The Foxx Amendment and Miscarriage

So in the news recently I've been seeing the word "miscarriage" flung about. Following the links, I am told that I should be foaming at the mouth with rage, because an Evil Politician wants to prevent doctors from learning how to competently surgically manage a miscarriage . Further evidence of misogyny and general hatred and evilness.

Good heavens, how dreadful. Could this be true?

Well, before I get into that, I feel like I should assert my qualifications to opine here. Since "miscarriage" is being bandied about, and used as an emotional hook, I am fairly comfortable having a very strong opinion, given that I have been through three of them. Because of my history, I also have an increased likelihood of facing more miscarriages. And I have had a D&C for one of those miscarriages, and again have an increased likelihood of needing more in the future, if the future holds more miscarriages for me. I say all of this for the sole reason of assuring readers that I do have personal experience in this subject, and I am not theorizing or hypothesizing or practicing arm-chair analysis. Miscarriage has affected my life in a very real way. And the quality of medical care available to miscarrying women matters to me.

And the Foxx Amendment doesn't scare me.

So, am I grateful for competent doctors?

Absolutely.

Do I think it is a wonderful thing for doctors to practice "emptying the contents of the uterus" on living and healthy unborn babies in elective abortions, in order that I as a miscarrying woman can be assured of having a fabulously skilled person scraping the body of my dead baby out of my womb?

Not really. In fact, that particular argument puts miscarrying women in a class above those electively aborting. I'm sure it's unintended by its advocates, but that's the logic. And it's kind of squicky. And not at all comforting.

If abortion is really such a grand advancement for women's rights, I would think that women who electively terminate pregnancy deserve competent care just as much as women who are miscarrying and in need of surgical assistance. Instead, these arguments put aborting women in the category of "practice work", handy bodies on which new doctors can perfect their ability to scrape out uteri without killing somebody.

Yikes. Might want to rethink that one, folks.

But let us move on to the medical side of this.

Do doctors need to be well trained in order to practice procedures like D&C or D&E when such actions are required due to complications from a miscarriage?

That would be an obvious yes.

So how to doctors reach a level of competency? By practicing, of course. At the beginning of their careers, they will be less knowledgeable and less practiced than after 2 decades. No matter what their specialty or what procedures they normally do. This reality is why residency and internship exists after medical school, and why doctors must continue to learn and have their knowledge regularly evaluated and certified in order to continue practicing.

Here's where it gets weird.

I am supposed to believe that if I want to get top notch care during a miscarriage, I must accept that the only way for that to happen is for a doctor to have performed lots and lots of abortions on living, healthy unborn babies. If a doctor has not done this then there is no possible other way for them to have gained the knowledge and skill needed to perform a safe D&C.

I disbelieve.

Were I to want a competent surgeon in order to have the best chance of a successful heart or lung transplant, I would not be asking how many prisoners he has practiced on, or how many "undesirables" he has "harvested" hearts and lungs from and successfully transplanted them into the bodies of wealthy patrons. (A disturbingly common theme in dystopian literature.)

Were I to want a gangrenous toe removed, I would not be looking for a surgeon who had lopped off [insert adequate number of] non-gangrenous toes "for practice".

No. What kind of psycho would I have to be to approach my health care providers in such a way? When looking for a surgeon, normal people look at the doctor's education, recommendations, history, bedside manner, accountability, and overall career. We all understand that at the beginning of this person's career, they were under the supervision and instruction of skilled surgeons, who showed them and taught them how to perform these procedures, and gradually gave them opportunity to practice them while under supervision. As the doctor performed with increasing confidence and competence, they were given increasing opportunities to work, until they gradually went from student to practitioner, and hopefully moved on to teacher at some point in their career as well.

Given the large numbers of pregnancies that end in miscarriage (25%, by some counts), and the medical establishment's love affair with intensive, immediate, high-intervention management of miscarriage, there is no reason for someone who intends to specialize in obstetric surgery to miss out on learning the procedures for surgically treating miscarriage, without ever completing an elective abortion. Doctors have been managing miscarriages, well, pretty much as long as the profession has existed, and long before abortion on demand. Further, doctors have many and varied opportunities to deal with uterine issues that have nothing at all to do with abortion or miscarriage (endometrial problems, fibroids, and polyps, for instance). Lots of practice that doesn't need to involve abortion.

But as with any other speciality, and any other procedure, some people are going to end up on the "less skilled" side of a doctor's career, while others will benefit from the years of practice and skill development later in that physician's career. No matter what the medical need, what one hopes for is that "less skilled" doctors are working in concert with and under the supervision of more skilled doctors, and are held accountable for the work they do, and under the requirement to seek assistance if they do not feel competent or well-practiced enough for a particular job.

The lack of federal funds for training in elective abortion does not affect this reality, nor will it in actuality prevent those learning the art of medicine from developing the skills required to properly dilate cervices and apply appropriate medical and surgical interventions to uteri for the multiplicity of "female problems" that exist in this world.

Taxpayers do not need to pay for abortions in order for miscarrying women to get quality care. Women do not need to have abortions to provide the "practice" doctors need to become skilled at "emptying the uterus". Doctors do not need to go against their concience and perform abortions in order to become capable at managing miscarriage.