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. Join us for Texas biggest politics and policy event when you buy your tickets today. Elizabeth stood up to get some lunch. One persons emergency may not be another persons emergency, said Dr. Robert Carpenter Jr., an obstetrician in Houston. SHORT TITLE. 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. Doctors can clearly legally save a woman's . But the National Advocates for Pregnant Women provide free legal assistance to women who have been charged with a crime because of a pregnancy loss like a miscarriage. ", 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. Grumet: Fears over Texas' abortion laws interfere with urgent, life-saving care. It is an editorially independent operating program of KFF (Kaiser Family Foundation). When Roe v. Wade fell in June, Elizabeth's pain and anger surged up again. But there is no definition for that term in the statute. State House Bill 2709, filed Thursday, would penalize individuals for the use of medication to cause abortion in the state of Texas, whether the pills were acquired at a local pharmacy or . The new law in Texas bans abortion at 6 weeks when a fetal "heartbeat" can be detected. She took a swipe of the new discharge, and placed the toilet paper in a Ziploc bag to carry with her. This current law excludes treatment for miscarriage or ectopic pregnancy. July 20, 20225 PM Central. hide caption. For 24/7 mental health support in English or Spanish, call the Substance Abuse and Mental Health Services Administrations free help line at 800-662-4357. Elizabeth says. Since the Texas laws include a stipulation that there must be intent to induce an abortion, Mayo said that he'd advise physicians and other clinicians to closely document the rationale for medical care, whether it's to treat a miscarriage or an ectopic pregnancy. 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. 7:49 PM on Jul 14, 2022 CDT. "I said 'Well, is there a heartbeat still?' The color was darker and the odor was foul. This chapter may be cited as the Texas Abortion Facility Reporting and Licensing Act. Texas' "trigger" law, which outlaws abortion "wholly or partly", is set to be in effect 30 days following . The ethics panel had reached a decision, the doctor told them. Or you wait till your baby's heartbeat stops.'". Cedar River offers specialty care for patients facing lethal fetal abnormalities like anencephaly. I couldn't give you life. There was still a fetal heartbeat, but it could stop at any moment. The hospital where she works pays me to have these conversations with patients, but theres not necessarily any guarantee they would have my back should someone decide to list my name on a lawsuit, she said. In Poland, protests over that countrys abortion laws erupted this year after a 30-year-old pregnant woman died of septic shock. Midnight came and went in a blur. After her initial miscarriage in 2018, Stell and her husband had their first child, a daughter, in April 2020. But studies show that pregnant teenagers are more prone than older women to developing a dangerous condition called pre-eclampsia, and they are more likely to have preterm deliveries, small babies and stillbirths. But for patients facing a medical emergency, or low-income or uninsured Texans, seeking a second opinion may not be possible. 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. "You know they paint this woman into being this individual that doesn't care about her life, doesn't care about the life of the children she creates or whatever. She felt lost and confused. 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.'". 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. "And they decide to sue for malpractice," she said. 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. With it in place, his patient faces a pregnancy rife with potential medical problems. 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. "He and I kept telling each other 'What is the whole point of the Hippocratic oath to do no harm?'" Hall has struggled with depression, and as the weekend wore on, her mental health deteriorated. The one exception is a medical emergency, but the law requires doctors to document the reasons for the exception with great specificity. SB 8, which was signed into law by Texas Gov. "'I'm just using this because this is not a viable pregnancy.'". And they're telling me to think of the positives. They stood up in the middle of the ER and embraced. Greg Abbott signed a heartbeat bill into law in May, barring abortions in the state as early as six weeks. This represents more confusion around state policy. These cases are only going to grow until the law is either repealed or clarified. The women who will be forced to carry these babies are the women with less resources, he said. Even with the slim chance of survival to 24 weeks, the newborn would face intense physical challenges and aggressive medical interventions. Disclosure: Southern Methodist University, Texas Medical Association and New York Times have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. ", "Because that doesn't really exist right now," he added. "It might even be scary for you to reach out and seek support even mental health support. It was just too hard, as she navigated a complicated mix of relief and grief. "Any law that creates a hesitancy for physicians to uphold the standard of care for a patient has a cascade of harmful effects both for the patient but also for everyone else," said Esplin. But I need you to tell me the truth, because I don't think all the positive things that they're telling me are real. Julia Robinson for NPR Lauren Hall stands for a portrait on Sept. 10, 2022, in the room that she and her husband had prepared as a nursery. Greg Abbott last year, not only bans abortion after six weeks of pregnancy but also deputizes citizens to enforce it, allowing any person to bring a . But first, shes focused on her mental health and getting through the next few months. Dr. Jennifer Liedtke, a family physician in Sweetwater, Texas, who delivers about 175 babies annually, no longer sends misoprostol prescriptions to the local Walmart. She recalls looking at her baby's little hands and crying. They also had an anatomy scan, which revealed no problems. Doctors and experts also worry that patients with pregnancy complications may be too afraid of being accused of inducing an abortion to seek care. Texas abortion laws make no exception for these cases, which are not as rare as people would like to imagine, said Dr. John Thoppil, an Austin OB-GYN and president of the Texas Association of Obstetricians and Gynecologists. 