← The Tim & April Show
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- [00:00]
A
You're listening to a new evangelicals production.
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B
As the crispy chicken sandwich from 7 11. People always call me loud and I'm like, yeah, I know I'm crispy. Did you expect me to whisper? If you want quiet, go eat some soup and reflect. Like, I know I'm a handful. I'm bold, I'm juicy. Throw some pickles and barbecue sauce on me and baby, I'm a whole meal. And with seven rewards, I'm just $4 quiet, no crispy, saucy and $4 very only at 7Eleven through 62326 participating stores only while supplies. Lastly, app for full terms, The Tim
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A
and April show, where we unravel faith, politics and culture.
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C
Hey everyone. Welcome back to the show. I am Tim Whitaker.
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A
And I'm April Ajoy.
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C
Yes, you are April. You are April. Ahjoy. Good to see you. I don't know where that came from. We have a very interesting episode today. Kind of, kind of a different topic than what we usually cover. Although very much relevant to Christian nationalism and maga, today we're talking about abortion, which is always, you know, such a fun one. Yeah, just what you want to be talking about on a Tuesday morning. But here we are. We think it's important because obviously April, you and I grew up deeply entrenched in the pro life movement and, and we were taught all kinds of things about, about. About what abortion is and how bad it is, how it's murder, yada, yada, yada. And then you and I, as we deconstructed, kind of took a different approach and kind of changed our perspective on it. But I think, honestly, at least for me, I still have like, questions about. About, like, well, what actually is it? Why is it helpful? Ultimately, I, I just have general questions that I want to have answers by a, a professional. So we're doing that today. Today we're gonna be talking to an actual doctor who deals with this subject a lot of in person and with real experience to kind of help us dispel some of the myths I think that our evangelical pro life movement gave us and why reproductive care is very important.
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A
Yeah, and I'm actually, I'm looking forward to it too, because I think I've done a lot of research and I've learned a ton and I've obviously unlearned a ton as well. But when you come from this world, especially if you're evangelical, very conservative, not only are you very ignorant on the topic, but you're kind of told not to look into it. Like it's it's murder. Period, point blank. That's all you need to know. No, don't look into it anymore. They're going to try to deceive you and tell you it's women's rights. They literally put it in quotes. So, yeah, and I think it's really important because there are so many people that are one issue voters, and if you're taught, like, literally will only vote Republican, like, could never vote for a Democrat because of this issue alone, which
- [02:52]
C
is wild because as we've covered, abortion rates actually went up slightly during Trump's first term. So it doesn't make any sense. But we're going to get into all that and more. So, friends, if you're watching, please make sure to subscribe and like the video. If you're listening on podcast, thank you so much. Please consider sharing this episode and liking and subscribing to the podcast. Okay, so let's bring in our guest today. She's actually a fan of the show, a listener. I met her in person at the Ology Beer Camp, and we were talking behind the scenes and she was like, you know, I think abortion could be a really important topic to cover. We said, yep, let's go ahead and do it. So please welcome Dr. D to the Tim April Show. Hello, Deanna. It's good to see you.
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B
Hi. Good to see everybody.
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C
So let's just kind of hop into it. Why don't you go ahead and give us some of your background, you know, what you do for a living, your credentials, and then we'll hop into the topic.
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B
Yeah, sure. So my name is Deanna de Gruppont by training. I'm a family medicine physician, which means I did four years of college, four years of medical school, three years of family medicine residency to become board certified. I practiced four for a total of about seven years. And then I got injured. I actually have been out of work, but I've spent that time kind of deconstructing my Christian nationalism and learning more stuff. And I think it's made me uniquely qualified to discuss these kind of science topics with the nuance of having that Christian nationalist background. So currently I trained in Louisiana, but currently I live in rural Montana. And I'm a mom and a political candidate. And like I said, family medicine doctor by training and kind of have done all of the things er, obstetrics clinic, nursing home, inpatient hospital, all the stuff. So I've had a lot of different experience.
- [04:37]
A
You've seen a lot.
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C
You've seen a lot. Yeah. You've experienced the Pit seasons one and two in real life, it sounds like that's what I'm hearing you say. So. Well, let me ask you a question, because you kind of said something interesting. You said that you deconstructed your Christian nationalism over time. I'm kind of curious. Is that linked to, or was that linked to your education as a doctor? As you were learning more about health and science and all of these topics, did that kind of start putting cracks in what led you to eventually deconstruct, especially around this topic of abortion?
- [05:08]
B
Yeah, so I would say the short version is abortion was probably one of the biggest pillars to come down. Learning in medical school about embryologic development, fetal development, and then seeing all of the complications that can happen during pregnancy, that really opened my eyes to just how complex of a topic it is. And then in 2020, I was in residency when Covid hit, and I saw the church tradition that raised me turn its back on the healthcare system as a whole, especially physicians, and really villainize us. And that was really hard when I was seeing patients literally in the ICU for Covid, telling me Covid wasn't real and knowing that this was where this was coming from. So I would say that was kind of the final pillar. And then it just all, you guys know, once it unravels, it just crumbles down.
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C
Yes, yes, that's right. Once you start pulling the string, it just starts unraveling. So let's hop into it then. You know, the first thing I think we want to ask you is what is abortion and what isn't abortion? Because I think again, growing up, right, you kind of hear that the liberals want to kill infants up until the point of birth and then some, and that's what abortion is. But, like, what actually is going on here? And what is abortion? Not.
- [06:22]
B
Yeah, so that's a great question. So abortion is, first of all, it is a medical term. It has been politicized for the last 50 or so years, but it's a medical term. And medically we use it to describe any pregnancy that doesn't result in the live birth of a child. So we will call miscarriages spontaneous abortions. A lot of times, the political type of abortion you think of, we call elective abortions, which really is a little bit of a misnomer because other elective procedures are things you can generally delay. So there's a lot of push to change it to therapeutic abortion or medically indicated abortion. For the purposes of this, I'll probably use the term I was trained with, which is Elective abortion, but that's what we're generally talking about. So a miscarriage or a spontaneous abortion is exactly what we think of miscarriage to be. So an embryo or a fetus not surviving and either passing naturally or having to be removed from the uterus.
