In this chapter: (1) "Abortion" means the act of using or prescribing an instrument, a drug, a medicine, or any other substance, device, or means . Sept. 1, 1989. I couldnt do that., by Eleanor Klibanoff It's an emotional and legal dilemma that potentially faces not just obstetricians and midwives, but also family physicians, emergency physicians, pharmacists, and anyone else who might become involved with pregnancy care. And I knew my baby was suffering, I knew I was suffering, I knew my husband was suffering.". Elizabeth and James Weller at their home in Houston two months after losing their baby girl due to a premature rupture of membranes. Under Texas law, doctors can be sued by almost anyone for performing an abortion. Dr. John Thoppil, an obstetrician in Austin, doesnt perform abortions, providing prenatal care and delivering babies. Because the alternative was hell.". Many of the patients that we see in my practice already have to drive so far away to get basic prenatal care, Cheng said. But it was the only choice they had to save this young woman. She eventually agreed, and the treatment was begun as soon as an abortion was performed. But now "your medical provider says that it's illegal and they can't provide it. Thaxton, who supervises the obstetrics-gynecology residents who have seen these patients, said sometimes the prescribing clinic will intervene, but it takes the patient longer to get the medication. For example, last year's Texas Heartbeat Law incorporated Texas' Health & Safety Code 245.002, which states (emphasis added): And quickly. "You have to ask yourself, would I put any living thing through the pain, and the horrors, of having to try to fight for their life the minute that they're born?". Texas Gov. She was diagnosed with an aggressive lymphoma, a cancer of the immune system. And at least one Texas pharmacy has let area physicians know that they would no longer dispense methotrexate, the medication used to treat ectopic pregnancy, citing the law. We do what we can to honor each of those cases.. We havent seen a large issue, but there are certainly anecdotes, Thoppil said. These are the patients that are the most affected.. Confusion around the laws has caused issues for patients outside of emergencies. With regard to pregnancy-related complications for women of any age, Dr. Skop said, the new law allows doctors to act when necessary and to justify their treatments in court if they are sued. Selective reductions are forbidden under the new state law. Texas' current heartbeat ban enables private citizens to sue anyone who helps someone get an abortion after about six weeks. But the language is ambiguous, and travel can be expensive and onerous for pregnant women, especially if they are unwell. Marlena Stell always wanted a big family. Every OB-GYN has cared for someone who has died from a hemorrhage, she said. Tom Mayo, a professor of law at Southern Methodist University's Dedman School of Law in Dallas, understands why some in Texas' pharmacy community might be nervous. Its been a difficult few weeks since the procedure. The protesters outside a Seattle-area abortion clinic waved pictures of bloody fetuses, shouting that she was a baby killer and begging her to choose life. With it in place, his patient faces a pregnancy rife with potential medical problems. And it had to smell foul, really bad. hide caption. It was just too hard, as she navigated a complicated mix of relief and grief. A miscarriage is generally defined as the loss of a fetus before the 20th week of pregnancy typically because of complications outside of a patients control. After Hall made it through the protesters and the clinics security screening, the clinic itself was an oasis, she said. If someone is hemorrhaging while miscarrying, how long do I have to wait?. Frustrated with her experience on hormonal birth control, she and her husband decided it was time for her to get off of it. 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. The crisis the Wellers endured is emblematic of the vast and perhaps unintended medical impacts of the criminalization of abortion in Republican-led states. She places the blame for the ensuing medical trauma on the Republican legislators who passed the state's anti-abortion law, on Texas Gov. Her water had broken midway through the pregnancy, but her doctors, fearing prosecution if they violated the abortion ban, did not begin treating her until the fetuss heart stopped on its own. They were just all shocked, like, Surely, theres an exception for this, Hall said. About 10% to 20% of confirmed pregnancies end in miscarriages, but estimates are as high as 30% to 50% for all pregnancies, including those in which a person may not know of the pregnancy. The measure deputizes private citizens even those with no connection to the patient, doctor or health center to sue anyone who performs an abortion once cardiac activity can be detected in the embryo. Texas' abortion restrictions a ban that prohibits most abortions after about six weeks of