By Thomas Perille MD July 26, 2025
It seems that we live in an era of Rorschach tests. You only have to say one word and you will create a predictable and visceral response depending on where you lie in the political spectrum. Migrants. Gender. Ukraine. Gaza. Guns. And one of the most enduring triggers and divisive words is abortion. How do we navigate in a world characterized by such extreme polarization and tribal political organization? Is abandoning efforts to engage with those who possess a different worldview the most logical and realistic path? Should those who hold the majority view simply squash those with a dissenting view? Or is there something fundamentally lost in society when we relinquish our innate human desire for solidarity with those in our community -even when they may harbor radically different perspectives. Can a democracy survive such division? Is there a way to model a different approach? Addressing abortion in a constructive way can be the prototype for a host of other heated, if less contentious issues. It seems the first principle of engagement should be to assume that those with an opposing view aren’t ignorant or evil but rather sincere and motivated by a desire to make the world a better place. Second, we need to look beyond the propaganda on both sides of an issue, to create space for dialogue. It isn’t necessary to agree on the veracity of all the published information pertaining to the topic, but we should be prepared to establish a set of underlying moral principles/values that best reflect the differing views. Lastly, it is important to acknowledge the very real differences in our beliefs but focus on finding common and overlapping interests. It is never necessary to abandon firmly held moral principles to forge policy and programs that appeal to those with opposing views. And establishing a relationship with someone you adamantly disagree with doesn’t mean you subscribe to moral relativism. For abortion, we first must acknowledge that many of those with the most emotional responses to the issue have either had an abortion or their sexual partner had an abortion. Some will be asserting the righteousness of their abortion decision and others may be reacting with guilt/shame to the memory of their abortion. If we aren’t sensitive to these emotions, it will be hard to move towards a productive dialogue. And we should recognize that both prolife and prochoice adherents deeply care for the health/life of women. The prolife movement bends the truth to advance their cause. You often hear prolife advocates state, “that abortion is never medically necessary”. This is more a semantic error than a factual error. For many, induced abortion is so morally abhorrent that they prefer to use the term “separation” or “premature delivery’ in the case of a medically indicated abortion. A medically indicated abortion refers to the previable termination of a pregnancy to prevent maternal organ damage or preserve the life of the mother with the unintended, but foreseeable, death of the developing human embryo or fetus. (In contrast, in an elective induced abortion, the expressed intent is to end the pregnancy by killing the embryo/fetus with the manner of fetal death and the gestational age being immaterial.) Medically indicated abortions are rare. Abortion to preserve the life or prevent serious bodily injury represents approximately 0.05% of abortions based on a high-quality registry study from the UK where reasons for abortions are tracked. (The US does not track indications for abortion). “Therapeutic abortions” were part of medical reality long before Roe was decided in 1973 and were incorporated into the medical repertoire of every OB/GYN for decades, including the prolife clinician. Prochoice advocates also sow confusion to promote their cause. They propagate the myth that “nobody can definitively know when human life begins”. The fact that a new human life begins at fertilization dates back to the first scientific observation of sperm and egg fusion in 1876 by Oscar Hertwig. To argue that a human life begins at birth is an antiquated religious view not based on science or biological expertise. What prochoice adherents may mean is that a human being doesn’t have value, dignity, or legal rights till they are born – but that is an entirely different argument. They may believe that the moral significance of fetal life is not biologically determined, but socially or philosophically constructed. Nonetheless, they need to acknowledge that assigning differential value to distinct groups of human beings based on immutable characteristics such as age, sex, sexual orientation, physical/mental abilities, race, or ethnicity has been a fraught topic throughout human history. Those who promote abortion as a moral response to an unexpected pregnancy sometimes obscure the humanity of the developing embryo and fetus with dehumanizing language. Examples include describing a sophisticated human embryo as a “cluster of cells” in the New York Times or a second trimester fetus as “pregnancy tissue“ on the Rocky Mountain Planned Parenthood webpage. This stands in contrast to the language that is commonly used by every expectant mother and her obstetrician who routinely describes the “wanted” embryo/fetus as a “baby”. For the purposes of engagement, abortion proponents and opponents should avoid using loaded language that is intended to manipulate rather than clarify. The last domain of obfuscation pertains to the conflation of miscarriage and stillbirths with induced abortion. Miscarriages and abortion may require the use of the same medications and surgical procedures but that is where the similarity ends. In miscarriage or “spontaneous abortion”, the embryo and fetus suffer a tragic, but natural, death. A medical or surgical procedure may be necessary to remove any remaining fetal or placental remains to prevent infectious and hemorrhagic complications. Pregnancy has already terminated naturally; thus, this is not an induced abortion. In elective induced abortion, a medical or surgical procedure is performed to terminate the pregnancy explicitly by killing the embryo or fetus. Laws that restrict elective induced abortion have no medical or legal bearing on the treatment of miscarriage. Medical malpractice rather than anti-abortion laws drives much of what the mainstream media cites as evidence to the contrary. The primary reason that any doubt exists in the minds of inexperienced clinicians is the misdirection by professional