The earliest time that any genetic testing could be done would be at seven weeks, Dr. Palmer said, so the patient decided to terminate her pregnancy before the six-week mark, in Texas. At the office, her ob-gyn turned down the ultrasound volume so they wouldn't have to hear. Since that time, thousands of women have left Texas to obtain abortions in other states. Dr. Ghazaleh Moayedi, an obstetrician/gynecologist and abortion provider in Texas, said the new law leaves unclear whether a physician can act when a woman has a spontaneous miscarriage and is bleeding heavily, but the fetus has not passed. Back at home, the Wellers got more serious about their travel plans and started booking tickets. Fetuses who do survive a premature delivery can die soon after birth, or, if they survive, may experience major problems with their lungs, or suffer strokes, blindness, cerebral palsy or other disabilities and illnesses. The Texas Health and Safety Code allows abortion in cases of an ectopic pregnancy or during a "medical emergency," when a "life-threatening physical condition aggravated by, caused by, or . area received a letter from a pharmacy in late 2021 saying it would no longer fill the drug methotrexate in the case of ectopic pregnancy, citing the recent Texas laws . KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Enough to make her retch. I couldn't give you life. It is life-threatening to the mother and is not viable and needs to be removed. I want to see legislation come out that will both do more as well as clarify the ways that we are protecting the life of the mother.. Or hell honestly it shouldn't even get to the point where you're having to save a woman's life. It was just the most tender moment, she said. Enough to make her retch. Many Texans facing this same set of circumstances wont have the means to leave the state, Thoppil said, contributing to the states high rates of maternal morbidity and mortality, particularly among communities of color. Among other risks, both the fetus and Elizabeth were now highly vulnerable to a uterine infection called chorioamnionitis. Just a reminder here that in 2019 an Ohio Republican proposed a bill requiring that in the event of an ectopic pregnancy the zygote must be removed from the fallopian and reimplanted in the uterus or the physician should face murder charges. She had cramps, and was passing clots of blood. After her initial miscarriage in 2018, Stell and her husband had their first child, a daughter, in April 2020. But some health conditions can jeopardize a womans health in the long term but not necessarily constitute an immediate threat to her life. That's when she felt something "shift" in her uterus, down low, and then "this burst of water just falls out of my body. A clinical battle begins behind the scenes. And it's this stupid, like, distinction that you're just making in this grief. She never had to use that bag. An attendee holds her child during A Texas Rally for Abortion Rights at Discovery Green in Houston, Texas, on May 7. "And if they didn't believe me, I was going to show it to them and say "Look! But the lack of clarity accompanying the threat of jail time and six-figure fines for medical professionals has led some hospitals and doctors in the state to deny or delay care for pregnancy complications, according to multiple reports. care provider and intended to remove an ectopic pregnancy that . An ultrasound confirmed that she had suffered premature rupture of membranes, which affects about 3% of pregnancies. Her discharge had to be darker. But Prager believes that the laws in Texas and perhaps elsewhere soon could boost physicians' vulnerability to medical malpractice lawsuits. As Hall learned the hard way, the law makes no exception for lethal fetal anomalies. Another area of Texas law that Seago cited provides an exception to the state's abortion restrictions if the mother's life is in danger or she's at "serious risk of substantial impairment of a major bodily function" unless an abortion is performed. But those numbers have skyrocketed since Roe v. Wade was overturned. Crescenda Uhles, a genetic counselor in Dallas, said the Texas law puts people like her in a bind when advising patients. Starting last September, when the [ban on abortions after about six weeks of pregnancy] went into effect, we started getting calling from Texas and it hasnt stopped.. Her husband took over, asking the doctor what, if anything, they could do. the U.S. that have trigger laws in place banning abortion in the . Under another new Texas abortion law, someone who "aids or abets" an abortion after cardiac activity can be detected typically around six weeks can be subject to at least a $10,000 fine per occurrence. If patients run into trouble filling