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C
The,
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B
the elective abortions can be broken down further into several different categories. And I do want to clarify that an embryo is up until the end of the eighth week of fetal development and then it becomes a fetus. I'll probably say fetal development just as a blanket statement, but that's good to know.
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C
I did not know that. Yeah, that's helpful.
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B
That was the thing they drilled into us like week one of medical school in embryology. Embryo becomes a fetus at the end of the eighth week. And also just in relation to that, it can be a little bit confusing because when we count pregnancy weeks, we count it from your last menstrual cycle. But as we know, you don't get pregnant until you ovulate about two weeks later. So it can be a little bit misleading when we talk about these six week abortion bans. Really, somebody's only been pregnant for four weeks because the first two weeks of their pregnancy was pre ovulation. So I think that's something we need to keep in mind when we're talking about this stuff too. And then so out of the like medically indicated or therapeutic abortions, elective abortions, they're further broken down into medication abortion, dnc, which is a dilation and curettage, D and E, which is a dilation and evacuation and an induction abortion. And I can kind of. I'll go into those a little bit more into detail. But you know, like I said, it's anything where the pregnancy ends before there's a viable baby that's delivered.
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A
Is there any case? I've seen some extreme sensationalized stories that come from the right. One of them being I. And I've seen this a lot actually, where they say an abortion is where they go in and they decapitate the baby that is inside the womb. Is. Does that ever happen?
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B
So yeah, let me. How about I break down these four types of like elective abortions and we kind of will touch on where that comes from. If that's. If that's okay.
- [09:26]
C
Yes, please.
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B
So a medication abortion is usually what's used in an early pregnancy. There are some medical contraindications to this. I won't go into all of that. That's for people to discuss with their physician. But this is the two Pill combination. So mifepristone, which has been in the news a lot lately, and misoprostol or cytotec. Mifepristone is a. It binds to the progesterone receptors in the uterus. So basically, especially early in pregnancy, it's very much driven by HCG and progesterone. And so it'll go in and bind to those recept and the embryo or the fetus can no longer get nutrients. And so the contents of the uterus, the blood supply gets cut off. And then about 24 hours later, people seeking the abortion will usually take misoprostol. This is the most common way in America. There are some slight variations, but misoprostol or cytotec, which we sometimes use, like for labor inductions and other things as well. So when we start messing around with these meds, you can see where it could cause problems in healthy pregnancies. And that helps dilate the cervix and contract the uterus to actually get the contents out before 10 weeks. There's a failure rate of about 2 in 1,000 that will require to actually go in and aspirate any remaining contents of the uterus that don't fully come out. But like I said, that's all kind of the nuanced stuff that you would talk to your doctor about individually. A D and C dilation curettage is something we think about a lot of times in relationship to miscarriage or spontaneous abortion. So we do use them medically often for things like a missed miscarriage where somebody goes in for their ultrasound and there's no cardiac activity of the embryo that would be considered a missed miscarriage. Or you had no symptoms that the pregnancy ended, but there isn't a viable embryo in the uterus anymore. We use that procedure, but it can also be used. That's that aspiration procedure where you go in and you're actually manually removing the material. Generally, like over 60% of abortions in the United States are medication abortions, especially because most of them, the vast majority, 96 plus percent, are done before 16 weeks. We consider it to be safe up until about 10 weeks. There's a little bit for the medication, there's a little bit of wiggle room depending on size and all these different factors. Like I said, medicine is incredibly nuanced. So when you get above a certain gestational age, like it might not everything may pass out of the uterus. So then you're going to be more likely to need a surgical procedure. But the, I mean, the earlier the safer, generally because you're not going in and messing around with stuff. There is a lower like post procedure bleeding rate with the surgical type, the DNC or the aspiration, just because you're physically going in and getting everything out. But overall, those first two, especially since they're usually done very, very early in pregnancy, tend to be extraordinarily safe when they're done by legal safe means. A D and E or dilation and evacuation is where this whole idea comes from of like decapitating the baby and all of these things. This, this very like volatile language that can be used.
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C
Yeah, gruesome language. It's just like, it's, you know, very visceral.
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B
Yes. You get people like activated. Right. And passionate about it. So this is where it starts to get a little bit complicated. So DNEs are used for larger gestation pregnancies or older gestation pregnancies. So you're talking 16 up, more like 18 and up weeks usually. So these are going to be for a larger fetus. Now I have to point out that these types of abortions, not only are they incredibly rare, they're only done in a few states in the country as it is, but they are extraordinarily rare circumstances. I mean, there aren't many women that make it to 18 or 20 weeks and just wake up one day and decide, you know what, I don't want this pregnancy anymore. That is not a common way. What usually happens is 18 to 20 weeks, we do an anatomy scan and a lot of times we will find terrible developmental anomalies, oftentimes that are incompatible with life. And these are wanted pregnancies for the most part. These are families that have picked out a name and a nursery and, you know, want this baby and find out their baby has something like anencephaly, where they don't, they're not developing a brain. That is not a survivable condition. And so oftentimes to prevent the mother from having to carry a baby that they know is gonna, they're gonna deliver and won't survive that, like emotional turmoil to prevent that. And also pregnancy is not health neutral. Like every minute you are pregnant, you are at greater risk of an adverse health outcome than when you are not pregnant. So if you are carrying a non viable fetus, there aren't a lot of medical indications to remain pregnant. Now if you have a ethical or spiritual issue where you, you know, objection to it, where you would prefer to continue the pregnancy, obviously people should be allowed to do that, but they should
- [14:47]
C
know and they are allowed to do that. Right. There's no doctor, no state, saying, sorry, you have to now terminate this pregnancy.
- [14:53]
B
We're not like holding women down on the operating table and putting them under anesthesia.
- [14:57]
C
Right.
- [14:58]
B
So with a dilution evacuation, yes. You're dealing with a larger fetus, so it has to be removed in parts. Now most often these are either, this is either a fetus that already has undergone fetal demise, so there's no cardiac activity, or oftentimes what they will do is they will use an injection to actually stop the heart first. I will also add the caveat that we know from extensive studies, autopsies, various things, that not only the nerves in the periphery of the system that perceive pain, but the pathways that go up to the brain and tell your brain that you are feeling pain are not well established and well developed in the fetus until about 24, 25 weeks of gestation, which is generally the cutoff. Most people about agree where we shouldn't be just doing them willy nilly anyway because that's right around viability. So people. Yes, that DNE is a little bit more of a graphic procedure just because of the physical. Like actually having to remove a fetus out of the cervix, but it's not like torture in the way that it's portrayed by the. Right.