medical abortion advocates such as ACOG (American Association of Obstetricians and Gynecologists). After peeling away the spin/propaganda from either side of the abortion debate, you have a much simpler discussion: when is it permissible to kill a dependent human being to respect a woman’s bodily autonomy and free her from the physical, social, emotional, and economic demands of pregnancy and childcare. Prolife advocates need to aggressively address the needs of the woman and not focus exclusively on the fetus. Prochoice advocates need to explicitly address the biological reality and moral relevance of the developing human and not focus exclusively on the woman. Framed this way, the potential for finding common ground dramatically increases. Prolife advocates can agree that there is real, albeit very rare, medical indications for abortion. They can work with prochoice advocates to ensure that all medical professionals address the needs of both of their patients while working vigorously to save the life of the mother when pregnancy complications would jeopardize the lives of both. It is possible to imagine that an agreement to limit late abortion on healthy women carrying healthy fetuses’ post-viability could be achieved. Restrictions of abortion techniques which are especially inhumane, such as D&E, which involves the systematic dismemberment of a pain capable fetus, may be another area of agreement. There shouldn’t be controversy making high risk second and third trimester abortions safer through state licensing, regulation, and inspection of late abortion facilities since the health/safety of women drive both perspectives. Prochoice advocates should support medical professionals who have conscientious objections to participating in abortion since elective induced abortion involves intentionally taking the life of another human being. This is not a trivial or arbitrary moral decision. It reflects their sincere commitment to foundational secular humanist or religious principles. Prochoice advocates who believe that abortion must be a free choice, should find common cause with prolife advocates to prevent the social/economic coercion that commonly drives an abortion decision. Both could embrace a parallel interest in reducing the asymmetrical burden of human reproduction. This may be accomplished through a variety of initiatives. Joint efforts to improve accommodations for pregnant women in education and the workforce would become a major priority. Supporting/expanding paid family leave programs and subsidized daycare would be another. Publicizing government/private non-profit programs that provide counseling and material support to pregnant women and their families – including Pregnancy Resource Centers (PRCs) – would be a third. Ameliorating the financial burden of pregnancy that disproportionately falls on women would need to be addressed. Expanding male partner prenatal/postnatal financial support is one tool. Making birth (prenatal, birthing services, and post-partum care) free through a combination of government/private insurance programs is essential. Men should not be able to avoid the financial burden of human reproduction by avoiding child support or purchasing “skinny” health insurance without pregnancy coverage. Conservative prolife legislators should eschew their aversion to insurance mandates to serve a greater goal. It is a matter of reproductive equity. PRCs offer millions of dollars of uncompensated assistance to pregnant women and their families. However, those expressing prolife beliefs undermine their dedication to women and their preborn children when they refuse to acknowledge the role of government in setting policies and supporting programs that address their additional needs. There are already recent examples of legislative efforts that demonstrate how prolife and prochoice advocates can work together for the common good without compromising their sincerely held beliefs regarding abortion. At the federal level, Senators Hyde-Smith (R), Kaine (D), Hawley (R), and Gillibrand (D) recently introduced the “Supporting Healthy Moms and Babies Act” which would make birth free. In Colorado, Senator Jeff Bridges (D) sponsored SB25-144 which extended family leave for mothers of very premature babies that require prolonged neonatal intensive care. He also sponsored SB25-118 which took a small slice out of the prenatal care cost burden in Colorado. Unfortunately, there are many more examples where this kind of dialogue is considered too politically risky. A very sad example was the recent defeat of a bill (HB25-1252) to allow the Colorado Department of Public Health and Environment (CDPHE) to regulate second and third trimester abortion facilities using evidence-based best practices– as they do with other medical facilities with lower or similar risks. It was killed in the House Health and Human Services Committee along tribal ideological lines. It is past time to bridge the ideological and political divide. Let partisans on either side of a hotly contested issue commit publicly to constructive engagement. No longer should we treat people with opposing views as “enemies”. Collaboration should be the norm in our communities and state/federal legislatures rather than the exception. When you seek to identify core values, you can invariably find overlapping interests. There isn’t an issue that doesn’t lend itself to this approach. This is good for our communities, good for our nation, and good for democracy writ large. Ultimately, it may even move the culture towards the morally correct position.
By Thomas Perille MD April 30, 2025
This is cause for celebration. Warren Hern was an outlier in the field of medicine that itself is an outlier. It is the only medical specialty that is devoted to killing human beings rather than restoring health or ameliorating suffering. Hern famously compared humans to a spreading “cancer” on the earth. It is not surprising that he devoted his career to using abortion as a form of population control. He considered pregnancy a disease and felt that no justification was needed to pursue abortion at any time for any reason. The fact that 70% of his late abortion practice targeted healthy women carrying healthy fetuses was often underappreciated or misrepresented by the media. One can hope that the fact that he could not find another physician to assume his grisly late abortion practice may be a sign of hope that the era of unlimited, unrestricted, and unregulated abortion may be nearing an end.