prescriptions, Thoppil and Crawford say they should try to find another pharmacy or talk to their health care provider. Even in Texas, whose "heartbeat bill" was one . The new law in Texas bans abortion at 6 weeks when a fetal "heartbeat" can be detected. It doesnt take a huge leap to see that our rates of complications will go up because we have a selection bias on who is going to have to continue more complicated pregnancies.. Correction, Oct. 24, 2022 at 4:12 p.m.: by Mara Mndez This chapter may be cited as the Texas Abortion Facility Reporting and Licensing Act. A doctor sat down and told her: "There's very little amniotic fluid left. She considered Colorado and New Mexico, the nearest states without a total ban, but both states are being inundated with patients from Texas and elsewhere. Every OB-GYN has cared for someone who has died from a hemorrhage, she said. "And yet we're being pulled through this.". All of Texas abortion laws have exceptions to treat miscarriages and ectopic pregnancies, a potentially life-threatening condition in which a fertilized egg grows outside the uterus, as well as to save the life of the pregnant patient. Confusion around the laws has caused issues for patients outside of emergencies. The Ohio state legislature, which introduced a bill in 2019 requiring doctors to "reimplant an ectopic pregnancy" into the uterus, or face charges of "abortion murder," despite the fact . As Elizabeth recalled hearing, it was one particular doctor who had argued her case: "They found a doctor from East Texas who spoke up and was so patient forward, so patient advocating, that he said 'This is ridiculous.'". In Texas it's literally written in the law that an act is not an abortion to remove an ectopic pregnancy. Another patient in Dallas was denied a surgical procedure for a miscarriage, according to The New York Times, and a Texas woman told CNN she had to carry her dead fetus for two weeks until she could find an OB-GYN willing to remove it. Cheng did not treat Hall, but has counseled patients facing similar situations. She knew she did not have the flexibility to be able to travel out of state for an abortion later on. Elizabeth and James keep remembrances of their baby in a picture frame at home. hide caption. Cheng, in San Antonio, said that even as she cautiously points her patients to their options out-of-state, shes well aware that many of them struggle to even make it to their appointments in-state. After all, she didnt need an abortion she needed convenient pregnancy care. Pregnancy is dangerous, and there are many potential risks for a fatalityectopic pregnancy, severe preeclampsia, cancer, heart conditionsall things that would drive a person to seek an abortion. It includes laws about. Things did go fairly smooth at first. pursuant to the preliminary injunction in texas v. becerra, no. Other times patients don't report the problem and miscarry on their own, she said, but without medication they risk additional bleeding. This current law excludes treatment for miscarriage or ectopic pregnancy. And now the Texas abortion law has created an additional bind, Cavazos explains. ", And at this particular point in her life, pregnant for the first time at age 26, it was still somewhat abstract: "I had not been put in a position to where I had to weigh the real nuances that went into this situation. Today, abortion is also illegal in Texas under an old 1925 law that the state's Attorney General Ken Paxton declared to be in effect after Roe was overturned. But now in Texas, the new laws are creating uncertainties that may deter some doctors and other providers from offering optimal miscarriage treatment. But he did not address the question of lethal fetal anomalies, which are fatal for the fetus during pregnancy or shortly after birth. That is a pregnancy that occurs outside the uterus. There are currently no abortion laws that outlaw treatment of ectopic pregnancy. And I told her 'I'm so sorry. How Every State Pro-Life Law Handles Ectopic Pregnancy and Miscarriage Texas police separate anti-abortion protestors from abortion supporters during the nationwide Women's March in Austin, Texas . A doctor hugs a patient at an abortion clinic in Santa Teresa, New Mexico, on 13 January 2023. A miscarriage is generally defined as the loss of a fetus before the 20th week of pregnancy typically because of complications outside of a patient's control. I couldnt do that., by Eleanor Klibanoff tex. "He and I kept telling each other 'What is the whole point of the Hippocratic oath to do no harm?'" other than an abortion performed due to a medical emergency as defined by Section 171.002, Health and Safety Code]. Unnamed, unknown doctors somewhere had come to an agreement that Elizabeth could be