It’s expected for politicians to speak out about proposed amendments collecting signatures, but health professionals and doctors are not usually folks who get involved. But when it comes to the Arkansas Abortion Amendment, Dr. Amy Galdamez says she’s compelled to speak up. She’s a board-certified obstetrician and gynecologist based in Little Rock, and she spoke with Ozarks at Large’s Matthew Moore. When she was asked why she decided to talk about the amendment, the answer for her was easy.
The following is an edited transcript of that conversation.
Amy Galdamez: My patients, and I've had so many of them say thank you. Thank you for speaking out. Patients who have been ostracized by their family because of terminations in the past, again, before June 2022. Patients who are worried for their children, they're worried for themselves, they're worried for their spouses. My daughter. My family is complete, she's only 10, but my daughter and her friends and her entire population. I don't want anybody to ever need these services. I don't want anybody. I want them to be unnecessary and unthinkable, but they can't be illegal.
Matthew Moore: From your professional perspective, what are some misconceptions people may have about abortions and even perhaps what constitutes an abortion?
AG: A phenomenal question. A big challenge is how we define a lot of these procedures and how we define a lot of these labels. Medically, an abortion is any sort of ending of a pregnancy. That could be spontaneous, where a body ends it for whatever reason — a miscarriage is how most people would consider that — but we call those spontaneous abortions. An induced abortion would be where we are ending the pregnancy and that could be any way, from a medication to a procedure to a labor induction. Even depending on how you define it — and that's what gets so tricky, when you start trying to legislate a lot of this — labor inductions with the plan for palliative care and not NICU resuscitation, in certain cases — those could be considered abortions.
The challenge becomes the language that's used. I think most people assume that those are procedures that people do because they just don't want to be pregnant anymore. And that's a vast oversimplification in what, how we use various medications or procedures when appropriate for health care.
MM: In a world before Roe was overturned, I imagine you oversaw abortions. Can you talk about what did those procedures look like and maybe what was the emotional state of the situation? Because I think that's something we can kind of take for granted is there's a bit of an assumption — as you pointed out — that abortions are always wanted.
AG: A lot of that, even before June of 2022, depended on your facility, where you had privileges to operate, to deliver and a lot of those were governed by those facilities. For example, I've got a precious patient who's actually about to deliver her very, very precious baby here in a few weeks. But back in 2019, she had a new breast cancer diagnosis. And after lots of research on the tumor itself, the tumor markers and counseling with her oncologists and her breast surgeons over at CARTI, the best chemotherapy for her actually was the one chemotherapy that would have been very tenogenic. And tenogenic is the word for could have really hurt her baby. So, despite her having a very wanted pregnancy back in 2019, by early 2020, the best thing with her team, her cancer team, me, her husband, her pastor, our team, the decision was made together to go ahead and terminate her end this initial pregnancy, let her fight her cancer and then pursue.
I spoke with our administration here at Baptist Hospital and was able to offer it here. Yes, it was legal, but the facility had a couple of rules. And so, I offered that, she was 12 weeks pregnant. Yes, it was emotionally devastating. It was horrific. I had some OR staff who couldn't be there. The procedure itself is very similar to what we do during a miscarriage, so there's not much at that gestational age, not much different technically compared to how you handle miscarriage, but the emotion is much different, right? had OR staff that needed to excuse themselves. And of course, that was supported and that was fine. And afterwards, after everything was stable, my patient was taken care of, of course, I cried with her. But she was able to fight her cancer and get pregnant again. And I'm doing her C-section in two weeks.
MM: So let's continue the hypothetical here then. Let's say that the patient that you had in 2019 who had cancer, if that happened now, what would your options be?
AG: I'll be frank, I live in a little bit of a bubble where my patients typically have privilege. They have commercial insurance, they have resources. And so, I admit that my patient population is such that have left the state. They have gone to Kansas, Chicago, to the Illinois side of St. Louis, to Denver, to Portland, because these things are happening, right? Breast cancer didn't stop happening after June 2022.
I haven't had that exact situation, but I'm sure others have Since June 2022, I've had patients who have had fetuses, very wanted pregnancies with pretty significant chromosome abnormalities ,diagnosed early on that are typically incompatible with life who have opted to again, go ahead and wrap that pregnancy up rather than let it progress and let our moms get into higher risk time periods. They've gone to Chicago.
I had one that was diagnosed with some pretty impressive heart defects that weren't going to be real compatible with surgery afterwards. And she went to Denver. It's been challenging. And again, I admit that my patients typically have those resources and have those connections and feel comfortable talking to me about what their options are, and we can work together to find those resources. But not every woman can take a week off of her job to get these procedures out of state.
MM: Earlier you said when it comes to the nuances and gray areas of what is and isn't an abortion, that you should let “us” decide. By us, you mean the medical professionals instead of the politicians?
AG: Yes. And we understand that these are not to be taken lightly. We understand that there are physical and medical and emotional complications that can happen. And we understand that these are not risk-free procedures to undergo. But in certain cases, risk and benefits being weighed, it makes medical sense. And so, we have to be able to do that. If we get tied up in a [legal] case, we can't take care of our patients. We are living in fear going, does this count? Will I be the first one? Is there going to be a phone call from attorney who got an anonymous tip from somebody who didn't understand what we were really doing and thought that we were doing an illegal abortion when we weren't?