By Thomas Perille MD April 22, 2025
April 17, 2025 Governor Polis, Democrats for Life of Colorado implores you to consider the fiscal implications of signing SB25-183 into law. Research from the Guttmacher Institute published in 2024 demonstrates that in states where Medicaid pays for elective abortions, 62% of abortions are Medicaid abortions. If you apply this figure to Colorado, this means that SB 183 will create a huge financial liability for the Colorado Medicaid system at a time when the state is straining to contain a greater than 1-billion-dollar budget deficit. CDPHE reported that there were 10,368 abortions on in-state residents in 2023. The legislative council’s fiscal note on SB 183 estimates a $800 Medicaid reimbursement for medication abortions and a $1300 Medicaid reimbursement for surgical abortions. The legislative fiscal note also divides abortions into 50% medication and 50% surgical in calculating the state’s financial commitment. This would translate into a total cost of $6,749,568 for the estimated 6428 abortions (using the 2023 CDPHE numbers). If you use Guttmacher estimates for the number of abortions in Colorado, the number would be at least 40% higher. The fiscal liability doesn’t stop with the monetary payment for elective Medicaid abortion, since the Legislative Council adds the loss of $1,721,497 federal matching dollars. This will make the total estimated state’s obligation at $8,471,865 using the more conservative CDPHE numbers. And you can’t count on the misleading Legislative Council analysis for cost savings from “averted births”. This is an overly simplistic analysis for many reasons. Up to 20-30% of miscarriages occur after 6 weeks. This means that many of these “averted births” would have ended in miscarriage and not cost the state the cost for funding an abortion. Most births won’t be “averted” because these women will go on to have pregnancies that go to term later in their reproductive life. We know that the risks of pregnancy complications correlate directly with maternal age. These “delayed” rather than “averted” births, will increase Medicaid costs because of the increased risk of gestational diabetes, preeclampsia, and premature births in these later pregnancies. It is also well established that surgical abortions increase the risk for premature birth in subsequent pregnancies, including extreme premature births. To the extent that this legislation increases surgical abortions, it will markedly increase Medicaid Neonatal Intensive Care Unit costs. Furthermore, there is good data that suggests that women undergoing abortions seek mental health services at a much higher rate, which also will increase Medicaid costs. There is evidence that subsidizing abortions for lower income women, increases abortion rates which will, in turn, increase Medicaid abortion costs. The Legislative Council used a tiny study from Louisiana to estimate the number of additional abortions that will be performed when public funding is available. The Louisiana study demonstrated that only 1% of Medicaid eligible women who were pregnant (and didn’t already abort) would have considered abortion if the state had providing funding. This means the immediate impact on increasing abortion access will be extremely small but likely increase over time. The Legislative Council failed to acknowledge that Louisiana low-income women have very limited access to private abortion funding. This is in stark contrast to the robust private funding for abortion from the Cobalt Fund and the National Abortion Federation funds here in Colorado. Consequently, you can’t rely on the experience in Louisiana to project Colorado’s costs. SB 183 will simply be shifting abortion costs for low-income women from private sources (Cobalt/NAF) to Colorado taxpayers. We are very concerned that Medicaid already fails to reimburse pregnancy services adequately which results in maternity deserts. This new elective abortion financial obligation will likely further compromise pregnancy services and other higher Medicaid priorities. The multimillion-dollar increase in state funding that is necessary to pay for elective Medicaid abortions stands in contrast to the “zero” fiscal impact that Amendment 79 was purported to have based on the Bluebook verbiage. If voters understood that they were voting for a multimillion-dollar tax increase to pay for abortion, it is safe to say that more than 38% of the Colorado electorate would have voted against the amendment. We are opposed to using public funds for elective abortions. However, even if you thought this was required for “equity” purposes, this is not the time or the fiscal circumstances that justify such an expensive measure. Thanks for your consideration. Thomas J. Perille MD FACP FHM President, Democrats for Life of Colorado
By Tom Perille MD March 24, 2025
The campaign to use public taxpayer funds to pay for elective Medicaid abortions has been a sham from the beginning. During the Amendment 79 campaign for the constitutional right to abortion, the Legislative Council’s Blue Book disingenuously stated that “the measure will have no fiscal impact”. This was an attempt to deliberately mislead Coloradans. Now the pièce de resistance, SB25-183 claims that by paying for elective Medicaid abortions, the state will save hundreds of thousands of Medicaid dollars from “averted births”. The Legislative Council made their projection based on a tiny study from Louisiana where 12 pregnant Medicaid women said that lack of public funding was “part of why (they) have not had an abortion”. The Council ignored the fact that only two of these 12 (1.2% of all Medicaid women interviewed for the study), would have still considered abortion if the state paid. Furthermore, in contract to Louisiana, Colorado has generous private funding available for both in-state and out-of-state women seeking abortion. The Legislative Council analysis was clearly designed to produce the desired “cost savings” reported. They offset the millions of dollars of abortion costs with the money from “averted births”. However, they ignored critical facts in this oversimplified analysis. The principal flaw is that “averted births” are illusory since most Medicaid women will simply pursue births later – when the risks of complications and associated Medicaid costs will be higher. It also ignores the number of pregnancies that would have ended in natural miscarriage, the increased costs for premature birth in subsequent pregnancies for women who had surgical abortions, and the increased cost of mental health treatment for those who seek abortion rather than childbirth. Aside from the moral issue, the state will suffer the fiscal consequences of the ill-advised public funding of elective abortion.
