Amy Agostino

As a NH resident, voter, mother, and nurse, I urge you to oppose HB1590. “Fetal personhood” is a deceptive term. This is an abortion ban – and there are many reasons why even a 20 week abortion ban is bad for pregnant women. From Pew Research (https://www.pewresearch.org/short-reads/2024/03/25/what-the-data-says-about-abortion-in-the-us/ ): The vast majority of abortions occur during the first trimester of a pregnancy. In 2021, 93% of abortions occurred during the first trimester – that is, at or before 13 weeks of gestation, according to the CDC. An additional 6% occurred between 14 and 20 weeks of pregnancy, and about 1% were performed at 21 weeks or more of gestation. One percent. One percent of abortions occur after 20 weeks. Please keep that in mind as you read - and I really hope you are reading this. It’s a bit long, because of my professional connections to the topic, but it’s a good read. Really. As a registered nurse, I spent my entire career working in hospitals, over 15 years of that working in multiple aspects of women and children’s health, mainly maternity and level 2 NICU, but also labor & delivery. You will notice that I use fairly casual language in this letter, because that is how we as health providers often speak in order to communicate complicated heath information to lay people rather than sound like we’re reciting passages from medical texts. Here are things I personally and professionally know to be true: Women are NOT sauntering in to clinics at 20 weeks and saying, “Nah, just decided I don’t want to do this anymore and I’m going to have an abortion”. On the off chance that someone did do that, no physician is going to respond, “Sure, that sounds reasonable. Please come in and let’s get rid of that for you.” There are *reasons* that only one percent of abortions in the US occur after 20 weeks’ gestation. Even the term “abortion” is misconstrued outside of a medical setting. It refers to the ending of a pregnancy, and to procedures used to end a pregnancy. Did you know that in official medical terms, even a miscarriage is called a “spontaneous abortion”? Laypeople often think (due to rampant misinformation) that “abortion” means that some woman gets irresponsibly pregnant, perhaps repeatedly, and decides to just “get an abortion” as a casual form of birth control. And that somehow doctors and health care facilities blithely roll along with that. Health care facilities are not fast food drive-thru. You cannot just go up to the window, order an abortion procedure, and be told, “That will be this many dollars. Drive on up and have a nice day!” Any pregnancy termination happening after 20 weeks – one percent of all abortions, remember? - is due to a severe and unforeseen medical complication. And if the woman and her doctor decide the pregnancy must be ended, the procedure at 20 weeks and beyond would look similar to any birth – either induction of a vaginal delivery, or a cesarean section if needed. Do not believe the gory urban myths (I almost typed out some of the revolting common propaganda; I will refrain. You’re welcome.) Pregnancy complications occurring at 20 weeks or later can be life threatening for the mother, and can develop rapidly. Doctors have the advanced education and experience to know how to treat these situations. A qualified physician will discuss the situation, risks, and possible treatment options with a pregnant woman and her family, and come up with a plan together. There is often very little time to make these decisions in medical emergencies, and having to waste time consulting administration and lawyers would delay care and cost lives. Legislators who think they know better than OB-GYNs and their patients are deadly to pregnant mothers; there are many examples from the US southern states where women have died, have spent long days or weeks in the ICU and almost died, have developed permanent life-altering medical conditions due to sepsis and organ damage, and/or have had permanent infertility due to bad legislation causing delayed response in treating their pregnancy emergency. I want you to know that and take it to heart – every instance of permanent medical disability, infertility, and death will be on your conscience. Blood on YOUR hands. We as doctors, nurses, and other providers go into health care to help people. We spend years in school to have the knowledge to do so. We pass licensing exams and take ethical oaths. Please let us do our jobs without the state government trying to second-guess how to deal with true obstetric emergencies. Would you like to use your legislative power to help mothers and babies have healthy outcomes? Support comprehensive sex ed in schools to prevent unintended pregnancies. Expand and fund Medicaid so that women and babies receive the care they need, especially important prenatal care. Support and expand SNAP coverage for pregnant women, children, and their families. Support and expand mental health care - postpartum depression is a huge and ongoing problem, and many moms fall through the cracks. You can use that legislative power to make changes that will help babies and their mothers, not hamstring their health team. Please stop trying to second guess experienced medical professionals; abortion bans make bad law and cause harm. No HB1590.