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Potential effects of new anti-abortion laws and 2014 'personhood' measure raise medical concerns in N. Dakota

dahl photo
Dr. Stephanie Dahl

Among the patients Dr. Stephanie Dahl has treated so far this year were two college students with cancer. Both radiation and chemotherapy can destroy a woman’s fertility. So that each has the chance to have a family at a better time, Dahl, a reproductive endocrinologist in Fargo, N.D., fertilized eggs from each and froze the resulting embryos.

If North Dakota voters next year approve a radical proposal to define “personhood” as beginning the moment sperm meets egg, Dahl will have to stop offering in-vitro fertilization, among other services, or risk criminal charges.

“What if a catheter was dropped, or an embryo accidentally dropped during transfer from one dish to another,” said Dahl, whose specialized practice draws patients from as far away as eastern Montana. “That would be the death of a person. Could we be charged with murder?”

When personhood first came under discussion in North Dakota, like many others Dahl assumed its sole intent was to outlaw abortion. She knew the amendment would have drastic ramifications on everything from birth control to organ donation. Her efforts to educate lawmakers delivered a second shock.

“Initially, I felt the senators and representatives didn’t realize what the law would do,” she recalled. “Now [that] I know they know, it’s intentional.”

And if North Dakota seems like an entirely different political landscape from Minnesota, with our much more purple electorate, think again. Personhood is on the ballot as a result of a new, deliberate and effective strategy — and despite the opposition of many of the state’s veteran pro-life politicians.  

“It’s not so abstract for us here in Minnesota,” said Sarah Stoesz, president and CEO of Planned Parenthood of Minnesota, North Dakota and South Dakota. “Mark Dayton won by 8,000 votes. If he had not won, we would have had Gov. Tom Emmer. [And] we have another election coming up.”

Passage of a personhood amendment in North Dakota would likely energize campaigns in other states, including Wisconsin, where the concept has been raised in recent years.

Nor is it abstract for Stoesz’s organization, the main reproductive rights advocacy group serving Minnesota and the Dakotas. “Minnesota is in this bubble,” she said. “But we have North Dakota, South Dakota and Wisconsin all around us passing these laws that are very damaging to women’s health.” 

A departure from usual tactics

The quest for personhood represents a fundamental departure from abortion opponents’ customary tactics, which aimed to chip away at access to legal abortions by creating thorny regulatory burdens for clinics and doctors, curtailing the number of weeks the procedures can be performed and forcing women to view ultrasounds of the fetus.

Personhood USA, the Colorado organization pushing the initiatives, defines its mission as a desire to “glorify Jesus Christ in a way that creates a culture of life so that all innocent human lives are protected by love and by law.” The term personhood had biblical roots.

Personhood laws and amendments have been put forth and rejected in a number of states in recent years, in part because many pro-life leaders fear ultimately they would backfire disastrously, even leading to a stronger U.S. Supreme Court decision upholding the right to choose than Roe v. Wade.

The efforts are frequently helped by confusion about the extent of the ramifications. In 2011 a proposed personhood amendment seemed headed for victory in Mississippi, with the support of gubernatorial candidates from both major parties. Just days before the vote, Gov. Haley Barbour expressed concerns. Ultimately 58 percent of voters rejected the measure.

Like Mississippi’s, North Dakota’s electorate is conservative and heavily religious; 40 percent of residents are Roman Catholic. Personhood legislation has been introduced in every legislative session in North Dakota since 2007. (State lawmakers convene every two years.)

Moderate conservative Republicans targeted

The first three times it was introduced, Republican lawmakers were among those who voted it down. Many of them were targeted in the 2012 elections by religious extremists who did not raise personhood on the campaign trail.

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Sarah Stoesz

“None of these issues were debated in the 2012 elections,” said Stoesz. “Once they took power in 2013 they began to do things that had never been discussed publicly before.”

As evidence, Stoesz noted that in June 2012, North Dakotans rejected a religious liberties proposition by 29 points. “Had they run on these issues they would not have been elected,” she said.

Nor is North Dakota the only place where moderate conservatives have been targeted by extremists who fail to disclose their entire political agenda, she said. “Wisconsin, South Dakota, Texas, Ohio — those are all examples of states now suffering conservative legislators who did not run on the agendas they are now advancing.”

In 2013, three separate personhood bills were introduced in North Dakota. The proposed constitutional amendment was the only one to pass both chambers. It will go directly on the 2014 general election ballot.

