There’s almost no topic in healthcare (and beyond) more polarizing than abortion. But in the setting of new laws that directly criminalize physicians, we need to talk about it.

This may well trigger pretty much everyone, when I released this to the Supporter Tribe on Facebook and the discussion there has been respectful, emotional, and ridiculously productive.

I made is big error in this video though, please read below and watch the following video:

After the video was released, many obstetricians that I respect and trust pointed out that the language I used to describe my 3rd year med school experience with second trimester abortion was scientifically incorrect and misleading. This was unintentional, and I do agree with them, so here’s a deeper dive for those brave enough:

Okay, this is gonna be a tough one. Everyone’s gonna be mad but my goal here is to talk about abortion and actually bring both sides by the ears to the center, if we can do that.

Okay, why is a guy talking about abortion? Because a bunch of guys just legislated what medical professionals can do in Alabama so I think it’s time that we talked about this. Okay, let’s start with just the medical reality about pregnancy termination. 25% of women have had an abortion in this country by the time they’re 45 years old. Just let that sink in. This happens.

So the reality is when Alabama says that we are absolutely outlawing abortions in every single case, including rape and incest, except if the mother’s life is in danger, what they are basically relegating women to do, especially poor women, especially young women, is to either go to a back alley, where they will be potentially injured, made infertile, or die, because that’s what used to happen, or they’re saying go to another state.

Now, that’s preferentially penalizing people who have no money to do that. So what these male legislators are basically doing is telling women you don’t have a right to choose what goes on with your body and they’re telling physicians that you will go to jail for 99 years, murders and rapists often don’t get those kind of sentences, if you do what you were medically trained to do, which is a medical procedure, which is abortion.

Now, why do we even have abortion? Because women want to be able to control what happens to their body. If they get pregnant, they want to be able to actually terminate the pregnancy if that’s what they want to do, if they feel they can’t raise the child, et cetera, et cetera, et cetera. And forget about all the moral stuff for now, we’re gonna get to that, but think about just the practical stuff that happens. Rape, incest, you have an 11 year-old daughter. Would you tell her that you have to carry that baby to term because the law says you can’t do otherwise? That is insane.

Now then, you have the religious side that says okay, we think is a human life and it’s murder if you commit abortion but at the same time, you can’t use contraception, you can’t teach sex education. Anyone who subscribes to a religious belief that says those two things is subscribing to a religious belief that is abject garbage. Grow up and get into the 21st century. We don’t live like this anymore. This isn’t the Middle Ages.

Okay, that all being said, it is a woman’s right to choose what happens to her body, period, and I support that. Now, here is the difficulty now.

When you’re telling physicians you can’t do your craft, when you’re saying to the University of Alabama Birmingham, where I’ve spoken before, that you can’t train residents on how to perform abortions if they’re an obstetrician, how can legislators practice medicine? You want a 99-year sentence? Send them to jail for 99 years for practicing medicine without a license.

Now ZDogg, what do you think about abortion? This is where the people who talk about it in very negative terms and I might have something in common because I’ll tell you a story. When I was a medical student, a third-year medical student, one of my first rotations was OB-GYN. And I saw the miracle of birth. I got to deliver babies. I got to be with these fabulous clinicians who did surgeries and saved women’s lives constantly. And then one couple of days, we went to the urban inner-city hospital and had to be present during late-second trimester abortions that were elective abortions from women that were poorly educated, that were really using it as a type of contraception, and this is what I saw. I saw baby parts being pulled out, a baby basically macerated to death, trying to get away from the probe on the ultrasound, and arms and legs being pulled out. And I saw the clinician who was so dedicated to the rights of the mother and they felt they were so right that they were doing it with almost a kind of a passion.

And it so disturbed me that I still haven’t really settled myself on this. If I had my way, I would wave a magic wand and every single abortion would disappear. We would not do it. A practical answer is well, maybe there should be some limits on elective abortions but in the case of medical need and the case of incest and the case of rape, how can there be limits?

And it’s always a tension between the mother’s rights and what we might imagine is this a conscious entity? And if you look at the bigger picture, you have to look at what is the overall level of suffering in the world?

If we allow an unwanted child to be born when the mother did not want this child and is forced to raise it to term and to bring it into the world, you are gonna create a wave of suffering that goes out into the world in ways that you cannot predict. And sure, sometimes it will go right, but if you look at the cold, hard data, when crime rates dropped in the 90s, most of the data suggest that that was because Roe v. Wade went live in 1973 and we were seeing less unwanted, unloved, unsupported children, less suffering in the world.

So, the bottom line is it’s hard, I hate abortion, I don’t like to see it. Whatever your belief is, we need to come up with practical solutions and the take home is this. We can prevent every, pretty much every abortion, with rare cases where the mother’s life is in danger or there’s an abnormality that’s only described late and they have to make a decision. And it’s called education. It’s called making contraception basically free and available to everyone. You can teach abstinence but if you make that your primary form of sex education, you are deluding yourself. That’s not how humans work.

So let’s be realistic, pragmatic, compassionate, and loving and let’s try to respect people on both sides of this issue because we’re all good people trying to do the right thing using the best moral tools that we have. All right, guys? Do me a favor. Like this video. Become a supporter if you want to get a deep dive where me and Tom talk about these issues in depth in an hour-long show and we out.

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