Hi, everyone.
I'm Kate Smith from Planned Parenthood.
And this is Planned Parenthood presents the state of abortion.
This week we have another incredible guest.
We're talking to a provider in Houston.
His name is Dr. Bhavik Kumar.
He works at our Planned Parenthood affiliate in Houston.
And he's experiencing all the new laws that are happening in Texas.
And can speak to us from his experience on the ground.
Dr. Kumar joins me now.
Dr. Kumar, thank you so much for being here.
I really appreciate it. Hi, thanks for having me.
If we can start off by getting everyone on the same page,
can you walk me through all of the different abortion laws
that are on the books in Texas right now that you're abiding by since Dobbs?
Yeah.
So I think since the Supreme Court decision was made,
that's the most important one, which really bans all access to abortion
meaning since the decision on June 26,
we can no longer provide any kind of abortion in Texas.
And I think since the Dobbs decision, there's really been a chilling effect.
And, you know, murky waters, gray areas uncertainty.
We haven't been in this place where Roe wasn't the law of the land
in almost 50 years.
So we don't know what these laws that were on the books in 1920 something
actually mean and how far governments will go to enforce these laws.
And what we're seeing in reality is, and you know, I've heard these stories
I'm sure other folks have heard some of these stories about people
presenting to the emergency room with an ectopic pregnancy
or somebody having a very serious emergency,
but they're not sick enough to get the care yet.
But at the end of the day,
doctors and clinicians, we know how to practice medicine.
We know what we would do
outside of this context out of this legal, political context.
But it becomes difficult and murky and complex
when we have politicians making these laws about what we can and cannot do.
And it doesn't make sense to us.
Have you yourself been in a situation where it was murky, like you
say, since Dobbs in terms of treating a specific patient like that?
Yeah, absolutely.
You know,
I think it's really surprising how much it shows up and how heavy it feels.
You know, certainly
I take care of patients that are coming in for an ultrasound and wonder
how far along they are in the pregnancy or have questions.
And so we can still
see these patients and assist them in whatever ways that we can.
But in the back of my mind, I'm still thinking, am I allowed to say that
before I say it?
Now it feels like there's this other entity
that's in the room and it's the government.
And of course, providing abortion care in Texas, this is not new.
It just feels heavier and darker now because I'm thinking, oh,
before I do something, let me make sure I'm
not going to get in trouble, not because I'm doing the wrong thing
just because the government is being more aggressive and intense and their pattern
of behavior and doing things that are not in the interest of people,
not about health and safety, and actually really harming people.
Having that extra entity in the exam room, like you mentioned,
having kind of that third entity, you, your patient and the government,
has that impacted your ability to provide the best possible care for patients?
Can you say that?
Yeah.
I mean, I think
it would certainly be easier if, you know, that third entity wasn't there.
So if that wasn't there and it didn't have to think about that and I wasn't worried
about all of these potential scenarios that haven't even happened yet,
I could really fully focus on my patient and take care of them.
In the law that is on the books right now that governs Texas, this 1925 Pre-Roe
abortion ban, there's
no exceptions for rape and incest, but there is one for the life of the mother.
To me that seems very clean on paper and very messy in practice.
Can you walk me through that?
Yeah.
I think when you ask any clinician what that actually means
and what criteria I need to be met, I think to lay folks, you know,
it's like,
well of course if, if it's, if you provide the abortion
that saves that person's life, then it's understandable.
But there's not really a clear way to know for sure in medicine
at what point that is.
And so sometimes in pregnancy, people will have complications
and sometimes that may mean that their blood pressure is dropping
or their vitals are unstable, or maybe they're bleeding.
But how much does that need to change?
How much bleeding needs to occur before you might intervene?
What if somebody is bleeding and they're getting a blood transfusion?
Does that count?
What if you're doing that for hours on end?
We don't wait until the blood pressure gets low enough or somebody bleeds
a significant amount.
