYN, whether you’re an emergency physician, whether you’re a high-risk specialist, we see complications of pregnancies all the time,” Avegno said. “And we have pretty tried-and-true, safe ways to manage those that allow us to preserve health and put that patient’s life first.

“What’s happening now is that we’re being asked to second-guess so much of that, and that is a horrendous position to put a physician in.”

In Baton Rouge, there were new court filings this week related to a lawsuit challenging the bans. The suit originally was filed in New Orleans, but a judge last Friday decided it should be heard in the state capital. Judge Ethel Julien also refused to extend a temporary restraining order blocking the bans.

Louisiana Attorney General Jeff Landry was asked about doctors’ concerns as he talked to reporters on Friday.

“Those doctors can become plaintiffs if they so choose, and they can go to Baton Rouge, and we can debate this issue in the courts,” he said.

On June 29, Landry sent a letter to the Louisiana State Medical Society, in which he issued the opinion that the temporary restraining order then in place “does not – and cannot – immunize medical providers from liability from criminal conduct.”

“We have spoken to both the medical society and the medical board,” Landry told reporters. “We’re trying to work through particular issues that doctors have to try to clarify the concerns that they have.”

Avegno said maternal outcomes in the state already are sub-optimal, especially for Black women.

“Louisiana is a state that consistently ranks at the bottom for its maternal mortality and morbidity rates, in a country that ranks at the bottom compared to other developed countries,” she said. “So, we already do not have a system in place that really supports robust women’s health, particularly for our Black women who are at even higher rates of bad things happening during pregnancy.”

She believes the abortion laws will cause doctors to ask themselves if they want to practice in Louisiana when there is a chance they could be jailed for making what they believe is the best decision about their patients’ care.

“Any delay in care makes outcomes worse,” Avegno said. “What it also does, for a lot of my physician colleagues, is make them wonder, ‘Do I want to practice medicine in a state where I could go to jail for trying to do what I was taught to do, what I know to be good medical care?’ A lot of them are going to make a decision that they don’t. We already have a physician shortage, particularly an (obstetrician) shortage, in the rural areas of the state especially. So, that affects everyone.”

In an affidavit filed July 5 for the lawsuit, OBGYN Dr. Alexandra W. Band said a patient could not get the drug Cytotec filled at a pharmacy for an IUD procedure, given concerns about Louisiana’s strict anti-abortion laws.

A portion of her affidavit said: “Walgreens called my office. They asked if the prescription was for an abortion. And when the response was, ‘No, it’s prescribed for IUD insertion to make it less painful,’ the response from Walgreens was that it would still not be filling the prescription because they could not be sure we weren’t prescribing this for an abortion, and so they will no longer dispense the drug. For obvious reasons, this is interfering with the best, medically appropriate care I can give to my patients, and interferes with any medical judgment and my patient-doctor relationships.”

Fox 8 reached out to Walgreens for comment, but so far has not heard back from the company.

Avegno was asked if the Louisiana legislature should tweak the controversial laws.

“Absolutely,” she said.

Avegno gave specifics of what she thinks the legislature should address.

“For example, two physicians having to certify a medical futile pregnancy. There is a real burden for women who live in the one-third of our parishes where they don’t even have one OB provider, much less two OB providers,” she said. “The hard jail time for physicians has a chilling effect on their ability to practice and that could be removed. And a lot of the vagueness over medications that are commonly used for miscarriage treatment, that now we’re finding our pharmacies are afraid to dispense.”

Meanwhile, the Biden administration is telling hospitals that they “must” provide abortion services if the life of the mother is at risk. It says federal law on emergency treatment guidelines preempts state laws in jurisdictions that now ban the procedure without any exceptions.

The Department of Health and Human Services on Monday cited the Emergency Medical Treatment and Labor Act, which requires medical facilities to determine whether a person seeking treatment may be in labor or whether they face an emergency health situation - or one that could develop into an emergency - and to provide treatment.

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