- [16:15]
C
Yeah, I mean, what I'm hearing. Sorry, really quick, I just wanted to add, you know, what I'm hearing you say in April. Feel free to chime in on this, but look, obviously we want to deal with this kind of issue as, as gently and as kindly as we can and as humanely as possible. Right. But like you said, a lot of times when you get to this point in a pregnancy and there's an abortion that takes place, something has gone horribly wrong. It's not like someone is bored one day and goes, you know what, I want to take out this fetus and bits and pieces out of me because I just don't care anymore. No, something has gone wrong where the fetus is no longer viable. And frankly, and not to make it sound too, you know, like nonchalant, but any surgery procedure is gruesome and graphic. You can make anything sound incredibly, you know, I, you know, there's stories I've heard of doctors have to like literally torque on a wrench to get someone screwed in like their pelvis as they're trying to, you know, get the procedure done. Right. That sounds insane to me. So like, my point. Yeah. So my point though is that while, yes, obviously it is graphic Obviously it is gruesome. It's not because people just want to kill things or just want to kill babies that that I think is the key part to keep in mind here
- [17:19]
B
and I will say so this brings me into the next type of abortion, which would be an induction abortion. These are more common than a D. Not only are they considered to be safer because you're not having to be under anesthesia, but a lot of families opt for this, especially when it's a non viable pregnancy, because it gives them the opportunity to grieve and bond with the fetus or the baby once it's born. And so this would be just like any induction of labor. So say you find out the baby has a terrible anomaly at 20 weeks, decide you don't want to continue the pregnancy, they would admit you into the hospital, give you medications and have you deliver the baby. Now the D and E tends to be cases more where it's something so such a grotesque anomaly that the family doesn't want to see it, or maybe the pregnant patient has had multiple C sections before and they're at really high risk for labor, things like that. They may be somebody that's kind of risk out of an induction. But most hospitals don't do D and Es. Like I said, there are only a few states in the country, let alone facilities in the country that do them. So induction tends to be the option that is more available, but also the one most families choose just from experience. And I would say just to insert a patient story here, I had a patient in training once that had severe preeclampsia, so pregnancy related high blood pressure. And she was 24 weeks pregnant, but the fetus was so growth restricted from the high blood pressure that he was measuring about 20 weeks. And this was very much a wanted pregnancy. She was so high risk of seizure and stroke and all of these things. We actually had her admitted in the hospital and we were hoping that she could make it to a more viable size because normally 24, 25 weeks we would consider viable, but. But not when it's a fetus that's measuring 20 weeks. So we had her admitted, hoping she could make it until the fetus was viable. And then at some point on the ultrasound, the blood flow through the placenta just was so poor that there was literally no benefit for the fetus to stay inside and it was putting the mother's health at great risk. So with consulting all these specialists, they discussed with the mother that she could either have an induction and that would be considered an induction abortion. Because the fetus would have passed during delivery. Or we could attempt a C section. They gave the baby about a 10% chance of survival. And it was a classic C section, a vertical incision on the uterus. Not that, not the low horizontal incision. So now any future pregnancies at greater risk of all kinds of terrible complications, but she opted to do the C section. And I remember having the realization, I was still very much a Christian nationalist at this point point, but I remember having the realization that if she had chosen to be induced, the baby wouldn't have survived and then it would have been an abortion. And that, like, was something that really sat with me. So I was in for the C section and we delivered a 13 ounce newborn. We almost couldn't intubate the baby, he was so tiny. And I never got to follow up on what happened. But I'm pretty sure he did not ultimately survive. He wasn't doing well when I switched hospitals for training. But, you know, I mean, these are the kinds of scenarios we're talking about. These are like, yeah, very fraught decisions that are involving multiple doctors, multiple specialists, family, friends, clergy.
- [20:55]
C
Yeah.
- [20:55]
B
Counselors, all of these people. And, and when the government comes and starts messing around in these very nuanced situations.
- [21:03]
C
Right.
- [21:04]
B
We see lots of problems.
- [21:05]
A
Problems, yeah. Yeah. I remember having a conversation with one of my conservative family members around, and I was still very pro life. Honestly, I still consider myself pro life because I think that. I think being pro choice is the most pro life position that you can have. But I was very like, pro, anti abortion still at the time because I just still had a very misunderstanding of it. But I was nuanced enough to know that if it was between me and my baby, like if my life was on the line, I, I would probably still choose to risk my life for the baby, but I feel like that should be my choice. And then the. My family member that I was talking to, she was like, no, it shouldn't be. Like, I shouldn't be able to have a choice. And I remember being so confused. I was like, you wouldn't want. Because you have other children, you wouldn't want to at least have the option to decide whether you want, like whether your other children should still have a mom. Like you think the government should make that decision for you. Like, that is a really complicated, hard situation and decision to be in that. I think at a minimum, even if you choose to try to make like to, to sacrifice yourself for the baby to live, that should be your choice, not some random politician in D.C. yes.
- [22:24]
B
Right. And when people talk about like, oh, I hope my husband chooses the baby over me, and all these things, like those scenarios don't happen with a viable pregnancy. Like, if you were past viability and your life is at that much risk, we just deliver you, period. So there's. That's not really a conversation that gets had very often. But yeah, I agree. I mean, if especially. It gets especially complicated when it's a mom that already has other children at home, if it's the first pregnancy, sometimes it's a little bit different. But when there's other kids at home relying on you, I mean, as a mom myself, how do you. I wouldn't want to make that decision for somebody else.