induced that night. An ectopic pregnancy, which occurs when a fertilized egg . '", "It was devastating to hear that," Elizabeth says. "The pharmacy has said, 'We don't know whether or not you might be using this medication for the purposes of abortion,'" she said. But when she called, they told her that nausea and vomiting weren't among the symptoms they were looking for. "We shouldn't have been celebrating," Elizabeth says. Right there in the office, James pulled out his cell phone, and started looking for flights to states with less restrictive abortion laws. Texas Health and Safety Code, Chapter 171. "It's terrible," says Dr. Alan Peaceman, a professor of maternal-fetal medicine at Northwestern University's Feinberg School of Medicine. "The penalties are quite draconian," he said, noting that someone could be convicted of a felony. ", State abortion laws are complicating other types of obstetric care. Idaho, Tennessee and Texas will implement abortion bans in 30 days, according to the text of the laws. "And she starts to cry and she tells me: 'They're not going to touch you.' Miscarriage And they're telling me to think of the positives. It was just a matter of time before the baby died, or maybe Id have to go through the trauma of carrying to term knowing I wasnt bringing a baby home, said 27-year-old Lauren Hall. Hall shelled out thousands of dollars to abruptly travel out of state while grieving a lost pregnancy. There they found themselves pinned down, clinically and emotionally, victims of a collision between standard obstetrical practice and the rigid new demands of Texas law. Hall was in her second trimester when the U.S. Supreme Court overturned Roe v. Wade. ", Later on, Elizabeth said she realized that her anger at Methodist was misplaced. Double your gift when you give by 6 p.m. Thursday. They have jobs and multiple children to take care of and they dont have the finances to take four or five days to go to a different state. Treatments for miscarriages and ectopic pregnancies are still legal under Texas abortion ban. It was just too hard, as she navigated a complicated mix of relief and grief. "I was just laying in bed, you know, wondering: Am I pregnant or am I not pregnant? She had to go two days in a row and both times the staff gave her the support, sympathy and care shed been missing in Texas. But in early May, not long after the uneventful anatomy scan, the Wellers suddenly arrived at that crossroads. In the nursery upstairs, they had already stashed some baby clothes and new cans of paint. Seventeen weeks into the pregnancy, they learned they were expecting a girl. Midnight came and went in a blur. Her mental health spiraled to the point that she considered checking herself into the hospital. But pregnancy care isnt as clear cut as the law makes it out to be, doctors say, and fear of criminal prosecution has led medical professionals to delay or deny care they otherwise would have provided. Given the states severe penalties, Grossman said medical professionals and their legal teams might err on the side of caution in regard to the law, even if it puts patients at risk. A wait for fetal death, or her own encroaching illness. It is the Cedar River Clinics in Renton, Washington, not the Cedar River Clinic in Seattle. As the Supreme Court appears poised to return abortion regulation to the states, recent experience in Texas illustrates that medical care for miscarriages and dangerous ectopic pregnancies would also be threatened if restrictions become more widespread. Elizabeth and James Weller at their home in Houston two months after losing their baby girl due to a premature rupture of membranes. Question women in America now have to ask. One option was to end the pregnancy; that's called "a termination for medical reasons." Later in pregnancy, doctors can try to delay delivery to give the fetus more time to develop, while also warding off infection or other maternal complications such as hemorrhage. Texas Attorney General Ken Paxton quickly sued the Biden administration over the federal guidance. "It's just really unimaginable to be in a position of having to think: How close to death am I before somebody is going to take action and help me?". Almost immediately, though, Texas conflicting and confusing laws on abortion started to cause problems for pregnancy care. "That's torture to have to carry a pregnancy which has such a low chance of survival," says Dr. Peaceman. SHORT TITLE. Because once they reached Methodist, while they were still checking in at the emergency room, her doctor called. We never advocate taking a life of an unborn child unless it is necessary to protect the life of a woman, said Joe Pojman, executive director of the Texas Alliance for Life. But Texas's medical