March 20, 2025
I am angry. More than angry, I am sad that our state legislators place allegiance to their “tribe” over the health and safety of the women of Colorado. On Tuesday, March 11, the House Health and Human Services Committee rejected HB25-1252 which would have instructed the Colorado Department of Health to develop evidence-based guidelines to ensure the health and safety of women seeking high risk second and third trimester abortions. The committee heard testimony that 10% of second trimester abortions have complications and 1.7% suffer serious, life-threatening complications. They heard that one in 50 women who had second trimester abortions through the University of Colorado required hospitalization. They heard that mid second and third trimester abortions are riskier than natural childbirth. They heard that the risks of dying from a late abortion are greater than the risk from dying from a procedure at an ambulatory surgical center. Every healthcare facility that poses this kind of risk to women is licensed, regulated, and inspected by the Colorado Department of Health. Late abortion is the only exception. The most heart wrenching testimony concerned the February death of an 18-year-old woman, Lexie. She died of complications from her second trimester abortion at the Fort Collins Planned Parenthood. At this same facility, 911 records documented at least three other emergency transfers already this year. My fel low Democrats have no problem regulating the energy/gas industry to safeguard the health of Coloradans. Do they only regulate industries with which they aren’t politically aligned? Tom Perille MD
November 14, 2024
We want to extend our sincere appreciation for the thousands of people who came together for a cause greater than themselves. The diverse group that opposed unrestricted, unregulated abortion reflected the broad-based coalition formed by Prolife Colorado that defies any simple characterization. We are Democrats, Independents, and Republicans from every race, and ethnicity. We are young and old, rich and poor, native and immigrants, religious and secular. We are defined by our common belief in the value and dignity of every human being and not by any demographic. Amendment 79 passed but that does not mean we failed. We have begun the long and arduous task of educating Coloradoans about the reality of abortion in our state. Few knew that abortion late in pregnancy on healthy women with healthy babies was common. Few knew that high risk second and third trimester abortion clinics were unregulated in our state and that women’s lives are in jeopardy. Few realized the implications of unrestricted abortion on the privileged relationship between parents and their teen daughter. Many underappreciated the fiscal impact of using public funds to streamline access to abortion through all nine months of pregnancy. Our only regret is that we didn’t have the money to share our message more broadly so that every Coloradoan could make an informed choice. The proponents of the measure raised 18 times the money we did largely from the abortion industry and wealthy out-of-state donors. They used their money to spread the myths that “abortion was healthcare” and that abortion saved women’s lives. They frequently tried to conflate elective induced abortions with miscarriages, ectopic pregnancies and treatment for life-threatening complications of pregnancy. We know that not a single women’s death has been the result of abortion restrictions and that recent highly publicized deaths in Georgia and Texas reflect the anticipated complications of drug-induced abortions compounded by physician negligence. We will continue to build a culture that respects every human life here in Colorado and envision a future where women are offered the support and the resources, they need to choose life. Women without financial resources and women of color should not feel that their only path to a successful life is through abortion. We will fight to remove the inequities in pregnancy care throughout our state and remove barriers for women facing unplanned pregnancies during their education and early careers. And yes, we look forward to the day when Coloradoans will vote to remove Amendment 79 from our constitution. Because life matters.
October 29, 2024
It is becoming more common for ideologues to gaslight the American public to promote their agenda. The latest example is the abortion industry’s attempt to have Coloradoans suspend their common sense, human decency and compassion to place Amendment 79 into the Colorado constitution. State law already protects access to abortion, but they would have us believe it is “progressive” to endorse this constitutional amendment. Amendment would enshrine unrestricted, taxpayer funded abortion into the state constitution. It would prohibit the government from “denying, impeding or discriminating” against the right to abortion. This goes far beyond Roe which was overturned by the Dobbs decision. Roe permitted regulation of abortion in the second trimester to ensure the health and safety of women and allowed states to recognize their compelling interest in protecting the life of a viable baby in the third trimester. Amendment has neither of these important features. If abortion is considered a fundamental constitutional right (unlike any other medical procedure), then a fetus, wanted or unwanted, has no constitutional rights under Amendment 79. Nobody could infringe on the exercise of abortion – no matter the circumstances. Late abortions are common in Colorado. While abortions after the limit of fetal viability only represent 3.2-3.4% of abortions each year, they account for hundreds of abortions. And we know that approximately 70% of these late abortions are performed on healthy women with healthy babies. Amendment 79 would prevent legislators from ever curtailing abortion late in pregnancy for social and economic reasons. The amendment does nothing to address the real needs of women facing financial challenges that forces them to consider late abortion. It leaves them only one regrettable choice. Is it progressive to focus solely on abortion access and forego the hard work necessary to make pregnancy more equitable for low-income women? The Colorado Department of Public Health and Environment licenses, regulates, and inspects thousands of health care facilities in the state to ensure public health and safety. The striking exception is second and third trimester abortion clinics. Abortion extremists pejoratively refer to any laws that regulate abortion clinics as TRAP laws. In their worldview the only motivation for such laws is to impede abortion access. They ignore the fact that second trimester abortions have a 10% complication rate and pose a 1.7% risk of life-threatening complications. While first trimester abortions are relatively safe procedures, the risk of dying from abortion increases by 38% for every additional week of gestation beyond 8 weeks. You would think we would have learned the danger of unregulated/uninspected abortion clinics from the Gosnell tragedy. Dr. Kermit Gosnell was responsible for the injury and death of countless women spanning decades because of the lack of governmental oversight at his Philadelphia abortion clinic. If Amendment 79 passes, legislators will be precluded from instituting prudent health/safety regulations for abortion clinics in Colorado. There would be nothing preventing a Gosnell-like horror in our state. Is it progressive to prioritize abortion access over the lives of women? A 22-week baby born prematurely enjoys all the rights and benefits of other Colorado citizens. Yet, a 22-week, pain-capable fetus in utero can be literally torn apart limb by limb during the D&E procedure favored by most abortionists in Colorado. Later in the second