Dear Board of the American Academy of Family Physicians,

We family physicians wish to express serious concerns about the American Academy of Family Physician’s public policy positions and actions 1, 2, 3, 4, 5 that signify significant movement on the stance on abortion. The AAFP appears to be bending to pressures of special interest groups both within and outside of the Academy. We, however, strongly support the AAFP’s mission and vision that we should strive to achieve optimal health for everyone, to improve the health of patients, families and communities. This also includes our fetal patients.

Firstly, as family physicians, we value the importance of obstetrical care, including the two lives at stake throughout the course of a pregnancy. Indeed, evidence-based medical treatments support fetal life and well-being, including maternal-fetal medicine and intra-uterine fetal surgery, wherein fetal anesthesia is provided. Furthermore, the claim that abortion restrictions result in higher maternal mortality is inaccurate and misleading. While it is true that some of the states that have more restrictive abortion laws also have higher maternal mortality, the causes of these deaths (severe cardiovascular diseases, postpartum hemorrhage, transfusion reactions, and sepsis/shock/DIC) do not derive from abortion restrictions. Moreover, some areas with the most liberal abortion laws have mortality rates just as high (e.g. the District of Columbia). Abortion does not address the underlying causes of such unnecessary deaths. The real challenge is not to end pregnancies but rather improve prenatal, intrapartum and postnatal care. As family physicians, we must advocate for better and more equitable healthcare for all vulnerable populations, continuing to speak up on behalf of all patients, at all stages of life. To advocate for termination of life rather than better access to maternal and fetal healthcare is disappointing and detrimental to our patient-centered mission.

Secondly, the AAFP is right to defend the “sanctity of the physician-patient relationship” and express concern about governmental intrusion in the field of medicine. However, this is now being used as political doublespeak to argue against any restriction on abortion. Smoking is legal, but we strongly discourage smoking in both patient encounters and public advocacy by medical societies, urging restrictions on the sale and use of tobacco. Similarly, we publicly advocate for vaccinations, encouraging some level of “interference” in the patient-physician relationship. Slavery was also “the law of the land”, but many fought to restrict and ultimately end this egregious affront to human life. Now we are rightly advocating for safe and humane living conditions for families at our southern border, appealing to public policy and legislation. The issue of abortion is also about saving lives: every abortion deprives someone not only of her freedom or health, but of her very life. For this reason, we see abortion as a grave human rights issue, opposing our most basic human right, the right to life.

Thirdly, the AAFP states that physicians have a wide range of views about this topic. Yet, those who share our perspective are clearly not being given the opportunity to share in policy development, whereas those advocating for unrestricted access to abortion have become integral AAFP Interest Groups that appear to be strongly influencing the Academy's recent direction. If the AAFP respects this diversity of opinion, why are only limited perspectives influencing and governing current positions and public policy and claiming to speak for all members?

In summary, given the moral gravity of this subject, we urge you to be sensitive and representative of your member physicians who value the human rights of those in the womb, including their right to life. Beyond this, we ask that you reject attempts to reframe and advocate for abortion under misleading verbiage or statistics. Failing to do this will place the AAFP in a position that will disaffect thousands of your members at a time when advocacy for our specialty is critical. Indeed, when we see the AAFP become focused on depriving life to the most vulnerable, reducing protections for women obtaining abortions at various facilities, advocating against conscience protections of medical providers and facilities declining to participate in abortion, and encouraging members to adhere to counseling and education on the necessity of abortion, the AAFP ceases to be representative of our interests or worthy of our support.

Thank you for allowing us to convey our views and our call to you as leaders of the AAFP, for policy and actions that are representative of all our membership, and committed to unifying principles on the issues facing all family physicians.

Sincerely,