Saving The Lives of Woman | The Evangelical Catholic Church

Saving the Lives of Women

A Pastoral Letter

Bishop James Alan Wilkowski

Dedicated to the victims of Dobbs v Jackson Women’s Health Organization

◊ Introduction ◊

This Pastoral Letter has been composed and offered to facilitate our collective thoughts and responsibilities to help, support and comfort women dealing with life threatening pregnancies.

As a Catholic and as a bishop within the Evangelical Catholic Church I have never been a proponent of wholesale abortion. I continue to believe in the gift of life.

I also acknowledge that this Pastoral may cause some to feel challenged. But I have faith that this Pastoral might help us to rediscover our obligations to fulfill God’s mandate to exercise positive dominion within the Kingdom of God on earth.

I have been a believer and follower of the theology of Social Justice and Peace for many years and I hear the calling of the Holy Spirit to come to the aid and assistance of His people who are in danger because of no fault of their own.

I hope this Pastoral might facilitate within us to embrace what the Late John Lewis called “Good Trouble.”

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In 2022 SCOTUS overturned the historic Roe v Wade via its decision in Dobbs v Jackson Women’s Health Organization.

As a result of Dobbs and the misogynists actions of too many of our sister states, the Kingdom of God in Heaven is being prematurely populated by its victims.

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In 1883 my maternal grandmother, Mary Oreskovich Sertich, was born at home in Croatia. There is no record of my great-grandmother receiving any care or assistance during her labor and delivery. What is known is that my great-grandmother died shortly after giving birth. History has established the fact that many women of that time died due to complications from their pregnancies or from their labors and/or deliveries. Had some form or knowledge of prenatal care been available in 1883 my great-grandmother might have survived.

The fate of my great-grandmother was a common fate of many women not only of her generation, but also for countless future generations of women until medical science made significant discoveries and methods of preventing the deaths of women during their pregnancies and afterwards.

The purpose of this Pastoral Letter is to be a voice for the women of this country who, through no fault of their own, have conceived a pregnancy that has put their lives in jeopardy and must consider the medical advice of their doctors to save their lives by ending the pregnancy.

In 1973, the Supreme Court's decision in Roe v. Wade established a woman's right to end a pregnancy, based on the right to privacy, and made it a federal right. It also saved the lives of many women dealing with life threatening pregnancies.

On June 24, 2022, the Supreme Court reversed Roe v. Wade in the Dobbs case, ruling that there is no constitutional right to abortion, effectively ending the federal protection for abortion rights. This decision meant that the legality of abortion would be determined by individual states, leading to a patchwork of extremist laws across the country. The decision has sparked significant debate and activism, with some states enacting bans or restrictions on terminating a pregnancy, while other states have taken steps to protect access to all forms of medical care.

The Dobbs decision, which overturned Roe v. Wade, has significantly impacted doctors, particularly OB-GYNs, by creating uncertainty, legal risks, and hindering their ability to provide evidence-based care, leading to some leaving the field or relocating.

Please consider the following effects on our medical community since Dobbs.

Legal and Ethical Challenges:

Interference with Physician-Patient Relationship:

The Dobbs decision has imposed a climate of fear and uncertainty, making it difficult for doctors to provide comprehensive reproductive healthcare options including and potentially putting them in legal peril.

Restrictions on Care:

Some states have enacted restrictions on medical options, making access more difficult and heightening disparities among states, impacting doctors' ability to provide appropriate care and counsel patients.

Moral Distress and Burnout:

The inability to provide care they know to be necessary, coupled with the fear of legal repercussions, has led to moral distress and burnout among doctors.

Impact on Medical Training:

Medical students and residents may be less likely to apply for residencies in states with restrictions, potentially leading to a shortage of trained OB-GYNs in the future.

Diminished Training Opportunities:

Medical students in states with total bans on terminating pregnancies must seek necessary training out of state. Diminished training opportunities can potentially lead to a decline in clinical skills, knowledge and experience.

Patient Care Impacts:

Denial of Care:

Patients in states with bans or restrictions may be denied access to necessary medical care, including termination and care for miscarriages and other pregnancy-related medical emergencies.

Increased Maternal Mortality:

Restrictions to access of necessary medical may lead to an increase in maternal mortality rates, especially among marginalized communities.

Worsening of Existing Health Disparities:

The Dobbs decision may exacerbate existing health disparities, particularly for women of color and those living in poverty.

At this important moment in time following the Dobbs v Jackson Women's Health Organization decision in June 2022, 17 US states have functionally banned the medical option for terminating a life endangering pregnancy except in narrow circumstances, and physicians found in violation of these laws face felony charges, loss of their medical license, fines, and prison sentences.