trimester and during the third trimester that fetus can be killed by poisoning before it is extracted during a D&X procedure. Digoxin is commonly utilized. Digoxin can cause hours of agonizing nausea, vomiting, and delirium before eliciting death. Is it progressive to define a human’s value and dignity based solely on their location or to sanction such excruciating deaths? Parental notification prior to a minor’s abortion is current law in Colorado. Guttmacher and other abortion advocacy organizations consider parental notification laws as impediments to abortion access. Amendment would eliminate this. The adolescent brain is still developing prefrontal connections that help modulate their subcortical emotional and impulsive responses to stressful situations, such as unplanned pregnancies. Without parental notification, our teen daughters may face these challenges with more input from their peers, teachers, or counselors than from the parents who love and know them best. And if parental notification is eliminated, sex traffickers will have an easier time eluding law enforcement as they coerce their young victims to have abortions. Is it progressive to remove parents from the most consequential decisions in their daughter’s lives or enable human traffickers? With Amendment 79 in the state constitution, abortions for any reason would be legal. Studies from the US and other countries document the extent that sex selection abortions occur, A Colorado late abortionist recently admitted that he has performed sex selection abortions. Is it progressive to allow abortion for blatantly sexist reasons? We know the answer. No, it is not progressive to promote unrestricted, unregulated abortion in Colorado. Abortion access is already ensured in Colorado. Amendment 79 is unnecessary, inhumane and potentially dangerous. Frances Rossi and Tom Perille MD - Founding members of Democrats for Life of Colorado
October 22, 2024
This piece was originally published in the Colorado Springs and Denver Gazette Perspective Column September 22, 2024 by Tom Perille MD (DFLCO President) and Wendy Smith What would it mean if the only medical intervention that is recognized in the Colorado Constitution’s Bill of Rights was abortion? And what would it mean if abortion was the only medical intervention that couldn’t be constitutionally excluded in private and public health insurance? Not access to basic medical care. Not pregnancy care. Not life-saving cancer treatments. Not mental health treatment. Not care for those addicted. Not affordable pharmaceuticals. Only abortion. That is what those who are pushing Amendment 79 (“Right to Abortion”) hope to accomplish. Not only would abortion at any time in pregnancy for any reason using any method become a fundamental right, but anything that “impeded” or “discriminated” against access to abortion would be prohibited. The people of Colorado have a right to know the profound and dangerous implications of such a measure which won’t be reflected in the Blue Book language. In a poll conducted in July by the Strategy Group, 71% of Colorado voters were unaware that abortion is currently legal under all circumstances in our state. Abortion access is guaranteed in Colorado law. Amendment 79 would do nothing to change that reality. Coloradoans have the right to know that with the amendment in the constitution, the people of Colorado and those working for them in the legislature could do nothing to regulate or restrict abortion in the future– even if those changes represented the overwhelming consensus of Coloradoans and protected the health and safety of women. There were between 468-486 late abortions after the limit of fetal viability (21 weeks) reported to the CDPHE in 2022 and 2023. Guttmacher estimates that there were 71% more abortions in 2023 than CDPHE reported making 500 a conservative estimate of the total number of post-viability abortions each year in Colorado. These babies can “kick” their mother, respond to her voice/touch, acquire her taste preferences, and feel pain while in the uterus. They can survive if born prematurely. Babies born at 22-weeks and later can be found lovingly cared for in neonatal intensive care units and nurseries across the state. Based on research from Boulder abortionist, Dr. Warren Hern, 70% of his late abortions are performed on healthy women with healthy babies. That translates into an estimated 350 healthy babies aborted late in pregnancy each year in Colorado for financial and social reasons. Coloradoans have the right to know that Amendment 79 does nothing to address the real needs of these women and simply streamlines access to one, tragic and regrettable choice. With Amendment 79 in place, legislators would be unable to restrict even the most extreme abortions on healthy women with healthy babies in the third trimester. Colorado parents are currently notified at least 48 hours in advance of their minor teen’s pending abortion. The abortion industry, their research allies (Guttmacher), and aligned medical professional organizations (ACOG) all consider parental notification before a minor teen’s abortion to be an impediment to abortion access. Coloradoans have the right to know that banning parental notification would be one of the most immediate consequences of Amendment 79. In practical terms, this means that the people that know and love the teen the most may be unaware of their pending abortion and unable to support their daughter. Even worse, teens may be pressured by peers or an abortion clinic counselor to pursue an action that is inconsistent with their wishes and core values. Parents may be blindsided by the potentially severe physical and mental health consequences of their teen’s abortion. And sex traffickers would be able to hide their nefarious trade by pursuing abortions for their teenage victims without the safeguard of parental notification. Trafficking is a multi-million-dollar criminal enterprise in Colorado. Victims rarely self-identify. Anyone who works with domestic minor sex trafficking knows that the very definition of trafficking involves force, fraud and/or coercion. It is also well known that girls who are trafficked often view their trafficker as their “boyfriend”, lacking the maturity and discernment to know they are being trafficked and in danger. If they refuse to do what the trafficker wants, they are often subject to physical and mental abuse until they submit. There is a growing concern over forced abortion, especially with the availability of medication and telehealth abortions. These girls are not free to choose. Without the safeguard of parental notification, minors may be exposed to continued risk. Keep in mind, minors can be brought across state borders by anyone for abortion, just to be released back to the trafficker/perpetrator. For this reason, parents have a right to know when their daughter is considering abortion so that they can seek help and intervene. Most states have regulations that pertain to abortion clinics and promote the health and safety of women. Colorado is not one of them. The abortion industry pejoratively refers to any regulation that specifically applies to abortion providers as TRAP laws. They view them as impediments to abortion access. Even though thousands of medical facilities and agencies are licensed, regulated and inspected by the Colorado Department of Public Health and Environment, second and third trimester abortion clinics are the glaring exception. This omission is especially perplexing since second trimester abortions have a 10% overall complication rate and 1.7% life-threatening complication rate. The risk of having a complication increases for each additional week of gestation. Furthermore, the risk of dying from an abortion increases 38% for each week of gestation beyond 8 weeks. We should