- [22:58]
C
Right, exactly. I mean, I'm also, based on what you just talked about, I'm imagining this is why third trimester abortions are so incredibly rare, because things have to get to a point where all the markers are green. Then suddenly almost, it seems like, you tell me if I'm wrong here, but out of the blue, something is direly wrong with the fetus inside and something needs to happen that's drastic. Which is a very different narrative then liberals want to kill children up until the point of birth. Like, you know, again, like, there's the propaganda, then there's the reality, which is, by the way, full of much pain. Like, you said these, I mean, we, we had our crib and our room painted well before Sarah gave birth to Tim or to Harper. Right. So. So we're expecting this to happen. And if we went into an appointment that was routine, and the doctor goes, hey, guys, we have a major problem here. We need further testing. And then that testing showed that the fetus was no longer viable. That would be heartbreaking. What I don't need is the government telling me or my partner, on top of your heartbreak, you have to be forced to deliver this fetus so that we tell you to, even if it's at great risk to your partner. That is for me, like, where it gets just so wild.
- [24:10]
B
Right. And so I feel like it's important to point out here that abortion is 14 times safer than natural childbirth. So that's also something I think is propagandized. And so like you said, in these third trimester cases, which I've never seen one, most OBGYNs I know have heard case reports have never actually been in the room for one of these.
- [24:35]
C
The Data is like 1% or less. It's incredibly, incredibly aware.
- [24:38]
B
Yeah, it's like less than, less than 1%. It's point, you know something? Percent. Because even say you were 30 weeks and suddenly found out that the fetus wouldn't be able to survive, most of the time, we would induce you. Unless you've had multiple C sections, sometimes with twin pregnancies, where one twin is viable and the other one isn't, this will be the procedure that is done. You know, like, these are extraordinary circumstances where everything has to kind of line up in just the right way, and then somebody's gonna have to travel. But in practicality, like, these are not just like, oh, yeah, I get to go, you know, do this. It's not even the doctors performing them. It's not like I've heard physicians say, I'm pro abortion the way I'm pro appendectomy. Like, I want you to be able to have one if you need one.
- [25:32]
C
Right, right.
- [25:34]
B
And I do want to just mention here, like, globally, 13% of maternal deaths are related to unsafe abortions. So people seeking illegal abortions, you know, not through these means. And so that's why it becomes such a big deal when the government starts mucking around and restricting access. Because now not only are women having later abortions, which are higher risk because care gets delayed, but your people will. People get desperate. I mean, think of an animal stuck in a trap, right? It will not leg off if it needs to. And I think we don't realize how desperate some people can be in these circumstances, and they will try to find a way to do it. And then we see people getting harmed in the long run.
- [26:23]
D
Hey, everyone, this is Melinda Hale, the executive director of the New Evangelicals. Listen. Every day we hear from people who feel isolated, disillusioned, and hurt by a version of Christianity that has been hijacked by politics and nationalism. And yet they still long for a faith that is rooted in love, justice, and compassion. And that's why the new Evangelicals exist, because we believe there is a better path forward. We're creating resources, hosting conversations, and we're building communities for people who want to reclaim Christianity and stay rooted in the teachings of Jesus. But building a movement like this takes time. It takes energy, and it takes financial support. So if this podcast or our YouTube, our educational offerings or community space or any. Anything that we've created has impacted you, would you consider becoming a donor? Even a gift of $5 makes a huge difference for small organizations like this. Your support helps us to continue empowering people to put their faith into action by rejecting Christian nationalism and to live in a way that shows people how to truly love our Neighbors together. I know that we could build something beautiful. So visit theneweevangelicals.com support to give today. You can find the link right in our show Notes. Thank you for standing with us.
- [27:40]
C
Let me ask you a question. One of the big pieces I hear of propaganda, especially from folks like Ali Stuckey, is there's two points I want to bring up about that person in particular and what she says. Number one is oftentimes she will say that a DNC is not an abortion or a miscarriage is not an abortion. And she'll try and separate the term abortion from, like, things that you just described. And so can you just speak to that, like, how these things are? Because, you know, there are several horrific stories of women who have bled out in hospital rooms because of these. These blanket abortion bans that make these hospitals have to, like, get lawyers involved. By then it's too late. But then Ally will say something like, you know, or someone like Ally will say, hey, but that wasn't like an abortion. They just, they didn't get the care that they needed. It's the hospital's fault. Can you kind of speak about that, like, how these laws actually impact women's health?
- [28:31]
B
Yeah. So, I mean, again, abortion is just a pregnancy that doesn't result in the live birth of a fetus. So technically, a stillbirth is not a medical term either. That would be like, technically an abortion. But that's a little bit more nuanced of a conversation. Obviously not for this episode.
- [28:52]
C
Sure.
- [28:53]
B
So, yeah, people on the right like to say that, like, if there's a medical reason or like, say, you know, you are induced at 20 weeks or 18 weeks, that that's not really an abortion, but that's the definition. Like, we, we will call it an induction abortion or, you know, a D and C. You know, there is a little bit of nuance when it comes to, like, did the cardiac activity stop before the procedure or after the procedure? But still, it's still technically would be a spontaneous abortion. So there's something called a missed miscarriage, which I kind of touched on earlier, where basically you still think you're pregnant. You go in and then there's no cardiac activity. And so at that point, especially if you're in the first trimester, you would need a dnc, and that's just completing the abortion. That's the way that's the terminology we use. It's an incomplete or a missed abortion. And then we go in medically and complete, complete the procedure because your body didn't do it naturally, but.
- [29:49]
C
Right.
- [29:49]
B
If you, you know, you want to argue over semantics, you want to change the definition of the word, that's a different conversation. But medically, this is the definition of it. And it gets real messy when you start going in and trying to split hairs and make laws, especially when so many different things can go wrong with the human body. I. I had a patient one time. Like, I feel like this is such an important story that people on the right don't understand. I had a patient that was seven months pregnant with her fourth child that I admitted into the hospital because she was in liver failure because she had cervical cancer that had spread to her liver. And when I asked her, she was on hospice, and we knew she'd deliver the baby and she wouldn't survive very long after. And when I kind of asked her, like, how did this happen? Because in America, we don't see a lot of cervical cancer, especially not that advanced. And so, long story short, she got diagnosed with stage three disease when she was, like, 10 to 12 weeks pregnant at her first visit for this pregnancy, they recommended a termination and a hysterectomy. This was prior to Dobbs. So even back then, she still was not able to access it because she would have needed to travel. We will touch on insurance briefly, but because of laws with federal dollars, most states do not have Medicaid that covers abortion care. That's a huge problem we can get. We'll get to. In a minute.