Two measures go into effect Aug. 1

Several other anti-abortion measures were introduced. One of the two that passed, a ban starting at the detection of a fetal heartbeat, which occurs about six weeks into pregnancy, will be the strictest in the country.

Another requiring doctors who perform the procedures to have hospital admitting privileges, sounds comparatively reasonable but will have the practical effect of preventing the three out-of-state doctors who travel to North Dakota from practicing in the state. This would shutter the lone clinic in Fargo and leave Great Plains residents from central Montana to Minneapolis without a provider.

Scheduled to go into effect Aug. 1, the laws will be the subjects of contentious legal battles that are expected to go on for years. The practical effect may be that millions of dollars will be raised and spent without a single abortion prevented, according to Planned Parenthood.

Medical disruptions predicted

A personhood amendment would also face an immediate legal challenge. As it played out, however, health-care delivery and scientific research and development would be severely disrupted.

Doctors fear they would not be able to treat women who experience miscarriages or complicated or ectopic pregnancies. Because embryos could not be frozen and providers could not dispose even of those with chromosomal defects that render them unviable, in-vitro fertilization would have to stop.

“We often see embryos that stop growing in the lab,” said Dahl. “Some do not fertilize normally. We do not keep those fertilized eggs we discard because they will not result in a live-born human.”

End-of-life issues would be affected, as would the viability of living wills and doctors’ ability to remove organs from donors on life support. A number of forms of birth control, including some pills, would become illegal.

The most extreme possibilities: Because a fertilized egg would become a person, legally, women who miscarry might be investigated to see if they caused the death. And because it’s impossible to know whether or when a woman’s eggs have become embryos, fertile women could be banned from taking certain drugs, including hormonal birth control pills.

Among the measures that did not pass the North Dakota statehouse were a bill that would have restricted doctors’ ability to use donor sperm and one that would ban birth control pills outright.

“It’s very aggressive,” said Dahl. “It’s eye-opening to me.”

The avalanche of anti-abortion activity sparked widespread consternation, added Stoesz. The North Dakota Medical Association advocated the bills’ defeat — the first time it has taken a public stance on abortion in its history.

Others who testified against the measures included a number of women’s health-care providers, the American Society for Reproductive Medicine, the Society for Assisted Reproductive Technology, the  American Medical Women’s Association and RESOLVE: The National Infertility Association.

Medical students say they'd probably leave state

In addition, a group of 26 medical students at the University of North Dakota testified that personhood would present such a barrier that they probably would not return to the state after their residencies.

“I acknowledge that North Dakota is a conservative state,” said Stoesz. “But that’s not the same as saying people want the state to interfere with medical decisions. ... Which they are only doing in this particular realm which has to do with women’s health.”

In 2012 the Oklahoma Supreme Court struck down a personhood law. The U.S. Supreme Court let the decision stand. And there is reason to believe court challenges to the two abortion-restriction laws set to go into effect in North Dakota may be successful in the end.

“But we’re going to have to raise a lot of money and there is going to have to be a very careful, respectful conversation,” said Stoesz. “It’s unfortunate, given how many real human needs there are in the state.”

Human zygote sketch from the public domain via Wikimedia Commons.

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Comments (25)

And so for the meantime

Minnesota will be tasked with providing civilized, basic medical care for women in the surrounding states. We are the adults in this room, apparently.

Wow, a

Wow, a straight-down-the-middle objective piece of "news reporting" here.

Yes, indeed.I think Beth

Yes, indeed.

I think Beth should have contacted the bills' sponsors to ask them if they fully understood all the ramifications of their legislation.

But then she would have cluttered up this news story with a whole lot of extraneous words such as "Huh?" "Duh" and "D'oh!"

no pretense

Minnpost stopped even pretending to do journalism on contraversial social issues quite some time ago; anything you read here on sexuality and the moral status of various related acts will be an advocacy piece, not a news story.

Basic Math

Just because there are two sides to a story it doesn't mean that both sides are equal.

our rights

It's almost unfathomable to me that this kind of legislation could pass, endangering all child-bearing-age women.
This is the most backward, medieval legislation. It actually doesn't even take up back to the Middle Ages. These are new movements, intended only to control women. It's not about whether a fertilized egg is a person; it's an effort to keep women in their place.
When people know this--and not just women since men contribute and are also affected--it will backfire. I can only hope all of these inhumane and irresponsible measures backfire. We have to try to see that they do.

Just a thought…

…but the North Dakota proposals, whether statutory or built into the state constitution, strike me as quite obviously religion-based, and thus unconstitutional on their face(s?). This doesn't really seem to me to have much to do with anyone being "conservative" politically, and has a lot more to do with an attempt to impose a particular theology on the population.