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. For patients who are not pregnant, it can also open up the cervix and make surgeries safer, Crawford said. And not only can they not provide it, but they can't talk to you about it," Cavazos says. If I dont provide my patient the standard of care, which they are due, I could be sued.. Hall had to travel to Washington state for an abortion after receiving a lethal fetal diagnosis, for which Texas abortion laws make no exception. Everyone was thrilled, buying them car seats and baby clothes. hide caption. It was someone else at Methodist Hospital, perhaps a clerk, calling to go over some paperwork. She and her husband booked outrageously expensive last-minute flights, got a hotel and, four days after they got the news that upended their world, flew out of Dallas/Fort Worth International Airport. 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. Enough to make her retch. It is life-threatening to the mother and is not viable and needs to be removed. The holidays are going to be especially hard. For the women, expectant management after premature rupture of membranes comes with its own health risks. Its our 10th year participating in Amplify, and to celebrate, weve got $15,000 in matching funds from four generous Tribune supporters. "Not because I wanted my baby to die, but because I needed this hell to end. 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.. Elizabeth knows it was just a terrible coincidence, an awful bureaucratic oversight, and yet it drove home to her how powerless she was, how alone, in that vast medical system of rules, legal regulations and revenue. For Elizabeth, that tragic conversation was just "the beginning of the hell that was going to ensue" for the rest of the week. And I told her 'No, ma'am. She wanted to tell these strangers about the day she ran into her husbands home office, pants still around her ankles, waving that positive pregnancy test. The laws supporters say that it provides sufficient leeway for physicians to act if a mothers life or bodily functions are compromised, and they insist those cases are rare. He said the association has been in communication with some pharmacy leaders to help clarify proper interpretation of the rules.. A recent study also reported 28 women with dangerous pregnancies at two Texas hospitals faced delays for care because fetal cardiac activity was detected, according to the AP. In some cases, the infection can become severe or life-threatening, leading to sepsis, hysterectomy or even death. "We shouldn't have been celebrating," Elizabeth says. Correction, Oct. 24, 2022 at 4:12 p.m.: If you do something to prevent that, you might be in fact performing an illegal abortion.. Every OB-GYN has cared for someone who has died from a hemorrhage, she said. hide caption. 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. "Later they laid down this beautiful baby girl in my arms. And I screamed because that's when I knew something wrong was happening. The bill makes no exceptions for pregnancies that resulted from rape or incest. 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. Right away, she ran into obstacles because of the Texas law. 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 . tex. Post-Roe v. Wade, abortion bans may keep doctors from providing timely, necessary care. Pregnancies can be complicated by any number of medical conditions. Among other risks, both the fetus and Elizabeth were now highly vulnerable to a uterine infection called chorioamnionitis. Treatment of ectopic pregnancy is not prohibited by Texas' abortion laws. Texas' "trigger" law, which outlaws abortion "wholly or partly", is set to be in effect 30 days following the . 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. Other times patients don't report the problem and miscarry on their own, she said, but without medication they risk additional bleeding. Because at this point, I'm in survival mode. The next day, Elizabeth's ob-gyn came to the hospital to arrange the procedure. They now had some of the symptoms they needed to show the infection was getting worse. I was so excited for this appointment because its so good to see her in there, she said. After talking with James, they both agreed they should end the pregnancy. James and Elizabeth cried out their thanks to the doctor. Texas' current heartbeat ban enables private citizens to sue anyone who helps someone get an abortion after about six weeks. Back at home, the Wellers got more serious about their travel plans and started booking tickets. "I remember hearing her, from my room, speaking loudly about how nothing is being done here.". 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. And it's strong. To deal with the increased demand, Cedar River has reopened a previously shuttered location, enhanced its telemedicine services and worked to find ways to help patients pay for travel and procedures. But Prager believes that the laws in Texas and perhaps elsewhere soon . Her doctor said she had been calling other hospitals, but none of them would help. And theyve had to navigate complicated politics when sharing their news. Or, like Hall, they can shell out thousands of dollars to abruptly travel out of state while grieving a lost pregnancy. Elizabeth chose to go home rather than wait to get sick at the hospital. 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