- [31:21]
C
Sure.
- [31:22]
B
And there are a lot of private insurances that don't cover it now, thanks to some rulings with the Trump administration. But so that's another problem. I mean, if you think about. Especially black women get disproportionately affected because of systemic racism. We tend to see lower socioeconomic issues with black and brown women. And so now you need somebody to travel. You need them to arrange childcare for their other children while they travel. They need to be gone for at least two days for a procedure. It's a whole bunch of hoops to jump through. And so she was not able to get the care she needed. The pregnancy continued. You're immune compromised when you're pregnant. Cervical cancer is caused by a virus. So it just spread and spread and spread and eventually spread to her liver. And. And it was very, very sad.
- [32:08]
C
Can I ask a question while you're talking, just so I understand. So the. This woman who couldn't get access to what she needed, I'm assuming, you know, she obviously, at some point went to, like, a doctor's office to confirm their Pregnancy. Do not all doctors or not all facilities perform abortions? Is that kind of how it works if you go somewhere special for it? I just don't know.
- [32:27]
B
Yeah. So yes. So medication abortions are much easier to access, but you still have to have pass all these different guidelines to be a facility that offers that. And a lot of that has to do with federal restrictions. Has to do with you. Like I mentioned the funding issue and I kind of have a timeline of different cases that I'll touch on in a second. But if you. So if you have. She had Medicaid. If you have Medicaid and Medicaid dollars are not allowed to be used for abortion care. Not at that point. She would have needed, especially with cervical cancer, she would have needed some kind of surgical procedure. And where I trained in the south, there just weren't a lot of places that offered it. So she would have had to travel. And medication is a lot easier to obtain, obviously, but she wasn't a candidate, so.
- [33:20]
C
Got it. Okay.
- [33:20]
B
That's when you end up in this situation. Thank you.
- [33:22]
C
Yeah.
- [33:23]
B
And then also the surgical procedure is much more expensive and if you don't have insurance that covers it.
- [33:28]
C
Right.
- [33:28]
B
How are you going to even begin to try to. Oh my gosh, people doing. Yeah, go fund me for cancer. But people abortion still so stigmatized that people aren't going to go and advertise I need to fundraise to go have an abortion in another state. Like that's just not a common thing. So I had asked her, what about in between your pregnancies, your, your general gynecologist didn't notice on your pap smears, you know, that you had pre cancer or cancer. And she told me that she only qualified for Medicaid when she was pregnant. So in between pregnancies she didn't go to the doctor. That is not pro life. Right. That is also not economically like fiscally conservative. Because now you're paying for a high risk pregnancy, a NICU baby and four kids that are going to grow up without a mom.
- [34:15]
C
Right.
- [34:15]
A
So that's like another thing I don't understand about the like extreme pro life. You know, anti abortion people is like usually they are extremely anti abortion. They want it completely banned, no exceptions. But they're also against universal health care. They're also against paid family leave, they're against paid child care, they're against easy access to birth control and they're against comprehensive sex education. Like they only want to teach abstinence. So they literally the thing that they want that they claim they care about more than anything. They fight against the things that would actually lower abortion rates. And I was seeing. I've seen a bunch of people talk about this online lately, but Texas has a pretty extreme abortion ban in the state, and I saw that because of their abortion ban, between 2019 and 2022, the maternal mortality rate rose by 56%.
- [35:15]
C
Yes. And infant mortality rate went up as well. Yes, Both.
- [35:18]
B
Yes. Yeah, I saw. I mean, this is obviously based on all kinds of math calculations that I don't understand, but based on all of the data and kind of looking at that I'm reading from my notes here, but. And. And it's. It's in the references I. I sent you guys. They believe that a total national abortion ban would increase overall maternal mortality by 21% and by 33% in black communities.
- [35:46]
C
And that's. That's. That's not to say that we already have very high maternal and infant. Infant death rates in this country compared to other countries that we compete with on the health care level. Our health care. Yes. Especially for black women and other marginalized groups. Right. I mean, the health care is. It's already bad, even for the. Whatever for white women. It's even worse for black women. And then this would even make it even worse. So it's not like we're starting from the top to go down to bronze. We're starting out like bronze, and we're gonna get off the fricking podium if this actually happens.
- [36:23]
B
Right. It's pretty bad. The only ethnic group that has a lower maternal mortality rate than white women are Asian American women, which I don't really fully know the reasoning. I find that interesting. But for. When you compare white women and black women, it's about four times.
- [36:41]
C
Oh, my God. Right?
- [36:42]
B
More. Yeah.
- [36:43]
C
Right. Yeah, I'm with you, April. You know, that was part of my unraveling, too, is like, wait, if you guys cared about what you say you cared about, if you really thought that an embryo at week four was a. Was a. Was a child, Was a literal child, wouldn't you do whatever you could do to prevent that pregnancy in the first place or to give that person as much access to the things that we know contribute to abortion rates, especially elective ones. Right? The poverty gap, access to health care, paid family leave, livable wages, et cetera. But no, they consistently vote against those things that make the system worse and worse. Then they punish the people who get access to care that they need. It's just. It's such a bad cycle. It's Wild. It's wild, right?
- [37:25]
B
And also if one in four pregnancies, sometimes as high as one in three, you know, because we miss a lot of them, result in a miscarriage. Wouldn't you be pouring tons of research dollars into figuring out why women miscarry?
- [37:36]
C
Tons. You would think. You would think.
- [37:38]
B
Because that is a way higher number than abortion rates, I guarantee. Like, it's good. It's exponentially more every year that are. If you believe that's a full human, a full person, a full life. Like we're losing more of those every, every year. And I, I wanted to mention also when we're talking about mortality rates, it's important to mentioned that the number one cause of maternal mortality in this country is homicide, usually by an intimate partner. So usually by a spouse or the person that got you pregnant. And so also we're not doing a whole lot to try to address that in this country.
- [38:19]
A
I actually got into it with some right wing people on Twitter because I'm back on Twitter because of my life.
- [38:26]
C
And you're all alone out there. There's no reinforcements. We all left.
- [38:30]
A
I know, like I don't have enough rest of my life with some right wingers, but I got into it with actually Megan Basham because I don't even remember what it was she like, I don't remember.