heed the lesson from other states that have tragically witnessed the maiming and death of women when government oversight is lax or non-existent – such as Pennsylvania and Dr. Gosnell. Coloradoans have a right to know that if Amendment 79 passes, the state will be unable to impose prudent health and safety regulations for abortion clinics which may jeopardize women’s health and lives. Another goal of Amendment 79 is to facilitate publicly funded abortions. Currently, Colorado Medicaid only pays for abortions in circumstances of rape, incest, and threats to the life of the mother. If Amendment 79 passes, the prohibition against public funding in the constitution will be removed and the state will be able to underwrite elective abortions for Medicaid patients. In states where public funding for abortion is already law, they spend millions of dollars subsidizing abortion for in-state and out-of-state women. Coloradoans have the right to know that this may take precious tax dollars away from other medical priorities like pregnancy services and mental health. It may even divert money from non-medical budgets for education, affordable housing, and the environment. There is already inadequate private and public support for pregnant women in our state. One of the few shining exceptions is the 58 pregnancy resource centers. They provide millions of dollars of uncompensated care to women during and after challenging pregnancies. However, because they typically don’t offer abortion services or refer for abortions, the abortion industry has been targeting these charitable organizations. Coloradoans have the right to know that the ability of pregnancy resource centers to assist pregnant women in need may be jeopardized by the passage of Amendment 79. Under Amendment 79, the right to abortion would become absolute. Coloradoans have the right to know the implications of such an extreme position. It would strip all rights and protections from the developing fetus, even those that are wanted. The legislature couldn’t proscribe abortion methods that are especially cruel such as second trimester D&E (dismemberment) abortions on pain capable fetuses. It would jeopardize the conscious rights of medical professionals across the state who maintain medical/scientific, moral or religious objections to elective induced abortions. Since the amendment forbids “discriminating” against a woman’s desire for an abortion, even physicians and nurse practitioners who perform abortions would be unable to refuse abortions for reasons they may view as morally repugnant – such as aborting a fetus solely because of their sex (which is already occurring) or because of the ethnicity/race of their father. Abortion access is already guaranteed in Colorado law. Making the right to abortion the only medical procedure recognized in our constitution is extreme and ties the hands of Colorado citizens and legislators. It goes far beyond the abortion rights promulgated in the Roe decision. Coloradoans have the right to know that Amendment 79 would have these many unintended consequences. Given the facts, we hope that Coloradoans reject Amendment 79.
By Thomas Perille March 1, 2024
By Tom Perille January 31, 2024
We should recognize ideological conflicts of interest in clinical research just as we recognize financial conflicts of interest in clinical research. It doesn't negate the studies, but tells us about potential biases and requires us to look more closely at the methodology and reporting.
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By Thomas Perille MD July 26, 2025
It seems that we live in an era of Rorschach tests. You only have to say one word and you will create a predictable and visceral response depending on where you lie in the political spectrum. Migrants. Gender. Ukraine. Gaza. Guns. And one of the most enduring triggers and divisive words is abortion. How do we navigate in a world characterized by such extreme polarization and tribal political organization? Is abandoning efforts to engage with those who possess a different worldview the most logical and realistic path? Should those who hold the majority view simply squash those with a dissenting view? Or is there something fundamentally lost in society when we relinquish our innate human desire for solidarity with those in our community -even when they may harbor radically different perspectives. Can a democracy survive such division? Is there a way to model a different approach? Addressing abortion in a constructive way can be the prototype for a host of other heated, if less contentious issues. It seems the first principle of engagement should be to assume that those with an opposing view aren’t ignorant or evil but rather sincere and motivated by a desire to make the world a better place. Second, we need to look beyond the propaganda on both sides of an issue, to create space for dialogue. It isn’t necessary to agree on the veracity of all the published information pertaining to the topic, but we should be prepared to establish a set of underlying moral principles/values that best reflect the differing views. Lastly, it is important to acknowledge the very real differences in our beliefs but focus on finding common and overlapping interests. It is never necessary to abandon firmly held moral principles to forge policy and programs that appeal to those with opposing views. And establishing a relationship with someone you adamantly disagree with doesn’t mean you subscribe to moral relativism. For abortion, we first must acknowledge that many of those with the most emotional responses to the issue have either had an abortion or their sexual partner had an abortion. Some will be asserting the righteousness of their abortion decision and others may be reacting with guilt/shame to the memory of their abortion. If we aren’t sensitive to these emotions, it will be hard to move towards a productive dialogue. And we should recognize that both prolife and prochoice adherents deeply care for the health/life of women. The prolife movement bends the truth to advance their cause. You often hear prolife advocates state, “that abortion is never medically necessary”. This is more a semantic error than a factual error. For many, induced abortion is so morally abhorrent that they prefer to use the term “separation” or “premature delivery’ in the case of a medically indicated abortion. A medically indicated abortion refers to the previable termination of a pregnancy to prevent maternal organ damage or preserve the life of the mother with the unintended, but foreseeable, death of the developing human embryo or fetus. (In contrast, in an elective induced abortion, the expressed intent is to end the pregnancy by killing the embryo/fetus with the manner of fetal death and the gestational age being immaterial.) Medically indicated abortions are rare. Abortion to preserve the life or prevent serious bodily injury represents approximately 0.05% of abortions based on a high-quality registry study from the UK where reasons for abortions are tracked. (The US does not track indications for abortion). “Therapeutic abortions” were part of medical reality long before Roe was decided in 1973 and were incorporated into the medical repertoire of every OB/GYN for decades, including the prolife clinician. Prochoice advocates also sow confusion to promote their cause. They propagate the myth that “nobody can definitively know when human life begins”. The fact that a new human life begins at fertilization dates back to the first scientific observation of sperm and egg fusion in 1876 by Oscar Hertwig. To argue that a human life begins at birth is an antiquated religious view not based on science or biological expertise. What prochoice adherents may mean is that a human being doesn’t have value, dignity, or legal rights till