I mean, we do D&Cs on labor and delivery for retained placentas. What if a nursing student sees the word D&C and misunderstands? Anyway, those are silly, but that's the environment that we've been living in. We just want to take care of patients. We don't want anybody to rely on pregnancy termination as their family planning method of choice. We understand that that's inappropriate and unsound medical advice. But we just want to be able to take of our patients in those hopefully really rare times, but when it's needed locally.
MM: I don't think it's silly to think in those terms, because this is your livelihood that you're concerned about. I think it's very rational to think that someone could misconstrue language that they've heard online, or they've heard in the media of their choosing. And perhaps they’re someone looking for a bone to pick and it just takes one person to ruin your professional career.
AG: potentially, that [D&C case] happened on a Friday, and by Saturday, I was texting attorney friends saying, “I need to know who to call if I get a phone call from a prosecuting attorney.” I've had that number or say my phone, I haven't needed it. But that's ridiculous. No, the medical profession has to worry about that. No, the medical profession has to worry if they opt for palliative care or hospice care that they might be called a felon.
MM: Do you worry that you may lose some of your patients because of your stance?
No, I don't. I really don't. And I think part of that is because I've tried to be so moderate, tried to be so appropriate. Let's not be flippant about terminations. We understand that they are big deals. And we understand that they should be used judiciously. And part of it is that I haven't yet. I mean, my article came out in March and my phone's still ringing. And I actually have more patients say, thank you. Thank you for standing up for us. Thank you for standing up for my daughter and my sister. Thank you for being a voice.
And admittedly, I've not been involved much in politics at all. And most doctors are too busy. We've got to meet patients and responsibilities and charts assigned. And you know, the phone's ringing right now from the high risk unit. We've got too much to do. But this was one of those things that I just had to do.
And I talked to my husband and my partners here at my office and my husband said, “Well, why does it have to be you? “And said, “Well, it has to be somebody.” And my partners, they said, thank you. Go, please be a voice. If you feel called, we support you. And before I've done anything, I've not asked their permission, but out of respect asked for their support. And I've gotten nothing but phenomenal support.
MM: Have you heard directly from folks who are opposed to this amendment?
AG: I've gotten a couple of comments of, I can't believe you would ever be pro-abortion. And that's inaccurate, correct? I'm not pro-abortion. Nobody's pro-abortion. Nobody thinks this sounds like fun today. That's an inappropriate argument. It creates more of an emotional response than a truthful response. And so, I have had a couple.
Usually it's a, let's sit down and talk about this. And after we do, they kind of go, “Well, I guess I get where you're coming from. I just still don't like abortion.” And I say, “I don't either. I don't want anybody to ever need it. But the reality is these things are going to happen.”
I’ve got a very complicated kidney disease patient who is terrified that she's going to get pregnant again. She's already had two very high-risk pregnancies and she's terrified, but she's not sure if she wants to go through with permanent serialization yet. And she's still very young, but she is just terrified that she may have a birth control failure or have a condom break or and she's just going, what do I do? Do I just live in fear? Do I just abstain for the rest of my life? And we're talking about that.
My husband will get the guy at the golf course saying, “Hey, my wife wants to tell your wife, thank you.” And he's just going, “Cool, okay.” And my kids will come home from school and say, “Hey, Miss so and so wants me to tell you, thank you.” And so I'm getting way more support in places unanticipated than any sort of real meaningful negative criticism.
MM: Does that surprise you?
AG: A bit, but very pleasantly surprised. Again, when you sit down and you have conversations about real people — these aren't hypotheticals, they're not theoreticals, these are real women who have challenging situations that they have to navigate — when you really make it real, most, most people are going, oh, well, that's different. Oh, well, I guess, I guess that's that one, that one's okay. And I say, well, that's the point. So again, a little surprise, but pleasantly surprised. And, and very pleased to see that most people go, I never thought of it that way.
I had a patient, in January I think, and this came up. I told her how sad I was for a patient that had to leave the state for this. And she goes, “I just can't believe any woman would ever want to do that.” And I said, “We're going to talk about that. No woman wants to do that. No woman looks forward to that. But let me explain some situations.” And, this is a very conservative patient, I've taken care of for a decade. And, she sat there real still — bless her heart, in a little gown in the office — and she goes, “Thank you. Thank you for adding humanity back to the conversation. I never thought about it that way. I really appreciate that.” It just gave me chills. I've been pleasantly surprised by even my very conservative patients who have gone, “I just never thought of it that way. I just had been told that that was for women who made bad choices or women who didn't think things through” or women who all kinds of unfortunate assumptions and to add that humanity back to the conversation, I think is critical.
MM: Amy, this is the last question I have for you. If you had an opportunity to talk to lawmakers, specifically here on the state level, what would you want them to know about how abortion works and why it's so important to have an amendment like this?
AG: Because it's so personal. And there are so many pieces to that risk-benefit decision that is so unique to each case. Everything from a patient’s age, to a gestational age, to a diagnosis, there are too many new nuances and too many gray areas to adequately legislate this. There's just too much. And thankfully, we have medical professionals who know all the too much and we're okay with the too much. And we've got this, and we love our patients, and we want the best things for them. So let us do those.
Ozarks at Large transcripts are created on a rush deadline by reporters. This text may not be in its final form and may be updated or revised in the future. The authoritative record of KUAF programming is the audio record.