I wouldn't be surprised if some of the same people supporting these proposals have very strong feelings against the imposition of "sharia" law, and either don't see, or choose to ignore the similarity between what they're trying to impose on North Dakota and what the Taliban and other reactionary Muslim groups try to impose in their societies. There are very good reasons why the Founders included that little bit about the establishment of religion in the U.S. Constitution.

Logical inconsistencies

I've been thinking about the logical inconsistencies of this for some time now.

One of the more jaw-dropping recent examples is in North Carolina where the abortion restriction measures were tacked onto anti-Sharia law legislation.

You can't make this stuff up.

You can't make this stuff up.

More than 54 million abortions since 1973.

One of the more jaw dropping facts.

Jaw-dropping

More than 54 million women in need of help.

Fortunately, they were able to find it.

"Help"

Miss Berg wrote:

"More than 54 million women in need of help."

What sort of "help"?

This isn't difficult

This isn't a difficult concept, Ms. Krasnoff. Have you ever become pregnant when it would create a hardship in your life?

If not, that may explain why you seem to require an explanation of "what sort of help".

This isn't difficult

I still need an explanation of how abortion (homicide of a viable fetus) is considered to be "help".

And that's *Mister Krasnoff* to you, Miss Berg.

Stupid

There are so many implications to this stupid law that serve to point out the stupidity of its authors.

It is just about impossible to determine the moment of fertilization.

Since any woman could at any moment be the vessel of a fertilized ovum, all ND women except those menstruating or without ovaries should be considered as pregnant at all times.

Women could always drive in the carpool line.

If a woman miscarries she could apply for bereavement leave, survivor benefits, and be obligated to pay for a funeral each time she gets her period.

Birth would be irrelevant since since masses of cells are already North Dakotans.

The census would include fertilized eggs, greatly increasing the population and perhaps earning crazy ND another seat in the House of Representatives.

Tax season would be complicated as would benefit programs calculated based on family size.

Scientists (obviously not North Dakotans) estimate that up to half of all fertilized eggs are "lost" before implantation and a woman's first period. What will happen to these legions of lost North Dakotans?

You truly can't help stupid when it goes this far!

More women in politics

My rough estimate is that in ND 13 of the 141 state legislators are women. So by overwhelming odds men are determining the woman's healthcare laws in ND.

Took a look

At the bios and pictures of the 141 legislators in no dak. 24 women are in the house and senate - approximately 17% of both bodies. The majority of the women are Republicans. The clear majority of the entire two bodies - older white males, mostly Republicans. Women's healthcare does not stand a chance in that state.

life begins at...

The series of biochemical events that happens when an egg is fertilized begins the process whereby a human body is formed. We should be able to agree that at death, something undetectable leaves the human body, leaving it lifeless. Therefore, there must be a point in time where that something enters the body, giving it life. Conception, 20 weeks, or first breath? PROVE IT to me and I will agree that the body is a person from that point forward. I don't consider opinions or scriptures as proof.

You remind me of one of my primary problems

with is whole "life begins at conception" canard. Sure. "Life" may begin at conception, but that isn't really the question. The question is when does that "life" become a "human" life, and as you correctly point out -- that has always been a philosophical/cultural/religious question, and excluded from legislative action concerning it per our constitution.

Beginning of Life

The concepts that life begins at birth or conception are both arbitrary concepts, designed to drive home a point that depends on which side of the debate you're on. The pro life (or anti abortion, if you prefer) group says that life begins at conception as a fertilized egg has the potential to become a viable human being. For that matter we could decide that every egg and sperm also has the potential and should be saved. Ridiculous, I know, as there would be hundreds of eggs and uncountable trillions of sperm. But that's where the logic of this situation takes us.

