Anonymous
By Dr. Katrina Mitchell
“The pills were malarone, not misoprostol.” My obstetrician colleague in Tanzania, East Africa, made a chilling discovery about medication I had purchased in a local pharmacy to use for terminating a patient’s pregnancy. Malarone is a powerful antimalarial agent that could have killed someone in the prescribed quantity for misoprostol, one of the drugs utilized in medical abortions.
During the four years I worked as a surgeon in Tanzania — where abortion is legal only to save the life of a mother — treating patients safely was challenging. As was my experience with a pharmacy dispensing incorrect medication, the barriers to care were often nuanced and dangerous to navigate.
In the weeks since the SCOTUS decision to overturn Roe v. Wade, I have been struggling to process its impact on my professional and personal life. Having lived abroad in several countries where violence against women is widespread, it is devastating to consider that protection within our American borders is disintegrating. But we can’t condone this — it’s not acceptable for us, or our future generations. I want my son to grow up in a world where the life of a woman is as valuable as his own. I want him to understand that dignity, bodily autonomy, and access to health care are fundamental human rights. I want him to bear witness to the sacred physician-patient relationship and respect my ability to protect those who entrust their lives to me.
I stand with the American College of Surgeons, American Medical Association, American College of Obstetrics and Gynecology, American Academy of Pediatrics, and all other organizations that have spoken out against this assault on medical practice and patient safety. Just as SCOTUS does not have the authority to dictate receipt of vasectomy or vaccination, it should not play a role in requiring a woman to accept the physical and mental health risks of pregnancy and childbirth. Making abortion illegal doesn’t stop abortions — it stops safe abortions. Our country already carries the highest maternal mortality rate of any western nation, and we can’t afford to lose more women.
At best, pregnancy and childbirth changes the mind and body of a woman forever. At worst, it ends in death. Our leaders are unaware of — or choose to ignore — these facts. If they could join surgeons in a day of work, they would experience a harsh awakening. I would invite them to watch as we perform an emergency hysterectomy on a woman hemorrhaging in labor. Sit with us as we deliver the news to her family that their beloved wife, sister, or daughter did not survive. Listen to us declare a depressed pregnant woman brain dead from a self-inflected gunshot wound. See us place breathing and feeding tubes in a patient paralyzed from eclampsia and hemorrhagic stroke. Smell the stench of leaking urine and feces from a rectovaginal fistula in an adolescent victim of incest. Hear our testimony in a child abuse case when a young mother, alone and overwhelmed, shakes her baby to death.
Our cultural idealization of motherhood leads to a complex reality for many women. During pregnancy and the postpartum period, women are at their highest lifetime risk for development of a mood or anxiety disorder. I have cared for tens of thousands of patients who are struggling in a healthcare system and culture that lacks safeguards to protect their physical, emotional, and economic wellbeing. Women who are suffering need access to obtain treatment, as maternal health directly affects fetal and childhood development. Restricting abortion further reduces the ability of women to conquer the multi-layered challenges they already face.
At this moment in time, we must raise our voices louder than ever and demand expansion of the support we can offer to our communities in need. This is a crisis. Our state will be receiving an influx of patients traveling from elsewhere to obtain reproductive health services. Planned Parenthood is the only organization in Santa Barbara that provides elective abortions, and this is not enough. Our medical establishments must accept this call to action and begin to prioritize women’s health — all aspects of it. Change is uncomfortable, but silence is complicity.
Women of all ages, races, ethnicities, gender identities, sexual orientations, and socioeconomic statuses deserve locally available comprehensive care for concerns unique to them at critical junctures in their reproductive life cycle — from puberty to menopause. Beyond abortion services, I propose the creation of a Santa Barbara women’s healthcare task force, composed of community leaders, healthcare providers, and stakeholders.
This task force can identify what we currently do well, and create a plan to address the gaps — including those that impact underserved and high-risk patient populations. As illustrated in Aftershock, the powerful new documentary exposing the epidemic of Black maternal mortality in the United States, birthing centers and midwifery care for low-risk patients is a standard worldwide. Method of delivery is significantly correlated with successful breastfeeding, and I see the effect of high-intervention birth in my lactation practice each day. We need to understand this association and ask how we can promote outcomes that influence a lifetime of health for mothers and children. Safe birth exists both in and outside of hospitals, and we should help patients explore all options based on their individual circumstances.