- [38:41]
B
I think she must like torture.
- [38:42]
C
I'm telling you. Geez.
- [38:44]
A
But we were talking about abortion or she brought up abortion and just to call me a baby killer because, you know, and when you come from that world, if you vote Democrat, that makes you a baby killer by proxy. And so I actually took the time because I'm Beecher is way more patient with right wing people than I am and actually is like, here's how we explain everything. So I tried that method and I was like, listen, I totally understand why you are against abortion because I was against abortion for a long time too. But I had to become pro choice because it's, and like I said earlier, it's the most pro life position because everything that you support in a pro choice position actually helps lower the rate. And abortion bans we see statistically do not lower the abortion rate. The rate actually goes up and you, you put women at risk. And I mentioned, you know, there were some women who died in Texas because of the strict abortion ban that the doctors did not perform. I don't know if it was a DNC or whatever that they needed because of these abortion bans because you have doctors that now risk losing their medical license or Possibly even go to prison by performing, you know, giving this life saving procedures that these women need who have miscarriages. So I say all of this and then I had these like really, really pro life stuff and people that like their whole page is like just gruesome images of bloody fetuses saying that, you know, well actually there's always room in these abortion bans for exceptions for miscarriage and that it's the doct doctor's fault for not doing it and that they actually were doing the wrong thing. But like can do you know of situations like I know that they're playing this very black and white, but do you know of situations where like. I don't, I don't think it's, I don't believe them. I think it's because of the laws that these doctors were not, you know, that are hesitant and that women die because, you know, because a lot of these situations require emergency decisions, like really quick decisions in order to save these women's life. And if you have a hesitancy because you don't want to lose your license, we're talking about your entire livelihood. I think these abortion bans would impact doctors decisions. Have you seen this happen?
- [41:01]
B
I mean, absolutely. I'm in a lot of social media groups with lots of other doctors and even the ones that are like, I'll deal with the consequences, I'm going to do what's best for my patient. Sometimes the hospitals have different roadblocks because they're worried about getting held liable. And also in some states you could spend life in prison.
- [41:27]
C
Wow.
- [41:28]
B
That's not nothing. Like it's one thing to lose your license and your livelihood. It's another thing to not see your family ever again. And you're asking doctors to now take that risk. That is an impossible decision to make. So I will share. This was also pre dobbs and thankfully she didn't have any barriers to care. But this is a physician mom that I is a friend of a friend. She was 22 weeks pregnant with twins, very wanted pregnancy and she started leaking amniotic fluid at 22 weeks. So her water started to leak and once that kind of seal is broken, bacteria can get in to the uterus and then that can become a huge problem not only for the fetuses, but mom can become septic. So they put her in the hospital and they had her on antibiotics and they were trying to get her to 24 weeks. Especially with twins, they're usually a little bit smaller. But she started to show signs of intrauterine infection. And she and her husband made the decision that she would be induced and deliver the babies. And they were born alive, but they didn't survive. And that's an abortion. That's an abortion. That's an induction abortion. And a lot of people on the right want to say, no, that's not because you delivered the baby, but you delivered a baby you knew wasn't going to survive with the intention of it not surviving. So technically, that's an abortion. And then they're trying to pass laws in some states where you would be required to give all. All emergency care to that baby to try to get it to survive. And so especially in a situation where it's like a birth defect, where we know it won't live, you're talking about whisking the baby out of the delivery room, taking them to the nicu, hooking them up to a bunch of tubes and machines, and trying to resuscitate them away from their parents. The few hours the parents might have bonding with them and saying goodbye. Gone now.
- [43:22]
C
And they're stuck with the bill, right? They're stuck with the bill, right?
- [43:26]
B
Yeah.
- [43:26]
C
The state's not gonna pay for that.
- [43:27]
B
These are not cheap, right? Yes. Yeah. I mean, in 1988, my older sister passed away from a congenital heart defect when she was an infant. So she was a newborn. And in 1988, that bill was almost $100,000. So, oh, my gosh, imagine what it would be now.
- [43:51]
C
Yeah. I mean, our healthcare system is so broken. As, you know, as a. As a doctor yourself, you know, it's like I. You know, it's. Anyway, April and I rant about this all the time, but we have an expert, so we'll keep it to more expert topics. But my question for you, Deanna, is talk about. About the changing legal landscape. I mean, obviously, a lot has changed over the past couple years. Roe v. Wade has been overturned. How has that affected access to abortion? What have you seen happening in the healthcare spaces that you occupy? Like, are there other decisions that have been made federally that have also impact this work that then impact the lives of people who are trying to give birth or who are pregnant? Talk to me about that.
- [44:29]
B
Yes, really quickly, before I do, I do want to just mention ectopic pregnancies, because this is another hot button issue that the right brings up. Ectopic pregnancies or just any pregnancy that doesn't occur in the uterus, most commonly in the tube. The right tries to say you can reimplant it in the uterus. That is not A thing. Oftentimes we can give medication for these or sometimes we have to do surgery. I don't know if we would. I mean, technically it's an abortion because it's not resulting in the live birth of a baby. But we don't normally characterize it as that in the medical record. But I did just want to mention that because that becomes one that they kind of mess with. But yeah. So in terms of the legal stuff, so Roe was passed in the roe decision was 1973. And all that did was say that the government could not become. Could not come between a patient and their doctor for these health care decisions. That's it. It didn't like make it a free for all. It, you know, it wasn't just like, yay, abortion everywhere. It just said that the government couldn't put a bunch of restrictions on it. And then the Hyde Amendment was passed in 1976, and this was a law and that said that no federal tax dollars. So mostly Medicaid, because Medicaid is disseminated by the states, but it comes from federal dollars. So they. The states allocate the money. Sorry, the federal government allocates the money, send it to the states, and then the states use it to provide care for the people in state. So because a lot of people objected and had moral issues with their tax dollars funding abortion, the Hyde Amendment was passed. And so no Medicaid, no federal Medicaid dollars are used for abortions. There are some states that have special funds for this. Obviously they tend to be blue states, but for the most. Most states do not offer it. And as a result of this ruling and adjustments to. Sorry, this law, and adjustments to this law that also affects tricare, which is military insurance, so va, they can't access it.
- [46:40]
C
Wow.