As a bishop for the Evangelical Catholic Church and as one who has never accepted the practice of abortion for convenience, I believe that I am being motivated and called upon by the Holy Spirit to employ my voice and energy to protect the lives of women dealing with life threatening pregnancies and to end the nightmare of the Dobbs decision. Too many women have died because of Dobbs and the draconian actions of 17 states, and I cannot sit back and watch the body count of women denied necessary medical care increase because of the unethical portal of Dobbs.

In my research and preparation for this Pastoral Letter, I have come to learn and relearn medical conditions discovered during a pregnancy that can place the life of the patient in jeopardy. Conditions which I believe cannot be ignored or dismissed.

Ectopic Pregnancy

An ectopic pregnancy occurs when a fertilized egg implants outside of the uterus, such as the fallopian tube (where eggs are carried from the ovaries to the uterus) or ovary. Ectopic pregnancies aren't viable, and if the fertilized egg continues to grow, it can rupture and cause the patient to bleed to death. Ectopic pregnancies are usually discovered during the first trimester, though occasionally later at 12 or 13 weeks. Women with ectopic pregnancies will have excruciating abdominal or pelvic pain as well as vaginal bleeding, extreme lightheadedness, or fainting.

Intrauterine Infection

Some of the most common causes of intrauterine infections happen from infections that start in the vagina and travel to the uterus. This is more common when a patient's bag of water (amniotic sac) has broken, but it can also happen without the bag breaking. Intrauterine infections can also happen because the fetus has died and the dead products inside the uterus cause an infection, she says. So, if an intrauterine infection is the result of the death of a fetus, removing the fetus is necessary.

Placental Abruption/Previa

Placental abruption happens when the placenta completely or partially detaches from the uterus due to some sort of trauma. When the placenta detaches from the uterus, it decreases the amount of oxygen and nutrients being delivered to the fetus and can cause severe bleeding.

Placental abruption can be managed without delivery until the amount of bleeding causes the pregnant person to become unstable. In the case of life-threatening bleeding, the fetus must be delivered, both for the health of the mother and the fetus if it's viable, she explains. If the fetus is not viable, then abortion is indicated because, without removal of the bleeding placenta, the patient will continue to bleed and hemorrhage to death.

This is also true for pregnant people who have placenta previa, where the placenta is covering the cervix and may cause life-threatening bleeding. In cases where the bleeding is severe, a surgical termination to save the patient, regardless of the viability of the fetus, as the mother could die from blood loss. Bleeding from placenta previa usually happens after 20 weeks of pregnancy.

Severe Cases of Preeclampsia

Preeclampsia is a form of high blood pressure that develops usually after 20 weeks of pregnancy. Preeclampsia poses a danger to the woman and the fetus because it raises blood pressure

The exact cause of preeclampsia isn't known. Something abnormal happens during the formation of the placenta, and it causes the blood vessels in the placenta to constrict. This blocks the blood supply to the placenta, and if it's severe, the fetus will die and the life of the women would be in jeopardy.

Antepartum Sepsis

Antepartum sepsis (sepsis during pregnancy) is the result of an infection that happens anywhere in the body, such as the lungs, gastrointestinal tract, or urinary tract. Sepsis is life-threatening because it causes the body to damage its own tissues in response to the infection. Antepartum sepsis can cause organ and placental dysfunction and is one of the biggest contributors to maternal and fetal mortality.

A fetus which has multiple birth defects that is incompatible for survival

There some conditions found in fetus that may cause chronic illness, disability, stillbirth or the death of a baby soon after birth (neonatal death). These conditions are sometimes referred to as fetal anomalies disorders or birth defects. Some rare pregnancy complications can risk the life or long term reproductive health of the women life if they continue the pregnancy.

Victims of rape and incest

One in 20 women in the United States has experienced a pregnancy from rape, sexual coercion, or both during their lifetimes. Specifically, over three million women have experienced pregnancy resulting from rape during their lifetimes. Nearly five million women have experienced pregnancy resulting from sexual coercion during their lifetimes.

Victims often reported other negative health impacts. Among women who experienced pregnancy from rape, 28% experienced a sexually transmitted disease and 66% were injured. Additionally, over 80% were fearful or concerned for their safety. Among women who experienced pregnancy from sexual coercion, about 35% experienced a sexually transmitted disease.

The majority of countries worldwide allow for the termination of a pregnancy in cases of rape and/or incest, either through laws enumerating these grounds or by permitting termination on request. Although rape and incest are distinct legal grounds for abortion, they are very commonly paired together in abortion laws and policies. Although a handful of countries only allow termination in cases of rape, and not incest, whereas there are not any countries that allow termination in cases of incest that do not also allow termination in cases of rape. Notably, countries that allow termination on health grounds, particularly mental health grounds, might interpret such exceptions to include cases of rape or incest, even when such are not explicitly articulated in law.

