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Opinion: I’m a cardiologist and I’m voting No on 115. It’s bad for women and bad for doctors.

Anti-abortion interest groups want you to believe they  care about the lives of pregnant women. But make no mistake —  in their recent attempts to ban abortion in Georgia, Ohio and Alabama they have worked to pass laws that either made no exceptions or had lawmakers supersede doctors in judging what constituted a life-threatening condition. 

Proposition 115, the abortion ban on the Colorado ballot this November, is no different. 

 Many of the same politicians and people behind these dangerous laws have come to Colorado selling another ban with no exceptions for maternal risk.  As a physician, I feel compelled to speak up, for women, for my patients and for my profession. 

Dr. James Monaco

Proposition 115 is bad for all of us.  It will result in unnecessary maternal deaths. It will force many women through suffering few could imagine. And it will make Colorado a less desirable place for all physicians to work.

I am a cardiologist. Most people know cardiologists manage patients with problems like heart attacks and strokes. Fewer may realize that we play an essential role in the care of high-risk pregnancy.  

A pregnant woman’s heart must perform incredible feats. It must pump 50% more blood per minute than it did before pregnancy. In delivery, it will face huge swings in blood pressure with each contraction. The heart must be able to tolerate losing up to a liter of blood during delivery.  

This is not trivial for even a healthy heart, which is why one in three maternal deaths happen because of heart or vascular disease. Cardiologists help women with increased risk navigate pregnancies that can be the most emotionally and physically demanding experiences of their lives. For most of these women, we are happily able to help achieve their goal of a safe and healthy childbirth. 

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Some, however, face unmanageable risks, or develop clear signs their bodies are not tolerating pregnancy. For these women, their families, and their doctors, it is essential that they have access to all medically appropriate options – including abortion.  

Defenders of Proposition 115 argue the measure provides women with ample time to be evaluated and determine if their pregnancy poses a risk to their health. Even in an ideal world, this would be false.  

It is important to understand that even an uncomplicated pregnancy carries a risk of death. For women with heart disease, this risk may be vastly higher, and does not remain static throughout pregnancy. 

The changes of pregnancy are dynamic, with the stress on the heart increasing almost continuously. It is unacceptable to have an arbitrary cutoff at 22 weeks where women and doctors are forced to let a tragic complication become a death sentence.  

As a physician, I can tell you we do not live in an ideal world where everyone has the same access to health care. The women most likely to seek medical care late in pregnancy are those with the greatest medical need, the greatest barriers to care and the fewest resources. These women are already our society’s most vulnerable, and Proposition 115 will disproportionately burden and victimize them further.

All abortion restrictions put women’s lives at risk. An overt goal of abortion bans is to shut down abortion clinics and punish or drive out physicians who provide abortion care. What is the sense in trying to drive off providers capable of providing critical health services? 

The harm will not be limited to obstetrics, either. Abortion bans make the states that pass them worse places to work for all providers. They insert politics where it doesn’t belong —  in the middle of the doctor-patient relationship.  

I am sure I am not the only physician in my specialty who does not want to work in that environment, and mine is not the only specialty outside of obstetrics that regularly addresses the intersection of chronic illness and pregnancy.  Placing legal barriers to appropriate care in any field will drive away providers and cause harm to everyone.  

There are many more reasons to oppose Proposition 115, and I hope the voices of the women it would harm the most are heard the loudest. However, I feel it is my duty as a physician to sound an alarm.  

Proposition 115 would result in women dying. Proposition 115 would result in worse medical care.  

Luckily, in November, we can reject this radical effort to harm women and health care in Colorado by voting “no” on Proposition 115.


James Monaco is a cardiologist practicing in the Denver metro area.


The Colorado Sun is a nonpartisan news organization, and the opinions of columnists and editorial writers do not reflect the opinions of the newsroom. Read our ethics policy for more on The Sun’s opinion policy and submit columns, suggested writers and more to opinion@coloradosun.com.

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