- [46:40]
B
Indian health services. So indigenous people, which we also know as a underserved, impoverished population. And then anybody incarcerated in the federal prison system, which I would have questions about how they got pregnant in the first place, if they are in the federal prison system. That's probably a whole other topic to discuss.
- [47:03]
C
Yep.
- [47:04]
B
Because a lot of those are under questionable circumstances. So California, New York and Oregon, they require all private insurance to cover abortion. And they also have funding. 26 states have bans on private insurance covering abortion care, and 11 even offer exemptions for assault. So you can see where that would also be a huge barrier to care. In 1992, there was a Supreme Court case called Planned Parenthood vs Casey. And so this was the ruling that was passed saying that a state could not place any undue burden on a patient that was seeking abortion care because, you know, they started trying to put restrictions about waiting periods and ultrasounds and a lot of states still have those things. But it was saying anything that would delay the care a significant amount. Now whether that's truly been followed I think is a different topic of conversation. I'm not a lawyer.
- [48:04]
C
Right.
- [48:05]
B
But and obviously with Dobbs that went out the window. And then partial birth abortion is a big one that is not a medical term. Also that's kind of this D and E procedure that people talk about which like I said, these are extremely rare. I've never seen one not in training, not in practice. I have never personally known anybody that has had one. I know a lot of obgyns, so I know some that have either in training or in practice performed them. But again, these are extraordinary circumstances and they're only done in a few states that get special facilities. But this idea of partial birth abortion came from the belief that, well there was an old practice where the fetus would be partially delivered and then the cardiac activity would be ended and then the rest of the fetus would be removed. And so that ruling was based on that specific procedure. But now we do a different procedure because that's a federal thing. So there's no like partial delivery of the. If the fetus starts to be delivered, you have to complete delivery. That's just the law now. And then the funding restrictions actually were part of the Affordable Care Act, Obamacare. I suspect that they probably couldn't get it passed through Congress without agreeing that private, there could be restrictions on private insurance providing money for abortion. The Louisiana and Texas do not even have for the life of the mother like I mentioned. And then I'm sorry, it's nine states that don't provide it for assault or incest. So even in those situations which the court system is slow, we know this. So even say you are in a state that has a funding exception for those things, you still have to get lawyers. You're still going to be delaying care to try to get the money to get it covered. So that's a whole different topic. And that's why a lot of times when you think of like a Planned Parenthood clinic, when people go to get especially a medication abortion, you're talking about in the several hundred dollar range because otherwise it would be unaffordable for people that need the care. I couldn't give you a number on what these more surgical procedures that was highly variable from hospital to hospital, state to state. But I, I can imagine people going into significant medical debt if they were in a real, you know, medically dire situation where they needed one of these procedures. And we've heard stories of women that have had to travel.
- [50:49]
C
Yeah.
- [50:50]
B
And take a second mortgage on their house to be able to travel and go have this procedure done in another state because their life was at risk or, you know, whatever there was. Oh, her name is escaping me right now. But a white woman.
- [51:04]
C
Was it Katie?
- [51:05]
B
Was there something really. That became really public. She was leaking amniotic fluid and getting an infection, and she ended up having to travel, I think it was to New Mexico to go have the procedure. But she, like the doctors in Texas, were worried that she wouldn't make it to the other state because she was getting infected. But they also couldn't facilitate the transfer because they would have been aiding and abetting. And so they had to let her leave against medical advice, get in the car with her husband and drive to another state or fly on a plane to another state to go get the care she needed. There's nothing pro life about that. So there was a recent case out of Louisiana where basically Louisiana was saying that patients using telehealth to get the abortion medication sent to them were violating Louisiana's state's rights. And for a few days, the ruling was such. Because they sided with Louisiana initially, the ruling was such that the only way to get the medication was to physically go to a clinic. You couldn't get it from a pharmacy or get it from the mail. And then On Monday the 4th, there was a stay by the Supreme Court actually saying, wait, hold off. Because other states were saying, well, now you're violating our right. Because even patients in pro choice states now couldn't do telehealth, couldn't get it from the pharmacy prescribed by their doctor. That is something to follow. That's going to be a thing. And then the so Dobbs in 2022 is the big decision, obviously. Right. They turned it over to the states. But now we're seeing the results of that. Yeah, we talked a lot about already.
- [52:50]
E
Hi, my name's Simon and I'm in Sydney, Australia, and I'm a monthly donor for the new evangelicals. I found the tne Instagram in 2021. I'd recently stepped down from my job as a pastor. I was beginning to find a real conflict between what I was beginning to believe about God and the world and the church and the evangelical spaces I was in. But at the time, it was really dark for me. I was really lonely. I was really isolated. I had so many questions and finding a space where it was okay to ask questions and to share my thoughts and ideas and hear other people's ideas years at the same time and just be able to connect with so many people that were going through similar things was incredible for me at a time when I needed it most. Since then I've been quite involved with the organization for a while. I was the moderator admin for the Facebook group and now I've just started out on the New Evangelicals board. I would love to encourage you if you can make a monthly donation to the New Evangelicals. There's some great work happening and particularly Project Amplifying and the opportunity it has. So many voices to give so many voices a chance to be heard. I know it's something I needed in my dark moments. It's something we're able to contribute to that can help other people as they begin to smell the fresh air outside that basement of fundamentalist evangelical spaces.
- [54:22]
C
I think a lot of us don't understand like the full on assault that's happening, you know, with these bills being introduced as much as possible to try and get all abortions deceased in the name of this pro life agenda. Before we wrap up here, why don't you go ahead and talk a little bit about the level of training it takes to become a doctor and why you think politicians are should not be the ones making these bills or writing these laws and then we'll get ready to wrap up.
