Should physicians stay in their lane on abortion?

Now more than ever, it seems that medicine, politics, social justice, and societal mores have become intertwined. There are so many “lanes” that the 405 to the 10 freeway splits seem like country roads in comparison. Perhaps we have social media to thank for this multitude of lanes. Or maybe it’s to blame.

When doctors were publicly berated (on social media, primarily) soon after we became outspoken about the issue of gun violence, by sharing (on social media, of course) countless images and stories of the graphic reality of the results of gun violence, we were told to “stay in our lane.” It became so widely stated that it rose to the prominence of a hashtag. When it becomes a “meme,” the true status of the term will be even more validated.

When doctors were — and continue to be — threatened publicly (on social media, of course) by the anti-vax community, the physician community proverbially insisted that the non-physician community, including some politicians advocating for the views of anti-vaxxers, stay in their lane. The latest in the long list of celebrity anti-vaccination voices is Jessica Biel, but she is by far not the first, nor the last, to gather a quick line of support, as well as opposition. Most in medicine and healthcare strongly suggest that she butt out. Vaccine-preventable illnesses such as measles, pertussis, and tetanus are rearing their ugly heads, in large part due to gaps in community-wide compliance with vaccination recommendations. The United States has reached over 1,000 cases of measles this year, a staggeringly high number not seen in many decades. We can thank non-physicians and some very misguided actual physicians from jumping out of their lanes to make recommendations based on pseudoscience, which doesn’t deserve a lane at all.

We are now in the throes of a nationwide abortion battle: between physicians, lawmakers, politicians, non-profit organizations and celebrities. There are many lanes. Graphic images and stories are circulating that a fetus is brutally maimed and murdered, feeling every surgical instrument throughout the process. More recent, extremely inaccurate, images of “post-birth” abortions (a political term, not a medical one) are spreading. These show a fetus being delivered feet first, followed by a sharp instrument entering the base of the skull to both cause its demise and decompress the skull, in order to enable the head to be delivered without injury the cervix. This type of image is what many think of when abortion is discussed. This is not typical, nor is it an accurate depiction.

Regardless of one’s views, abortions are a reality. The CDC estimates that just under 700,000 abortions are performed annually in the United States. Almost two-thirds of these are performed at less than eight weeks gestation (equivalent to being three or four weeks late for a missed period), and many are performed at less than six weeks gestation (barely missing a period, in menstrual cycle terms). Over 90 percent are performed in the first trimester, or before 13 weeks gestation. Does this make it less graphic, picturing a tiny cluster of cells smaller than a tadpole as opposed to one that looks like a baby? The answer is, it should be none of your business. It should be the business of the pregnant woman and her physician. But it is your business. It’s now everybody’s business. Cue the celebrities.

I’ll be the first to voice disdain about celebrity involvement with medical issues, health care, and the term that’s become a multi-trillion (yes, trillion) dollar industry — “wellness.” I’ve written articles, a book, spoken on television, radio, podcasts and in public about how celebrities need to stay out of the health care lane. When it comes to health and medicine, they should stay in their lane: on the red carpet.

But when celebrities began sharing their abortion stories, with the hashtag #youknowme, perhaps they were using their stardom for good. States which are banning abortion (with a #stoptheban hashtag in response) endorse that even under circumstances of rape, abortion should be banned. Busy Phillips testified about abortion rights before Congress and spoke about her own experience with abortion on her show. Celebrities, including Amber Tamblyn, Cynthia Nixon, and Jameela Jamil, just to name a few, added their names and stories to the #youknowme campaign.

By hearing that there are countless reasons for abortion, and reading and hearing these anecdotes and public testimonies from successful stars, it has added a positive spin on the controversial issue. While it is none of my business (or yours) why this actress or that CEO, attorney, physician, mother of four or college student had their abortion, putting faces, especially celebrity faces, to this conglomerate of intersecting “lanes” is a good thing.

We should welcome their getting into our medical lane for this one. Just as the #MeToo movement spread awareness and removed the shame in having been sexually abused, putting some big-screen faces into the abortion discussion can only help de-stigmatize this real component of women’s health care.

Nina Shapiro is a pediatric otolaryngologist and a professor, department of head and neck surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA.  She is the author of Hype: A Doctor’s Guide to Medical Myths, Exaggerated Claims, and Bad Advice – How to Tell What’s Real and What’s Not and can be reached on her self-titled site, Dr. Nina Shapiro, and can be reached on Twitter @drninashapiro

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