they are born – but that is an entirely different argument. They may believe that the moral significance of fetal life is not biologically determined, but socially or philosophically constructed. Nonetheless, they need to acknowledge that assigning differential value to distinct groups of human beings based on immutable characteristics such as age, sex, sexual orientation, physical/mental abilities, race, or ethnicity has been a fraught topic throughout human history. Those who promote abortion as a moral response to an unexpected pregnancy sometimes obscure the humanity of the developing embryo and fetus with dehumanizing language. Examples include describing a sophisticated human embryo as a “cluster of cells” in the New York Times or a second trimester fetus as “pregnancy tissue“ on the Rocky Mountain Planned Parenthood webpage. This stands in contrast to the language that is commonly used by every expectant mother and her obstetrician who routinely describes the “wanted” embryo/fetus as a “baby”. For the purposes of engagement, abortion proponents and opponents should avoid using loaded language that is intended to manipulate rather than clarify. The last domain of obfuscation pertains to the conflation of miscarriage and stillbirths with induced abortion. Miscarriages and abortion may require the use of the same medications and surgical procedures but that is where the similarity ends. In miscarriage or “spontaneous abortion”, the embryo and fetus suffer a tragic, but natural, death. A medical or surgical procedure may be necessary to remove any remaining fetal or placental remains to prevent infectious and hemorrhagic complications. Pregnancy has already terminated naturally; thus, this is not an induced abortion. In elective induced abortion, a medical or surgical procedure is performed to terminate the pregnancy explicitly by killing the embryo or fetus. Laws that restrict elective induced abortion have no medical or legal bearing on the treatment of miscarriage. Medical malpractice rather than anti-abortion laws drives much of what the mainstream media cites as evidence to the contrary. The primary reason that any doubt exists in the minds of inexperienced clinicians is the misdirection by professional medical abortion advocates such as ACOG (American Association of Obstetricians and Gynecologists). After peeling away the spin/propaganda from either side of the abortion debate, you have a much simpler discussion: when is it permissible to kill a dependent human being to respect a woman’s bodily autonomy and free her from the physical, social, emotional, and economic demands of pregnancy and childcare. Prolife advocates need to aggressively address the needs of the woman and not focus exclusively on the fetus. Prochoice advocates need to explicitly address the biological reality and moral relevance of the developing human and not focus exclusively on the woman. Framed this way, the potential for finding common ground dramatically increases. Prolife advocates can agree that there is real, albeit very rare, medical indications for abortion. They can work with prochoice advocates to ensure that all medical professionals address the needs of both of their patients while working vigorously to save the life of the mother when pregnancy complications would jeopardize the lives of both. It is possible to imagine that an agreement to limit late abortion on healthy women carrying healthy fetuses’ post-viability could be achieved. Restrictions of abortion techniques which are especially inhumane, such as D&E, which involves the systematic dismemberment of a pain capable fetus, may be another area of agreement. There shouldn’t be controversy making high risk second and third trimester abortions safer through state licensing, regulation, and inspection of late abortion facilities since the health/safety of women drive both perspectives. Prochoice advocates should support medical professionals who have conscientious objections to participating in abortion since elective induced abortion involves intentionally taking the life of another human being. This is not a trivial or arbitrary moral decision. It reflects their sincere commitment to foundational secular humanist or religious principles. Prochoice advocates who believe that abortion must be a free choice, should find common cause with prolife advocates to prevent the social/economic coercion that commonly drives an abortion decision. Both could embrace a parallel interest in reducing the asymmetrical burden of human reproduction. This may be accomplished through a variety of initiatives. Joint efforts to improve accommodations for pregnant women in education and the workforce would become a major priority. Supporting/expanding paid family leave programs and subsidized daycare would be another. Publicizing government/private non-profit programs that provide counseling and material support to pregnant women and their families – including Pregnancy Resource Centers (PRCs) – would be a third. Ameliorating the financial burden of pregnancy that disproportionately falls on women would need to be addressed. Expanding male partner prenatal/postnatal financial support is one tool. Making birth (prenatal, birthing services, and post-partum care) free through a combination of government/private insurance programs is essential. Men should not be able to avoid the financial burden of human reproduction by avoiding child support or purchasing “skinny” health insurance without pregnancy coverage. Conservative prolife legislators should eschew their aversion to insurance mandates to serve a greater goal. It is a matter of reproductive equity. PRCs offer millions of dollars of uncompensated assistance to pregnant women and their families. However, those expressing prolife beliefs undermine their dedication to women and their preborn children when they refuse to acknowledge the role of government in setting policies and supporting programs that address their additional needs. There are already recent examples of legislative efforts that demonstrate how prolife and prochoice advocates can work together for the common good without compromising their sincerely held beliefs regarding abortion. At the federal level, Senators Hyde-Smith (R), Kaine (D), Hawley (R), and Gillibrand (D) recently introduced the “Supporting Healthy Moms and Babies Act” which would make birth free. In Colorado, Senator Jeff Bridges (D) sponsored SB25-144 which extended family leave for mothers of very premature babies that require prolonged neonatal intensive care. He also sponsored SB25-118 which took a small slice out of the prenatal care cost burden in Colorado. Unfortunately, there are many more examples where this kind of dialogue is considered too politically risky. A very sad example was the recent defeat of a bill (HB25-1252) to allow the Colorado Department of Public Health and Environment (CDPHE) to regulate second and third trimester abortion facilities using evidence-based best practices– as they do with other medical facilities with lower or similar risks. It was killed in the House Health and Human Services Committee along tribal ideological lines. It is past time to bridge the ideological and political divide. Let partisans on either side of a hotly contested issue commit publicly to constructive engagement. No longer should we treat people with opposing views as “enemies”. Collaboration should be the norm in our communities and state/federal legislatures rather than the exception. When you seek to identify core values, you can invariably find overlapping interests. There isn’t an issue that doesn’t lend itself to this approach. This is good for our communities, good for our nation, and good for democracy writ large. Ultimately, it may even move the culture towards the morally correct position.