This task force can facilitate research into the ever-evolving physical and mental health needs of women in our county. It can fundraise to help build a facility that utilizes the latest technology and models standards of care for all facets of women’s health. Patients can receive their pap smear, mammogram, bone density test, menopause management, and female surgical services alongside obstetrics, reproductive mental health, lactation, and physical therapy. And this list is just a start. Many individuals throughout Santa Barbara have the vision, knowledge, and skills to build something great, but the system to support them must exist. This system must be intentional and proactive, not short-sighted and reactive.
When I graduated from medical school, I committed myself to a life of service to others. The work ahead requires more dedication than ever, but I am ready. My son is, too. Will you join us?
Dr. Katrina Mitchell is a breast surgeon, lactation consultant, and perinatal mental health provider. She is passionate about community education and advocacy for women’s health. This article reflects her personal views and does not represent that of the organizations with which she is affiliated.
I was also unaware of this. But there is a clinic in the strip mall off Patterson that’s called “Network Medical Women’s Center.” It bills itself as a women’s clinic but is an anti-abortion clinic that will give “free” or discounted services to pregnant women in order to shame them into not getting an abortion. It’s a pro-life organization that offers inaccurate information and details about Planned Parenthood. Check out the articles and reviews on this sham of a place who hires anti-vaxxer conspiracy theorist Kirk Cameron to give keynote speeches for their fundraisers.
“Do not we want children served when their needs are great, do we not the poor given care when they are denied it”
59% of women who get abortions already have children. 49% of women who get abortions are below the poverty line. (I believe the number is considerably higher for women who *seek* abortions … the poorer one is, the less likely one is able to get abortions or other health care.)
https://www.guttmacher.org/united-states/abortion/demographics
While supportive of the Right to Choose and the right of women to decide as to their body and its care, I do not understand the argument that the right’s of women should have priority over others. Do not we want children served when their needs are great, do we not the poor given care when they are denied it, do we not want all to get emergency help on a priority basis? Maybe the use of “priority” in this essay is just the result of sloppy language but it does seem that such claims antagonize natural allies of the cause being espoused.
CHEVY – How does sexist “feel?”
“prioritize: determine the order for dealing with (a series of items or tasks) according to their relative importance”
I’m genuinely confused by your comment. The article touches on so much yet your concern was that women will get priority care over children, the poor, and “all” ? I don’t feel like stating my confusion and expressing it feels sexist, and I’ll go a step further, reductive of the greater issue the article posits, as name-calling. Perhaps read the article a few more times and see if you still feel that comment was worth making.
“such claims antagonize natural allies”
It’s your choice to be “antagonized”.
Agree with Chevy and Marcel. @926am – your comment contradicts itself and you seem unwilling to listen when someone points it out. You support women’s rights but not that their health, where they are dying by the way, be prioritized. Seems you misunderstood the meaning. When you walk into an ER with a sprained finger and a woman in labor walks in after you, do you think you should be seen ahead of her? Prioritizing is dealing with the most critical needs first.
MarcelK–so the idea is not to “give priority” to a task? Priority means “the fact or condition of being regarded or treated as more important as “the safety of the country takes priority over any other matter” or “a thing that is regarded as more important than another” or “the right to take precedence or to proceed before others.” And,by the way, the first definition of “prioritize” is: “designate or treat (something) as more important than other things.” (You gave the secondary meaning, accident?)
We can argue whether the word “prioritize “ was the best choice for that one sentence. But the overall gist of the essay is clear: there are gaps in care, and some women’s health issues need more attention. There is nothing here to indicate that the author thinks that less care should be given to men’s health issues, or to any other specific category of health care. It doesn’t have to be a zero-sum game.
Thank you ACH, best to disregard the commenter’s 9:26a, 12:51p, and 4:17p statements that hint at #MensRights and #AllLivesMatter. It’s detracting from the entire purpose of this article and spinning into presumptions not stated by the author while ignoring the clear statements made.
This was a great article and should be listened to, by residents AND the local medical community which feels content in burying their head in the sand.