exception is narrower, and less defined . Halls entire vision of this pregnancy giving birth, becoming a mom, watching her daughter grow up evaporated in an instant. The one exception is a medical emergency, but the law requires doctors to document the reasons for the exception with great specificity. "Abortions are sometimes needed out of an act of an emergency, out of an act of saving a woman's life. "This poor woman had no idea what she was telling me. They also had an anatomy scan, which revealed no problems. Under Texas' Senate Bill 8, abortions are banned after six weeks of pregnancy, and the only exception is if a doctor determines a patient will face a "medical emergency" if the procedure isn't . But in cases of unviable pregnancies in which fetal cardiac activity can still be detected, treatment to remove the expected miscarriage could be considered illegal under Texas laws, Grossman said. Everyone was thrilled, buying them car seats and baby clothes. But the hospital staff told her that those weren't the right symptoms, yet, of a growing infection in her uterus. Hall, raised in a conservative Christian family outside Dallas, felt like she had whiplash from the sudden and tragic events that had brought her to an abortion clinic halfway across the country. For the women, expectant management after premature rupture of membranes comes with its own health risks. Join us for Texas biggest politics and policy event when you buy your tickets today. Everyone was so scared.. She was bereft, unable to even process the news. Anyone who aids and abets the procedure can also be sued, and the law promises plaintiffs $10,000 and legal fees if they win the lawsuit. Other complications that occur when a woman is carrying twins or multiples can be resolved by a selective reduction, or abortion, of one of the fetuses so that the other has a better chance to live. Many doctors say they are unable to discuss the procedure as an option until the patients condition deteriorates and her life is at risk. You open it. "And yet we were. This article originally appeared on Austin American-Statesman: Here's what current Texas abortion laws say, plus birth control info One of the most painful parts was trying to reach her medical team. I would always say, What if it was necessary to save the life of the mother? "And they decide to sue for malpractice," she said. Either way, she saw nothing ahead but fear and grief prolonged, delayed, amplified. "Later they laid down this beautiful baby girl in my arms. Thats what recently caused Dr. Jessian Munoz, an OB-GYN in San Antonio, to wait a day to treat a patient who had started to miscarry and developed a womb infection, according to the Associated Press. All you can do now is just hope and pray that things go well.". If youre having severe pain, if youre getting a fever, you need to keep your medical team in the loop, Crawford said. "I told her 'I'm so sorry. Many physicians say they cannot intervene in complex pregnancies that may not pose an immediate threat to the patient but can rapidly spin out of control. Hall was 18 weeks along when she went in for hers on a Friday afternoon. Despite the tragedy she was facing, Hall knew she was one of the lucky ones. Because at this point, I'm in survival mode. At that point, the patient can opt to wait until the bleeding starts and the pregnancy tissue is naturally released, Briggs said. Initially, the patient may not be in danger, and under the law physicians may be prohibited from taking action, even though the baby will not survive. We do what we can to honor each of those cases.. Time is of the essence. But the Wellers and 28 million other Texans had already been living under a de facto abortion ban for 8 months, since September 2021. And I screamed because that's when I knew something wrong was happening. But now were forcing someone to continue the pregnancy and go through all the risks of a potentially term delivery and all those potential complications for a pregnancy that has no chance of surviving. The women who will be forced to carry these babies are the women with less resources, he said. Thats why Crawford said its important for patients to quickly seek medical care if they notice their pregnancy isnt progressing normally or they are bleeding. hide caption. judicial order, all other provisions of Texas law regulating or She and her husband immediately jumped into planning mode, scheduling an appointment at one of the only OB-GYN practices in town. "It wasn't that the Methodist Hospital was refusing to perform a service to me simply because they didn't want to, it was because Texas law put them in a position to where they were intimidated to not perform this procedure.". 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