Oge Young, MD, is past president of NHMS and member of the general council representing New Hampshire obstetricians for 20 years.

Last week the NH House Judiciary Committee listened to testimony regarding HB 224 which would repeal the criminal and civil penalties of the fetal life protection act.

This “24-week ban on abortion” passed as an amendment to HB 2, the state budget. Presently, a physician can be incarcerated for up to seven years and fined up to $100,000 if he or she is found to have terminated (delivered) a pregnancy at 24 weeks or more.

It should be made clear that without this law, there never have been elective abortions of healthy pregnancies at 24 weeks or more in our state. There are three uncommon, but not rare tragic circumstances, where pregnancies are terminated (delivered) at 24 weeks or later.

The first is when a baby dies late in pregnancy. In these cases, women are offered induction of labor rather than carrying the dead baby for weeks while awaiting spontaneous labor. Prolonging a pregnancy with an intrauterine fetal demise can be associated with a maternal coagulation disorder that threatens a mother’s life.

A second circumstance where we offer pregnancy termination after 24 weeks or later is when there is a fetal diagnosis of an abnormality incompatible with life. By ultrasound, we can identify a baby without a brain (anencephaly) or without kidneys (Potters syndrome) or a fatal bone malformation (skeletal dyslasia). Most women make the decision to induce labor and deliver their babies before he or she dies so that they can hold their live newborn for the few hours or days it lives.

The third situation is when we deliver a baby prematurely because of a complication threatening the baby and/or mother’s life. Severe hypertension (pre-eclampsia), hemorrhage (placenta previa and abruption), or overwhelming infection (chorioamnionitis) are examples of these complications warranting an early delivery.

I cared for a woman and her husband (a physician) whose three pregnancies were all complicated by severe hypertension at 25-26 weeks, a very unusual case of recurrent early pre-eclampsia. She survived, but her first two babies died of complications of prematurity. Her third baby survived, but has developed cerebral palsy, a common complication of prematurity.

The decision to deliver a pregnancy early is often extremely difficult for an obstetrician and deeply personal for a woman. Given the complexities of some late 2nd trimester and early 3rd trimester pregnancies, criminalizing a physician for the delivery of a premature baby is unjust. This decision should never have to weigh the threat of incarceration.

These penalties jeopardize the recruitment of obstetricians to New Hampshire, where there is a scarcity of maternity care in the North Country. In particular, the criminal and civil penalties of the fetal protection act will deter maternal-fetal medicine specialists (those doctors who care for high-risk pregnancies) from practicing here. Two of our five maternal-fetal specialists in this state are retiring this year.

I strongly urge our legislators to pass and our governor to sign HB 224, repealing the criminal and civil penalties of New Hampshire’s fetal life protection act. Please make your feelings known to your legislators and our governor.

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