- [54:46]
B
Yeah, so there's a graphic we can put on the screen, but if so, if you go straight through college, through medical training, it's four years of college, four years of medical school and then three to seven years of residency. For family medicine I had to do three things like pediatrics also do three OBGYNs do four years and that's for a general OBGYN. So if you're talking about an OB GYN that has extra training and family planning or high risk pregnancy, that's another several years of training after their four years of residency. And emergency doctors get three to four years depending on what program they go to. And along the way we are taking test after test after test. I had to take a test to get into medical school. I had to take three board exams and pass them during medical school. One within the first year after graduating and then one to be board certified in family medicine. If you are say a high risk pregnancy doctor, you do all of those medical school ones and then one for obgyn, which is an oral where they ask you questions, you have to sit in person and defend what you would do in certain cases. And then they have to also take a certification for their maternal fetal medicine. So it's not just like willy nilly. And so when politicians that don't have any frame of reference come in and start mucking around like they don't, they call it a heartbeat at six weeks. It's cardiac tissue. It's not even a fully formed four chamber heart. You know, we're not talking about, you can't tell just by looking at them. It's hard to tell tell a human embryo apart from like a dolphin embryo. So that gets really complicated. And I also think when you start talking about like insoulmen and all of those things, you have to. I know you guys did an episode with this on people that are a little bit more experts in this area than me, but like who decides when that happens? And like, personally for me, I believe like around the time of consciousness is when you could, you should can say that one person has like personhood and autonomy. And I think that that is a safe place to draw the line. Because on the other end of the spectrum, brain death is something we deal with in medicine. That's why I've actually dealt with more than abortion specifically. But you know, brain death is anytime the brain stem and the actual cortex are not functioning. So usually from lack of blood supply, lots of different things can cause this. I won't get into all of that. But we can keep somebody's body alive on machines for a while, but they don't have any brain function. Like what makes them them is no longer existing. And once somebody is declared brain dead, which is a whole process, it takes multiple doctors, all kinds of testing. Once somebody's declared very brain dead, like that is their time of death, brain dead is dead. And so when you talk about organ donation, usually that's it's, it's in somebody where their body is still alive by machines, but there's no consciousness there.
- [57:54]
C
Right.
- [57:55]
B
And so that's where I kind of draw the line. And we know around this viability period is when babies will, or when a fetus will start to respond to music and the mother's voice and all these different things. And that's a conscious experience experience. So I, that's kind of where I draw the line personally. And I think that that carries over into those other areas like I'm talking about.
- [58:17]
A
Yeah, I think it's also I interesting too how the right is not only demonizing abortion, but is now wanting to Punish women that have to go through that. Like you see these bounty hunter laws that are in Texas where you can just like tattletale basically and report people that go out of state to get abortion. You can like sue them for 10,000, I think upwards of more than that dollars. And like to me, like, where's the pro life in that?
- [58:53]
B
Yeah, I just heard of another case. I think it was Mississippi, it might have been Louisiana where 16 year old was pregnant and the mother was planning to take her out of state to get a termination and somebody reported it and CPS came and removed the 16 year old from the home until after the appointment for the abortion in the other state had passed.
- [59:16]
C
I believe that in this, like I do. Deanna, if folks, first of all, I appreciate you making so much time and coming on and giving us your expertise. I think it's really important that people get educated on what's actually going on versus the narrative that the very loud megaphone of right wing media pushes, especially around this topic. But I know you're also running for a political office in your local state. If folks want to follow you or kind of get behind what you're doing, where can they do that?
- [59:41]
B
Yeah, right now social medias are all Dr. Dr. Deanna d e a n n a 4 f o u r Montana. All lowercase, kind of easy to remember. Dr. Deanna from Montana. And I'm running in For Senate District 19 in the state of Montana.
- [60:04]
C
All right, sweet. Well, Deanna, listen, I really appreciate you making time and coming on the show. It really means a lot. Folks. We'll make sure to follow you for sure. Let's keep in touch because we need some kind of expert on hand in this, in this, in this avenue of really the Maha movement that I think is doing so much damage. So I really appreciate your time and we will definitely keep in touch.
- [60:24]
B
Sounds good.
- [60:24]
C
Awesome, thanks.
- [60:25]
A
Thank you, Deanna.
- [60:27]
C
Oh my goodness. April. Jeez, I hate it here.
- [60:33]
A
It's just so hard you deal with like when you have conversations, refuse to acknowledge the nuance and the complications of this topic.
- [60:43]
C
Yes.
- [60:44]
A
Like they just call you baby murderer. That's it. Baby killer. I know, like there's no you. It is frustrating. But don't, don't let them gaslight you because it is so much more complicated. And like, truly, I switched from being very anti abortion to being pro choice because I am pro life because I saw all the harm that was caused by these abortion bans. They don't work. There are better ways. If your goal is to lower the Abortion rate. There are better, much better avenues to do that than just banning it.
- [61:17]
C
No, totally. And I think it's worth pointing out that there are other people groups with different religious preferences that we don't force people to accommodate. Meaning, you know, Jehovah Witnesses won't take blood transfusions. We don't have a law saying, sorry, you have to get this done to your body. Right. Like, there are other things that people will say I can or can't do when it comes to my, My, my own medical and my own healthcare. But for some reason, when it comes to abortion, we have to control women's bodies and what they do or don't do. And given what we just heard, all the complicated, you know, factors that go into why an abortion might be necessary, even what, even what the term means in and of itself has been so misconstrued. It's so, you know, the more I think about it, the more aggravating it is. And then you add the fact that the Moral Majority, which started this whole charade about the war on, you know, abortion started initially over fighting desegregation. And then they wanted to find a new wedge issue. So they found abortion was a good wedge issue. And even the Southern Baptist Convention, the sbc, right, said in the beginning that they were essentially pro choice. They had a pretty moderate pro choice position that as long as if it was endangering the life of the mother or her mental health, abortion should be permissible. So it's not even like this has been some, Some, Some from the beginning position that even evangelicals have had. They just been brainwashed over time by these larger forces to vote against the interests of themselves in many cases. And it's just very frustrating, frankly.
- [62:44]
A
That it is. That it is, Tim.
- [62:47]
C
Okay. Yeah, it is. Anyway, friends, well, listen, I appreciate you all listening. April and I love doing this show. We love your thoughts on this kind of episode. If you want more of these, you know, special focuses, I think might be worth doing a few different ones because this one on abortion was just so helpful for me. I mean, I learned so much. So let us know in the comments what you think. As always, make sure to like and subscribe. And we will see you all on Thursday. So I'm Tim Whitaker.
- [63:12]
A
And I'm April Lajoy.
- [63:14]
C
That you are. We'll see you later.
- [63:16]
A
Bye.