In this week's BMJ, a senior doctor raises serious concerns over abortion law in the US state of South Dakota.
Earlier this year, South Dakota passed a bill which bans virtually all abortions in the state except for circumstances in which the procedure is necessary to "prevent the death of the mother." Under this new legislation, doctors face prosecution for the termination of any pregnancy in which maternal death is not clearly averted by its performance.
This law does great harm to women with complicated pregnancies and must be opposed, argues, Dr Marvin Buehner, an obstetrician and gynaecologist who has practiced in South Dakota since 1993.
Even then elective abortions were performed only in a single clinic in this state, which was picketed for years, giving rise to the notion that providing abortion services would be professional suicide for any private practitioner, he writes.
"The environment of intimidation here is still so pervasive that neither I, nor my colleagues, nor our state medical association spoke in objection when the legislature proposed a sweeping abortion ban, vetoed in 2004, or when it was reintroduced this year."
But despite the difficulties, he is determined to continue to provide termination options for women with serious medical complications.
He has publicly testified that the law does great harm to women with complicated pregnancies and has worked with the South Dakota State Medical Association and the American College of Obstetricians and Gynaecologists to oppose the law for its "horrific medical consequences."
As a result, he faces "a daily parade of protesters" outside his office, even though neither he nor any of his partners perform abortions at their clinic.
Polling data show that 70% of physicians in the state oppose the law, and that the public is poised to reverse this draconian bill in a November referendum, primarily because there are no exceptions for victims of rape or incest, he says.
If the law is overturned, the battle over abortion will continue to rage on in the United States. But perhaps the defeat will allow more reasonable voices to be heard over the harsh rhetoric of extremists, he concludes.