Alla Korolevskaya - Greetings! This is Alla Korolevskaya, and welcome to my podcast, "Medicine in Patient-Friendly Language." Despite how challenging our fate can sometimes be, it holds immense potential for joy. As women, we have the incredible gift of carrying a child under our hearts—a profound happiness we share with our loved ones. However, today, many challenges arise when it comes to carrying a pregnancy. These challenges can relate to either the mother or the child, involving psychological, physical, or social issues, which can be seen as external factors but remain significant. For instance, regarding abortion, there is intense debate about what to do when carrying a child is not possible. People are searching for a middle ground, but there is no consensus yet on the right course of action. How do we address this, and where do we go from here? Today, we’ll discuss this with Yaroslava Kovtun. Good day, Yaroslava!
Yaroslava Kovtun - Good day, Alla! You know, this is a very concerning topic. These days, there is so much advertising encouraging women not to feel ashamed of even menstruation. Prominent figures promote various hygiene products, suggesting there’s no need for embarrassment, even if problems exist. So, when a woman faces the inability to carry a child or even to have an abortion, it becomes a much deeper issue. Currently, in America—and worldwide—there are ongoing debates about whether abortion should be banned. Many support such bans, but others strongly oppose them. In one instance, U.S. Senator Kamala Harris discussed this with another senator who supported abortion bans. She asked him: “Would you want the government or a piece of legislation to decide what you can do with your own body?” He hesitated and didn’t answer directly. Alla, as a doctor, I’d like to ask: Should abortion be banned or not?
Alla Korolevskaya - We need to approach this by addressing the right questions. In medicine, there are both indications for and contraindications to abortion. For example, situations where a woman physically cannot carry a child. Such cases are common and include genetic or oncological conditions where the mother's life is at risk. It’s hard to compare, but if a woman dies during childbirth, the child often dies as well. It’s similar, though not entirely comparable, to the COVID-19 mask rule: “First, put the mask on yourself, then help others.” Only by saving the mother’s life can we save the child’s. So, if medical contraindications exist, we must consider them. Physical health issues that endanger the mother or child’s life, if verified, leave no room for hesitation. Early intervention is crucial, as earlier abortions carry a higher chance of preserving the mother’s health.
Yaroslava Kovtun - However, often women face external pressure from their partners or families to have an abortion. We know of many such stories. If left to a woman who did not want the pregnancy, she might opt for an abortion and later regret the decision.
Alla Korolevskaya - Currently, no country can claim to have fully addressed this issue. It exists everywhere, regardless of the country’s religious or moral stance. Sexuality doesn’t disappear, and men and women alike don’t always restrain themselves. In non-assault cases, women may still face unplanned pregnancies.
These issues shouldn’t be discussed publicly, as they often are today, but rather handled individually. Ideally, a woman should consult a team that includes an obstetrician-gynecologist, a general practitioner or family doctor, a geneticist to assess the child’s health, and a social worker to evaluate the woman’s options. Different countries have different levels of social and financial support, and many women lack basic necessities like housing or proper nutrition. How can a woman struggling to sustain herself care for a child? Philosophizing doesn’t help if she can’t even feed herself adequately.
Yaroslava Kovtun - In such cases, who decides whether a woman should have an abortion if there are no medical indications? Should this decision rest solely with her?
Alla Korolevskaya - If the woman is competent and capable of making informed decisions, why not? However, for those unable to care for themselves, like individuals with severe disabilities, decisions should be made by their guardians.
Yaroslava Kovtun - This relates to the "my body, my choice" movement, advocating that no one should dictate what women do with their bodies. Some doctors warn that banning abortions could lead to an increase in unsafe, illegal abortions.
Alla Korolevskaya - I’m not sure if studies on this exist, but during our genetics course, Professor Grechanina mentioned research showing a rise in children born with genetic disorders following abortion bans. If abortions for medical reasons are prohibited, many children with severe health issues will be born, requiring lifelong care. Banning or allowing abortions isn’t the issue—it’s about addressing each case individually. Even with bans, illegal procedures will still occur, which can be traumatic for women. Abortions, especially late-term ones, are always devastating.
Yaroslava Kovtun - And what about medical indications?
Alla Korolevskaya - If medical indications confirm the child won’t survive or the pregnancy endangers the mother, there’s no debate. Early, medically-supervised interventions are critical. Women should be guided by professionals who weigh all risks.
Yaroslava Kovtun - This is a complex issue. We’ll continue this discussion in the next episode.
Alla Korolevskaya - Society must prepare to address these questions responsibly. Thank you, Yaroslava, for the discussion. See you next time on "Medicine in Patient-Friendly Language."