By Thomas Perille MD April 30, 2025
This is cause for celebration. Warren Hern was an outlier in the field of medicine that itself is an outlier. It is the only medical specialty that is devoted to killing human beings rather than restoring health or ameliorating suffering. Hern famously compared humans to a spreading “cancer” on the earth. It is not surprising that he devoted his career to using abortion as a form of population control. He considered pregnancy a disease and felt that no justification was needed to pursue abortion at any time for any reason. The fact that 70% of his late abortion practice targeted healthy women carrying healthy fetuses was often underappreciated or misrepresented by the media. One can hope that the fact that he could not find another physician to assume his grisly late abortion practice may be a sign of hope that the era of unlimited, unrestricted, and unregulated abortion may be nearing an end.
By Thomas Perille MD April 22, 2025
April 17, 2025 Governor Polis, Democrats for Life of Colorado implores you to consider the fiscal implications of signing SB25-183 into law. Research from the Guttmacher Institute published in 2024 demonstrates that in states where Medicaid pays for elective abortions, 62% of abortions are Medicaid abortions. If you apply this figure to Colorado, this means that SB 183 will create a huge financial liability for the Colorado Medicaid system at a time when the state is straining to contain a greater than 1-billion-dollar budget deficit. CDPHE reported that there were 10,368 abortions on in-state residents in 2023. The legislative council’s fiscal note on SB 183 estimates a $800 Medicaid reimbursement for medication abortions and a $1300 Medicaid reimbursement for surgical abortions. The legislative fiscal note also divides abortions into 50% medication and 50% surgical in calculating the state’s financial commitment. This would translate into a total cost of $6,749,568 for the estimated 6428 abortions (using the 2023 CDPHE numbers). If you use Guttmacher estimates for the number of abortions in Colorado, the number would be at least 40% higher. The fiscal liability doesn’t stop with the monetary payment for elective Medicaid abortion, since the Legislative Council adds the loss of $1,721,497 federal matching dollars. This will make the total estimated state’s obligation at $8,471,865 using the more conservative CDPHE numbers. And you can’t count on the misleading Legislative Council analysis for cost savings from “averted births”. This is an overly simplistic analysis for many reasons. Up to 20-30% of miscarriages occur after 6 weeks. This means that many of these “averted births” would have ended in miscarriage and not cost the state the cost for funding an abortion. Most births won’t be “averted” because these women will go on to have pregnancies that go to term later in their reproductive life. We know that the risks of pregnancy complications correlate directly with maternal age. These “delayed” rather than “averted” births, will increase Medicaid costs because of the increased risk of gestational diabetes, preeclampsia, and premature births in these later pregnancies. It is also well established that surgical abortions increase the risk for premature birth in subsequent pregnancies, including extreme premature births. To the extent that this legislation increases surgical abortions, it will markedly increase Medicaid Neonatal Intensive Care Unit costs. Furthermore, there is good data that suggests that women undergoing abortions seek mental health services at a much higher rate, which also will increase Medicaid costs. There is evidence that subsidizing abortions for lower income women, increases abortion rates which will, in turn, increase Medicaid abortion costs. The Legislative Council used a tiny study from Louisiana to estimate the number of additional abortions that will be performed when public funding is available. The Louisiana study demonstrated that only 1% of Medicaid eligible women who were pregnant (and didn’t already abort) would have considered abortion if the state had providing funding. This means the immediate impact on increasing abortion access will be extremely small but likely increase over time. The Legislative Council failed to acknowledge that Louisiana low-income women have very limited access to private abortion funding. This is in stark contrast to the robust private funding for abortion from the Cobalt Fund and the National Abortion Federation funds here in Colorado. Consequently, you can’t rely on the experience in Louisiana to project Colorado’s costs. SB 183 will simply be shifting abortion costs for low-income women from private sources (Cobalt/NAF) to Colorado taxpayers. We are very concerned that Medicaid already fails to reimburse pregnancy services adequately which results in maternity deserts. This new elective abortion financial obligation will likely further compromise pregnancy services and other higher Medicaid priorities. The multimillion-dollar increase in state funding that is necessary to pay for elective Medicaid abortions stands in contrast to the “zero” fiscal impact that Amendment 79 was purported to have based on the Bluebook verbiage. If voters understood that they were voting for a multimillion-dollar tax increase to pay for abortion, it is safe to say that more than 38% of the Colorado electorate would have voted against the amendment. We are opposed to using public funds for elective abortions. However, even if you thought this was required for “equity” purposes, this is not the time or the fiscal circumstances that justify such an expensive measure. Thanks for your consideration. Thomas J. Perille MD FACP FHM President, Democrats for Life of Colorado
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