Dr. Suzanne Poppema's blog

In Memory of Richard Hausknecht, MD

2008-11-01T09:00:00-04:00

On Sunday, the reproductive health community lost Dr. Richard Hausknecht, a pioneer in medication abortion, a founder of New York City's first abortion clinic, and a longtime advocate for women's reproductive health. He died of lung cancer.

With an M.D. from Tufts, Dr. Hausknecht became a resident at Yale before Roe v. Wade. Treating women who had been injured by illegal abortions compelled him to start advocating for reproductive rights and searching for ways to make abortion safer. He never stopped. "Abortion is stuck in a corner," he said later. "It should always be a part of general reproductive healthcare."

When New York State legalized abortion in 1970, he helped open the first abortion clinic in New York City, seeing patients who had traveled from around the country to have abortions. He also conducted pioneering research on the safety and efficacy of methotrexate-misoprostol for medication abortion, eventually serving as the medical director of Danco, the company that succeeded in bringing mifepristone to the U.S.

Over his five-decade career, he dedicated a great deal of time to training other doctors in techniques for both surgical and medication abortion. He maintained a private practice in New York City until joining Danco. He held academic positions at Yale, Columbia, Mount Sinai, and the Albany School of Medicine. He also served as a fellow in the American College of Obstetricians and Gynecologists and on the Medical Advisory Board of Planned Parenthood of New York City.

I knew Dr. Hauknecht as a founding board member of Physicians for Reproductive Choice and Health. In his eight years on the board, he helped build the organization, bringing his burning intelligence and passion to every project. Dr. Hausknecht did not suffer fools gladly, and his wit was sharp. I am sad to lose such a wonderful friend and colleague. He will be sorely missed.

Women's Health Exception in South Dakota Ban Not Enough to Protect Women

2008-10-21T08:00:00-04:00

Ever since Wednesday night's presidential debate, many Americans have been talking about what "women's health" really means. Nowhere is this issue more relevant than in South Dakota, where voters are poised to decide on a comprehensive ban on abortion. Initiated Measure 11 would ban most abortions, with narrow exceptions for rape, incest, and "serious risk of a substantial and irreversible impairment of the functioning of a major bodily organ or system of the pregnant woman." That's how South Dakota would define "women's health" if the initiative passes.

In August, I spoke out on behalf of the many doctors in South Dakota who, like myself, have devoted their lives to protecting women's health. They are concerned that the language used in this initiative would put women at risk. Doctors in South Dakota--and around this country--have all seen patients whose health was affected by pregnancy. As a family physician who ran an abortion clinic for many years, I've often seen women whose diabetes and heart disease were worsened by pregnancy. Many of them were mothers who chose to end their pregnancies so they could care for the families they already had. Every woman I treated made the decision to have an abortion thoughtfully and carefully, and thanked me for being there in a time of great need.

Proponents of Initiated Measure 11 argue that the health exception protects women's well-being. However, "substantial and irreversible harm" is hardly a black-and-white issue. Imagine a woman, recently diagnosed with cancer, who cannot begin chemotherapy while she is pregnant. Would she be forced to continue her pregnancy to term regardless of the risks? Who decides? If medical experts cannot agree on the precise risk to a woman's health, they may opt not to act at all rather than risk criminal penalties. As Dr. Marvin Beuhner, an obstetrician/gynecologist in Rapid City, told me: "We physicians [would be] left in the untenable position of trying to make a medical decision with our attorneys rather than our patients. The threat of a felony is truly frightening."

Just how murky the language in Initiated Measure 11 is became clear earlier this week, when a memo from Sanford Health (a hospital in South Dakota) was leaked to the media. In the memo, the hospital's lawyers state that the law is unclear, and could have "substantial legal implications." The end result is that, if passed, this law would tie doctors' hands and force them to watch as their patients' conditions worsen. As a physician, I can only imagine the needless suffering women in South Dakota would be forced to endure.

Beyond the risks to individual women, eliminating "women's health" in abortion regulations would undermine the doctor-patient relationship. Women rely on their physicians to give them complete and accurate information about their health, and to help them decide on the right medical treatment. Imagine your doctor saying, "Your heart disease is getting worse. I know a treatment that will cure you, but I can't provide it because our state believes you don't really need it." Women and men would be up in arms!

This isn't just an issue in South Dakota. We all need to be concerned about how women's health is defined in--or left out of--regulations that govern healthcare. Once a cornerstone of Roe v. Wade, protections for women's health were deliberately left out of the federal abortion ban-legislation upheld by the Supreme Court in 2007. We can no longer count on the courts to protect women's health.

When Roe was decided, women across America were dying from unsafe, illegal abortions. Women's health was essential to the ruling precisely because the risks of illegal abortion were so apparent. Thirty-five years later, we are fighting to protect the right of women to receive the medical care they need, and the right of doctors to provide it. I only hope we never go back to the days when the risk to women's health is visible in hospital wards everywhere.

Four Abortion Myths Dispelled

2008-01-11T09:04:00-05:00

For many years, I was an abortion provider. I owned and ran a clinic near Seattle, Washington, where I provided a range of reproductive healthcare-including abortions-to women, and I've remained active in organizations that support abortion providers across the United States. Over the years, I've heard many myths about abortion that are as pervasive as they are false. Four myths in particular never seem to go away, though any doctor who provides abortions can tell you they just aren't true.

Myth No. 1: Women need waiting periods so they can be sure they really want an abortion.

As if women haven't been agonizing about what they're going to do from the moment they missed their period! As if a woman who happens to be on her way to the grocery store drives past an abortion clinic and says to herself, "Hmm, I think I'll just pop over there and have one!" When a woman visits an abortion clinic, she has already thought long and hard about her decision. Mandatory delays just make it harder for a woman to get an abortion, especially if she needs to take two days off work for an initial appointment and then her procedure.

Myth No. 2: Women use abortion as a method of birth control.

I hear this one so frequently and yet in decades of providing abortion services to more than 30,000 women, I met only two women who used abortion as a birth control method. And they were absolutely right to do so. These two women experienced blood clots while on birth control pills, ectopic pregnancies with the IUD, and they were allergic to latex condoms and spermicide. Using the rhythm method with abortion as backup was the best method for them. I've never met a woman who cavalierly chose abortion as her method of birth control.

Myth No. 3: One abortion is okay, but three or four?

No woman thinks having an abortion is so much fun that she gets pregnant just to have one. The difference between the women who have unintended pregnancies and those who don't is pure luck-not age, education, social status, or intelligence. When women told me they were so ashamed of returning to my clinic for another abortion, I would ask them if they got pregnant on purpose just to have an abortion. It made them laugh, but really, that's the only reason for a woman to feel guilty. Abortion providers do our best to offer a very respectful and comfortable abortion, but they're not anyone's idea of fun.

Myth No. 4: Only irresponsible women need abortions.

We all behave irresponsibly at times. Have you ever driven without a seatbelt on, even for a short distance? Driven after drinking alcohol-even just a little? Smoked a cigarette? Not taken all of the antibiotics your doctor prescribed? These are all irresponsible behaviors, yet most of us have been guilty of at least one. Having unprotected sex is irresponsible, too, but a woman who decides that she is not prepared to be a good mother is behaving responsibly.

Until we have a foolproof, easy-to-use form of birth control-in my opinion, that would be a pill, paid for by insurance, taken only once a year, with absolutely no side effects or adverse reactions, and absolutely no failures -- then we cannot condemn women for having unintended pregnancies