First disclaimer: I would like to say up front that I am NOT pregnant. This is strictly a hypothetical question based on a bit of research I have been doing.
Second disclaimer: I would like to say that I am a firm believer in using at least 2 forms of birth control, so in addition to being on the pill my boyfriend and I use other birth control options, including but not limited to condoms. I consider abortion to be an absolute last resort so please don’t think this is my way of trying to figure out the best way to throw caution to the wind or anything like that. I don’t believe in leaving things to chance and I want to be as educated as possible about my reproductive rights and responsibilities. My research into the subject to educate myself has failed to answer a few very important questions though, so I am here seeking additional information.
Now, on to the explanation before the questions! I have heard through word of mouth (a.k.a. no cite) that there is a restriction on abortion options for women who are over or underweight. The person who told me this did not have a specific weight range or B.M.I. range or anything but they said that women who are too thin and women who are too heavy are not candidates for surgical abortion options. In my research I have discovered that the RU486 pill is only available to women who agree to come in for a surgical abortion if the pill does not work correctly because it would cause serious birth defects if the child were brought to term.
So if the weight restrictions are correct then does that effectively remove all abortion options for people who fall too far on one end of the weight spectrum or the other? Does anyone here know what the weight limits are, assuming that they actually exist? Does this then mean that women who are too thin or too heavy are then down to only two options, keeping the baby or adoption?
I would like to avoid this turning into an argument over whether or not abortion is right/should be legal/is a lynch pin in the current election/whatever which is why I put it in general questions instead of the pit.
There are no restrictions on surgical abortion options based on weight. Anesthesia becomes more difficult on a heavier woman, but it’s possible. A woman who has health issues that make the abortion difficult, like a blood clotting disorder, typically would be at higher risk carrying a pregnancy to term as well.
I am not an abortion provider, but I am a pregnancy care provider. I know of no restrictions on surgical abortions based on weight.
Disclaimer: I am not an M.D. or any form of counselor with knowledge of pregnancy options or training in that area.
With that said, and making the initial presumption that your hypothetical situation is one where an abortion might be appropriate on socioeconomic grounds, and with the moral question bound and gagged and set firmly to one side:
My understanding is that in circumstances where elective surgery (which is what an abortion technically is, from a medical perspective), people at greater risk than normal if undergoing surgery (unhealthily under- or overweight, high blood pressure, etc.) are discouraged from contemplating surgery, and educated as to the potential risks, so that they can make an informed decision.
it’s not “Surgeon X will not perform abortions on overweight women,” it’s that good medical ethics calls for him to counsel a patient who might be at risk due to weight or whatever, seeking alternatives to surgical abortion and ensuring the patient is aware of the potential risks.
One of the actual M.D.'s or parenthood counselors can clarify or correct what I’ve said where I’m off base.
Really fat is a problem, period, in medicine, and as you point out the catch 22 of using mifepristone in a morbidly obese individual is that if surgery is needed to handle a complication, it’s a bigger deal. On the other hand, you’d rather use mifepristone to avoid a surgical abortion in the first place…
So I wouldn’t be surprised if some clinics turn away the morbidly obese. Most abortion clinics do not want to do complicated procedures and do not want to create a complication they cannot handle.
In general we’re not talking about the tubbies. We’re talking about the really really fat, though. For those of you wondering how we even get access “down there” for the really really fat, I’d like to mention that it’s as hard as you think it is. So hard that even we in the Medical Profession wonder how the insemination was effected to begin with. Another thread, I suppose, where the Dopers could probably clear up something me and my colleagues have wondered for years.