Danielle Albushies

My name is Dr. Danielle Albushies. I have been practicing low and high risk obstetrics for the last 22 years in NH. I oppose HB 1590. Amending the fetal life protection act to a gestational age of at least 20 weeks represents disregard for the complexities of obstetrics and will put pregnant women of NH in harm's way. Complications of pregnancy can occur before 20 weeks and can lead to challenging discussions and decisions that should only be between a pregnant patient, loved ones and health care providers. For example, rupture of the amniotic membranes can happen before or around 20 weeks. Continuing a pregnancy can lead to life-threatening infection for the mother without induction of labor. The education about the risks to the mother is provided by maternal fetal medicine specialists who have at least 7 years of specialty training. The education and counseling about survival rates for the newborn is provided by neonatologists who have at least 6 years of residency to guide the conversation. The amendments in HB 1590 will change the care in this complicated scenario. This mom will have to be faced with being transferred out of state to get safe, evidenced based care or continue a pregnancy that puts her life in danger or forces her to carry a baby that has no chance of survival. This scenario does not fall under the exception for fetal abnormalities incompatible with life. Another clinical scenario can occur when a pregnant patient is bleeding from a placental separation from the uterus (placental abruption) before or around 20 weeks. She may have to deliver to stop the bleeding but how much bleeding allows for the exception of a medical emergency? Again, this mom will have to be transferred out of state or continue a pregnancy that puts her life in danger. These moms will need to be transferred or have life threatening scenarios because physicians will be scared of the criminal penalties attached to this change of gestation age in HB 1590. I can say with certainty that a class B felony, or any other penalty the court may impose, or a fine up to 100,000 dollars is intimidating and will change care for the women who are at least 20 weeks. The clinical scenarios I have shared are real life with catastrophic consequences. Please allow physicians to provide compassionate, evidence based, local care to pregnancies that can be unpredictably complicated without the interference of legislation and fear of criminal penalties and fines. Please ITL HB 1590. Danielle Albushies, MD Bow, NH