pregnancy, as well as a law passed last year that will ban nearly all abortions, plus older statutes . She had the proof. Seventeen weeks into the pregnancy, they learned they were expecting a girl. How do they follow the latest guidelines when numerous other people from other medical professionals to friends and family members can question their intent: Are they helping care for a miscarriage or facilitating an abortion? We physically watched her get sicker and sicker and sicker, he told the AP. ", "Let's say I do have to go through this situation again. These cases are only going to grow until the law is either repealed or clarified. All the changes your body faces in pregnancy are going to be very similar, no matter if your fetus is viable or whether the baby wont survive on the outside, said Cheng, who is also a fellow at Physicians for Reproductive Health. These dismissals only increase the sense of isolation, stigma and shame. ", State abortion laws are complicating other types of obstetric care. It went into effect on Sept. 1. "I told her 'I'm so sorry. There are currently no abortion laws that outlaw treatment of ectopic pregnancy. But Prager believes that the laws in Texas and perhaps elsewhere soon . While another law enacted last year forbids dispensing and shipping abortion-inducing medications like misoprostol, mifepristone and methotrexate past seven weeks of a pregnancy, it makes exceptions for when the drugs are used for other medical reasons.. I was so excited for this appointment because its so good to see her in there, she said. Financial supporters play no role in the Tribune's journalism. The emotional toll was what worried Hall most of all. Enough to make her retch. Or hell honestly it shouldn't even get to the point where you're having to save a woman's life. "I was just laying in bed, you know, wondering: Am I pregnant or am I not pregnant? Hall shelled out thousands of dollars to abruptly travel out of state while grieving a lost pregnancy. Because the state has made it very clear that if you talk about this, you're vulnerable to being sued," she added. How theyd told their families, picked out a name, built a crib and bought pink sheets. Hall has struggled with depression, and as the weekend wore on, her mental health deteriorated. "And if they didn't believe me, I was going to show it to them and say "Look! Pregnant people are now required to just wait, endangering their own lives with no hope of ever bringing home a baby. Delays in care particularly for first-trimester conditions such as bleeding, hemorrhaging, septic miscarriages and ectopic pregnancies can become lethal, said Dr. Natalie Crawford, an OB/GYN and cofounder of a fertility clinic. Lauren Hall, 27, fought the urge to scream back and tell them just how badly she wished life was a choice she could have made. She wished she could make them answer for the states near-total ban on abortions after the overturning of Roe v. Wade just a few weeks prior. . First she said, I cant, I want this baby so badly, Dr. Gunby recalled. They now had some of the symptoms they needed to show the infection was getting worse. "I ripped my organs out" to avoid that, she said. If the lawsuit is successful, plaintiffs can receive up to $10,000. October 22, 2021. ABACA. Among other risks, both the fetus and Elizabeth were now highly vulnerable to a uterine infection called chorioamnionitis. The Texas law, which is also called Senate Bill 8, carves out an exception for termination in a medical emergency, which is defined in the states health code as a life-threatening physical condition caused or aggravated by pregnancy that places the woman in danger of death or a serious risk of substantial impairment of a major bodily function.. And that 'you can either stay here and wait to get sick where we can monitor you, or we discharge you and you monitor yourself. Correction, Oct. 24, 2022 at 4:12 p.m.: The color was darker and the odor was foul. Patients experiencing miscarriage have also struggled to get prescriptions filled for misoprostol, which is used both to treat miscarriages and induce abortions. We both have good jobs, weve got a house and we were at a place where if it happens, it happens, she said. As a result, she was checked into a hospital and underwent a D&C. However, after the overturn of Roe v. Wade in June 2022, abortion laws and restrictions are now implemented by state, resulting in trigger laws or complete bans. "It's this woman who was saying 'Hi Miss Weller, you're at the 19 week mark. 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. Financial supporters play no role in the Tribune's journalism. You have to suddenly leave for a medical procedure, and you dont know whats going to happen, so despite everything that made me leave, it was a relief to be back home, she said. She wanted them to experience the agony she felt when she learned that her fetus was developing without a skull or a brain, a condition her doctors told her was incompatible with life.. James and Elizabeth cried out their thanks to the doctor. Updated: Oct. 24, 2022. 