If they're having complications, you want to intervene before
they get to that point.
And so that's where the murkiness happens.
The last thing you want when you're having an emergency
is your physician thinking about what the guidelines say or what
the lawyers say or consulting an attorney before they can move forward.
And that's where it becomes difficult.
So I think when folks think about it on paper, certainly it sounds like,
oh, the life if there's a life exception, that's okay.
But in actuality, an interpretation that can be very, very complex.
And in my opinion, they're just not worth anything.
And it really is not useful for us.
People should be able to get the care they need
that should be between them and their clinician that's taking care of them.
How dangerous is it for physicians to be thinking about the specifics
of the law while they're trying to save someone's life in an ER situation?
Oh, it is very, very dangerous.
It's so unnecessary, right?
And anything that I've provided or practiced or in talking
to my colleagues that work in emergency rooms, abortion care is the only time
or in pregnancy related issues is the only time where I've heard of folks
really being concerned around having to consult an attorney.
And it's an immediate situation.
I can't think of any other time where somebody would say,
oh, I need to ask the attorney before I can move forward.
This is new.
This is not something I've experienced before.
You know, it's the last thing that any clinicians
should be thinking about when it comes to taking care of somebody,
especially in an emergency or an urgent situation.
You said something that really stuck out to me.
This is the only situation really in an E.R.
where as you are trying to save someone's life,
you are trying to consult with an attorney.
Did I hear you, right?
Yeah.
I can't think of any other time where somebody might say, oh, let's ask
the attorney before we move forward, because I'm not sure what to do.
That seems to tell me everything I need
to know about the way abortion services and sexual
reproductive health, for that matter, is is legislated, no?
Yeah.
So it tells you exactly what this is designed to do
and what these set of laws are designed to do.
It's really to make it difficult
for folks to access this care and force people to stay pregnant, unfortunately.
I know that one of the number one questions
we got after Dobbs is how many Planned Parenthood clinics are closing
because of this decision.
Obviously, you work in a clinic in a state that has banned abortion.
Your doors are still open. Walk me through that.
Yeah, our doors are still open.
There's a number of other things that we provide, including access
to contraception, STI testing, and also treatment.
We provide some primary care.
So if you have a cold,
if you have high blood pressure, we can still take care of that.
We provide gender care.
We are also seeing folks for ultrasounds
if they need to know how far along they are in the pregnancy.
So there's a number of things that we're still providing.
Our health centers are still open.
We're answering our phones.
We're taking care of people.
We're doing what we did before.
The only thing we can't do is provide
the abortion care that we were able to provide before.
Dr. Kumar, people will be watching this and trying to make sense of the laws
in Texas themselves.
And I'm curious, as a physician, as a supporter of all of these rights,
what's your message
that you'd like to give them as they're trying to navigate this landscape?
Well, so I would say for folks that are not actually trying
to access care and just looking at the issue and thinking
through some of these laws, my most favorite thing to tell people, especially
if they're new to a lot of these laws, is don't try to make sense out of nonsense.
All of these things are nonsense.
All of these specific restrictions are nonsense.
And I see a lot of folks say, well, I understand.
15 weeks or I understand six weeks.
When you see a person who's 15 weeks and one day or two days
and you have to tell them now you're going have to travel to another state,
it doesn't make sense.
When you see somebody who has a fetal anomaly that's typically
diagnosed closer to 18 or 20 weeks, it doesn't make sense to them.
So what I say as a physician is leave those decisions between me
and my patients.
Let us do what's best for our patients.
You have no idea what it's like to be in their shoes
and just let us practice medicine.
I think that's what I would want folks
to leave with when it comes to abortion care.
Trust doctors, right?
Yes. Trust doctors.
Trust people who need access to abortions.
Dr. Kumar, thank you so much for your time and giving us really a perspective
of what it's like providing care in Texas and what these laws really look like.
Thank you so much. Sure. Thank you so much for having me.