Viability and arbitrariness

One of the arguments put forth by the pro-choice side (yes, I'm being polite and using the term they use for themselves; I thank Mr. Hintz for doing the same above) is that, prior to viability outside the womb, it's nobody's business but the mother - rather, potential mother - whether the organism within her is allowed to survive or not. That in itself is, of course, a moving target, as medical science will undoubtedly one day be able to do in a lab everything a womb can do, rendering "viability" coincident with conception itself. What then? I suspect the discussion will then shift to that of two posts above - when does this organism become a "human being" with all the rights that implies? I, as a pro-lifer, believe that happens when the egg is fertilized, but not everyone agrees. Let's call the organism "pre-human" up to that point, and agree for the sake of argument that it's morally permissible to end the life of a pre-human.
Please understand that I'm not trying to be facetious in what follows, rather to let pro-choice folks understand how their attempts to justify pregnancy termination sound to those of us on the prolife side. It's been put forth by some philosophers that what makes us human is the capacity for language and abstract thought. So let's suppose I believe an organism is pre-human until it acquires the capacity for language. This typically happens some time after it exits the womb. Up to that point, in my own sincerely held view, it is not yet a human life, so it is my choice , as the parent, whether it is continues to live and attain its "potential" to become human. You disagree, and wish to charge me with a crime - but *who are you to impose your own views about when an organism becomes human on me*?
Yes, this is really how you sound to us. This is why this issue isn't going away, and why neither side is willing to give much ground.

Rights

The basic issue is that the pro life side thinks the rights of a fetus trumps the rights of an adult woman. Just like a 26 year old has more rights than a 6 year old, a baby has more rights than a fetus. The pro choice side objects to the efforts to completely restrict abortion, give a fetus full rights, and allow the fetus' rights to trump the rights of a woman.

If the pro life crowd really wants to eliminate abortions, there are ways to do that without resorting to any of the above methods. (Assuming the moderator approves the message, I posted them at the bottom of the comments section.) Unfortunately the pro life people don't want to implement any of those methods as they fear it will promote sexuality in the young. Personally, I think America could do with less Puritanism and more sex, but that's a whole 'nother topic.

Rights...to what?

Of course a six-year-old has more rights than her 26, or 36, year-old mother; the parent, in fact, has legal authority over the child, which is entirely appropriate. But it's quite a stretch to go from having "more rights" than someone else to being legally able to *end the life* of the "less-righted" individual. Nobody, at least in polite company, suggests that a 26-year-old mother has the right to end the life of her six-year-old daughter because she finds her inconvenient. This is the crux of the matter. If someone doesn't have the right to continue living, then she has no rights at all.

The pro-choice position is that, up until some indefinable point in the development of a human being, a there is no such right to not have one's life ended. To take an extreme example, if the babies - and that's what they were - who survived Dr. Kermit Gosnell's attempts at abortion had emerged dead from their mothers' wombs, there would have been no charges to file; yet because, a short time later, he snipped their spines in order to finish his job, he is a murderer. Why? They were exactly the same beings inside the womb as out; yet if they'd died a few minutes earlier, there would have been no crime committed. This makes no sense.

Other than conception, there can be no rational, truly objective standard for when a human life begins. I agree that the North Dakota law was not well thought-out (but its striking-down was a foregone conclusion, anyway). But to make the perfectly reasonable statement that an adult, or even a teenager, has more rights than a pre-born human is not to say that those rights ought to extend to determining life or death.

Scripture and right to life

Scripture does not support or even offer any justification for this abominable legislation. The Catholic Church has been the leading opponent of the "right to life" but this is based upon canonical interpretations of Scripture, i.e. the Pope's interpretation. That is because there is nothing in Scripture which says anything about conception, abortion or the "right to life." Fundies will point to a verse in Psalm 139 but this verse only mentioned being "knit together in my mother's womb." Nothing about abortion being evil, or that people acquire a soul at some certain point. I think Roe v. Wade points out that religious authorities have always been divided about this issue. For as long as their have been religious affiliated hospitals, it's been well known that given the choice between saving the life of the mother or the child in birth, the Protestant and Jewish affiliated ones would save the life of the mother, whereas the Catholics would not.

Scripture can hardly be taken as any guide on the "right to life." The Canaanites, Jebuzites, Perruzites and other tribes wiped out in the conquest of the Promised Land were not limited to the males of fighting age. The Israelites were instructed to wipe out all the men, women and children and in some cases, even all of the animals. Maybe it should really be called "deserve to die" legislation because the only justification I can see for this terrible law is the arrogant and prideful judgment of the self-righteous that women who need the services ought to suffer and die instead.

Not Scripture

You raise some good points.

As I understand Roman Catholic doctrine, opposition to abortion is based on the idea that a soul is created upon conception. This is a non-scriptural notion. Conception creating a soul is base on teachings of St. Thomas Aquinas, who in turn got the idea from Aristotle.

Reducing Abortion

There's a whole bevy of ways to reduce abortions without having to result to draconian efforts.

1. Promote sex education.
2. Distribute contraceptives.
3. Family planning services.

Unfortunately these are all items that our conservative friends work to block rather than promote.