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, she said. "We shouldn't have been celebrating," Elizabeth says. Methotrexate, another abortion-inducing medication, is used to treat ectopic pregnancies as well as rheumatic illnesses, inflammatory bowel disease, psoriasis and cancer. But the hospital staff told her that those weren't the right symptoms, yet, of a growing infection in her uterus. Such a rupture can be life-threatening. All too often, Cavazos says, patients are told to get over it, move on, try again. In a joint statement, Maureen G. Phipps, MD, MPH, FACOG, ACOG chief executive officer and Eugene Toy, MD, FACOG, chair of ACOG District XI (Texas), stated, "By allowing third . "I told her 'Look, Doctor, people around me are telling me to keep hope. One reason is that amniotic fluid plays a key role in fetal lung development. the U.S. that have trigger laws in place banning abortion in the . But first, shes focused on her mental health and getting through the next few months. AUSTIN The Texas Medical Association wants regulators to step in after hospitals reportedly refused to treat patients with serious pregnancy complications for fear . The next day, Elizabeth's ob-gyn came to the hospital to arrange the procedure. But those numbers have skyrocketed since Roe v. Wade was overturned. "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?". In this case, the woman had the means to travel, and she obtained an abortion in another state, an option unavailable to many low-income and working class women. And it's strong. If you do something to prevent that, you might be in fact performing an illegal abortion.. "It's hard to form a relationship to say, 'Hey look, I'm not using this for an elective abortion,'" she said. Myth 5: Treatment for ectopic pregnancy is considered an abortion, and thus many women will likely die from lack of treatment in states where abortion is illegal. I would consider what I experienced that weekend a medical emergency.. A more common scenario also raises difficult questions, said Dr. Ghazaleh Moayedi, an obstetrician and gynecologist in Texas who provides abortions. "'I'm just using this because this is not a viable pregnancy.'". ", 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. It was someone else at Methodist Hospital, perhaps a clerk, calling to go over some paperwork. The fetus had a rare neural tube defect. Since Sept. 1, abortion has been illegal in Texas after six weeks gestation, with one exception: If a doctor determines that a patient will face a " medical emergency " if the pregnancy continues, they can perform an abortion later on without breaking the law. 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. ", Her waters had broken, launching her into what she calls a "dystopian nightmare" of "physical, emotional and mental anguish." Miscarriage Texas Attorney General Ken Paxton quickly sued the Biden administration over the federal guidance. 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. Midnight came and went in a blur. This chapter may be cited as the Texas Abortion Facility Reporting and Licensing Act. The Biden administration last week told hospitals they must treat pregnant patients who need an abortion to stabilize a life-threatening condition. The pink-sheeted crib is still set up in the nursery, filled with all the baby supplies theyd bought or been gifted that they now have no use for. See the growing speaker list and buy tickets. Elizabeth could not receive the medical care she needed until several days later because of a Texas law that banned abortion after six weeks. Doctors in Texas say they cannot head off life-threatening medical crises in pregnant women if abortions cannot be offered or even discussed. John Seago, legislative director for Texas Right to Life, described this type of hesitation as "an awful misunderstanding of the law." Once she made her way through the clinics stringent security, the nurses took her into a private room. I knew something was wrong.. Notably, under Texas' law, at least one patient was told to wait until her ectopic pregnancy ruptured her fallopian tubewhich would have put her at immediate risk of death from hemorrhage . Austin woman trying for baby says Texas abortion law nearly caused her death. 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. This current law excludes treatment for miscarriage or ectopic pregnancy. No one really knows what the legislature means by that, and they are afraid of overstepping. Anyone can bring that civil action, posing a quandary for physicians and other providers. In Texas it's literally written in the law that an act is not an abortion to remove an ectopic pregnancy. "Being pregnant in a state like Texas is a dangerous . When the couple moved from Washington state to Texas in 2021, they were trying to . The only way to stop the heavy bleeding is to end the pregnancy and contract the uterus, Dr. Moayedi said. 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.