“Our medical establishments must accept this call to action and begin to prioritize women’s health — all aspects of it. Change is uncomfortable, but silence is complicity.” Women are dying dude. Don’t worry you can still get your Viagra pills easily enough and see your physical therapist to keep shaking your cane at kids across the street.
AACHOO, If everything is equal and everything is a priority there is no meaning to that word.
I’m confused by your comment. She used the word prioritize once and you chose to focus on that? The article isn’t discussing women should always go ahead of others, but equal access and effort. Your comment on the other hand, feels sexist.
@4:17 She used the word “prioritize”, not “priority”. And I gave the definition of “prioritize” that best fit, whereas you are using the one that justifies your “antagonism” and trolling.
Chevy67, your defense against the actual meaning of the express language of the author (“priority”) “feels” pretty sexist itself. Can’t we have a discussion without resorting to such stereotypes and name-calling?
OP’s comment is along the same line as the “all lives matter” rhetoric. There is a national crisis in access to women’s health, people like this surgeon say in passing that women should be prioritized in response, then trolls come in and latch onto that with false outrage like “why don’t all people get priority?” It’s middle school debate club nonsense to distract from the salient issue at hand.
“Just as SCOTUS does not have the authority to dictate receipt of vasectomy or vaccination, it should not play a role in requiring a woman to accept the physical and mental health risks of pregnancy and childbirth. ”
I would like to know if Dr. Mitchell thinks people should be free to decide whether to accept the physical risks of Covid vaccination like she advocates for pregnancy and abortion. Or is she selective about what mandates she supports?
@LSS your comment reeks of false information and conspiracy theory. If you are so blind and afraid that you won’t get a safe Covid vaccine to protect yourself and others, that is your prerogative indeed, but what a DUMB one. The vaccines are SAFE, and no one is forcing you to get one, but you should, it would be a wise move. Curious, did you get a polio vaccine? A measles or shingles vaccine? Or did you shun those too? Abortion is a much heavier more serious issue with bigger consequences that affect women. I’m guessing you are a MAN.
“They simply moved the legislation decisions back to the State level of government, where it really belonged all the time. ”
Like slavery? We fought a civil war and the garbage that supported states controlling civil rights lost.
I don’t care if you call yourself XX, XY, YY, or any other combination. Until you’ve been in HER shoes you don’t know what you’re even talking about.
Let’s start promoting birth control not killing of babies who would otherwise be born healthy. A medical emergency and using abortion as birth control are two different things. I’m sure we all know a woman who has had abortions because it wasn’t in her plan to have a child yet. I for one was a young pregnant woman many years ago my doctor and parents tried to talk me into a abortion saying having a baby at 17 would ruin my life. Well I stood my ground had a precious little boy yes it changed my life not ruined it. It was very hard but now he is a wonderful loving young man. I’m so thankful I didn’t kill him,
Oh eff off MebK. Women do not use abortion as a form of birth control. It’s an insanely difficult decision that the majority of people do not take lightly. Stop villainizing women.
THANK YOU, Dr. Mitchell! Abortion should be available everywhere without question. If men could get pregnant, it WOULD BE. I have worked all my life for women’s rights, I’ve volunteered, I’ve donated, I have had an abortion. Abortion is NORMAL. I guarantee you that someone you love has had an abortion. And that is one of the most personal of all choices that a woman has to make. It is up to her, and her alone. Time to remove any remaining stigmas about it and call it what it is: essential healthcare.
@MEBK I was in the same position as you at that age. Thank GOD I had a choice and access to make the decision that was right for my life. Good for you that you are happy about your choice, too. I chose NOT to bring a kid into the world. I never wanted kids and it would have been a trainwreck of a life for the kid. I was poor and grew up in an abusive household, I would have had NO support from anyone. As it was, I was able to go to college, educate myself and pull myself “up from my bootstraps” isn’t that what the Republicans are so fond of saying?
Yes, let’s indeed focus on birth control, AS WELL as access to reproductive healthcare for ALL women, everywhere. More birth control means fewer abortions, but abortion is necessary.
My body my choice, my kids my choice yet they tell us what we have to do or we can’t work we can’t send our kids to school. I agree our bodies our choice but for every choice not hand picked ones. I have no political preference I vote as I choose so please don’t waste Luther’s time blaming republicans.