Despite the howls of celebration by the proponents of Dobbs, I believe that there remains some sanity of conscious by many who believe that those who become pregnant via rape and/or incest should not a further harmed by being forced to continue with such pregnancies. The decisions of many states since Dobbs have limited the window of time to discontinue such pregnancies or have completely denied the option to end such pregnancies.

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The Dobbs v. Jackson Women's Health Organization ruling, which overturned Roe v. Wade and eliminated the federal constitutional right to terminate a pregnancy, has had significant societal impacts, including restricting access to necessary medical care, increasing maternal mortality and morbidity, and exacerbating existing disparities in reproductive healthcare.

The consequences of Dobbs:

1. Reduced Access to Medical Care:

The Dobbs decision returned the regulation of medical procedures to individual states, leading to a patchwork of laws across the country.

Many states have enacted bans or severely restricted necessary medical access, forcing individuals to travel long distances or seek medical care in other states.

This has disproportionately affected marginalized communities, including Black, Indigenous, and people of color; people with disabilities; immigrants; and those living in poverty while facing life threatening pregnancies.

2. Increased Maternal Mortality and Morbidity:

Restrictions on medical access can lead to increased maternal mortality and morbidity, as women in need return to accessing unsafe procedures and dying from them.

The decision has also created a climate of fear among healthcare providers, potentially leading to delayed or inadequate care.

3. Impact on Healthcare Providers:

Providers in states with restrictive abortion laws now face evolving legal and ethical challenges, which can affect their safety, mental health, education, and training opportunities.

Some medical professionals are deviating from the standard of care due to abortion bans, leading to delays in care and adverse health outcomes.

4. Impact on Mental Health:

The loss of access to necessary medical care can have a significant impact on mental health, with individuals facing life threatening pregnancies and the emotional toll of being denied the option of saving their life.

The Dobbs decision has also placed further strain on already overburdened mental health systems.

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Medical care for pregnant women has vastly grown since 1500. Legend has it that a Swiss sow Gelder, Jacob Nufer, performed a successful cesarean section on his wife who had been in labor for several days, supported by thirteen midwives and had been unable to deliver her baby.

Our doctors today have the skills and knowledge to successfully assist their maternity patients to a healthy and joyous delivery of new life. Yet despite the skill and knowledge of doctors, there remains the fact some women are faced with life threatening and nonviable pregnancies and these women need the best medical care available. The SCOTUS decision on Dobbs is a disaster and has resulted in the premature deaths of too many women and this pro-life bishop shall stand and offer my voice and energy to protect these women from irrational and ignorant politics.

I want to believe that there are men AND women who are smarter than I and who have the gifts to untangle the noose created by Dobbs and reestablished the rights of women and their doctors to professionally and morally assist women dealing with life endangering pregnancies.

It is my hope and prayer that our elected state and federal representatives can focus their talents and energies on matters for the common good and refrain from engaging in matters beyond their scope of knowledge.

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As I conclude this Letter, I invite you to reflect of these passages of Scripture.

Whoever receives one such child in my name receives me, and whoever receives me, receives not me but him who sent me. (Mark 9:37)

When a woman is giving birth, she has sorrow because her hour has come, but when she has delivered her baby, she no longer remembers the anguish, for that a human being has been born into the world. (John 16:21).

Fear not, for I am with you; be not dismayed, for I am your God; I will strengthen you, I will help you, I will uphold you with my righteous right hand. (Isaiah 41:10)

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I realize that the words of this Letter might be difficult for some to read. It was, at first, difficult for me to even write these words. But as the body count of women denied life saving medical treatment increases, I came to the conclusion that the lives of these women cannot be discounted or dismissed and I found that I could not remain passive and silent.

As stated previously my position on abortion for convenience remains the same and I do continue to support the unborn and to help find alternative options for them.

Let us conclude this time together with prayer:

Loving Father of us all, we come to you to ask that you give your unconditional love and support to all women and their doctors dealing with the crisis of a life endangering pregnancy. Help these women and their doctors to discern their options and to come to their decisions.

And should the best life saving decision be to end the pregnancy, please do not abandon these women in their loss and griefs rather give them the hope that a future pregnancy will be bless and protected by you.

We make this prayer to you always through Your Son, our Lord Jesus Christ, who lives, and reins with you and the Holy Spirit, one God for ever and ever. Amen

Thank you for considering this Letter.

I remain,

Respectfully Yours in Christ,

James Alan Wilkowski

Bishop for the Evangelical Catholic Church

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