Researchers with the Texas Policy Evaluation Project at the University of Texas at Austin documented several cases in which doctors waited to treat pregnancy complications until a patients health had deteriorated to the point that their life was in danger. CONROE, Texas (KTRK) -- A Conroe woman who suffered a miscarriage says the state's restrictive abortion laws forced her into a dangerous health situation. ", State abortion laws are complicating other types of obstetric care. She never had to use that bag. For doctors treating such patients, the Texas law creates quite a conundrum, Dr. Snyder said. But the patient was past six weeks gestation, and under the new law, an abortion was not an option in Texas because the woman was not immediately facing a life-threatening medical crisis or risk of permanent disability. Financial supporters play no role in the Tribune's journalism. But things can be murkier when it comes to treating miscarriages, she said. Or in cases of rape or incest? Treatments for certain pregnancy complications are distinct from abortions under Texas laws, experts say, but confusion has already limited some patients access to life-saving procedures and medicines. Elizabeth chose to go home rather than wait to get sick at the hospital. The fetus had a rare neural tube defect. 1, eff. More often than not, they just say they lost the baby. But that comes with the same significant risks that accompany a viable pregnancy, said Dr. CeCe Cheng, a high-risk OB-GYN in San Antonio. Rather than warmth and sympathy, she was met with fear, hesitation and, worst of all, silence. Either way, she saw nothing ahead but fear and grief prolonged, delayed, amplified. At 6 weeks, many people . We usually have our moms register for delivery at this point. According to a letter from the Texas Medical Association, a physician in Central Texas was instructed not to treat an ectopic pregnancy until it ruptured, which can cause serious medical complications. "Later they laid down this beautiful baby girl in my arms. Elizabeth Weller never dreamed that her own hopes for a child would become ensnared in the web of Texas abortion law. Maybe they could get the abortion in Denver or Albuquerque. "Ectopic pregnancy" means the implantation of a fertilized egg or embryo outside of the uterus. "Not because I wanted my baby to die, but because I needed this hell to end. Since September 1, 2021, Texas Senate Bill 8 (SB8) has prohibited abortions after the detection of embryonic cardiac activity, which occurs around 6 weeks after a person's last menstrual period . Halls fetus was diagnosed with anencephaly, a neural tube defect in which the brain, skull and scalp do not develop properly in the womb. Federal law typically trumps state laws, but it will now be up to courts to decide whether that will be the case in this instance. "I wouldn't say this is true for our practice," he said. It is a horrible gamble that we are making Texas women go through.". But there was a vibe immediately. The facts were grim. Elizabeth's pregnancy crisis began and ended weeks before June 24, when the U.S. Supreme Court struck down the federal right to abortion in its Dobbs v. Jackson ruling. Texas Health and Safety Code, Chapter 171. I was so excited for this appointment because its so good to see her in there, she said. Treatments for miscarriages and ectopic pregnancies are still legal under the states abortion ban, according to state law and legal experts. If I offer the patient the standard of care, I could be sued for aiding and abetting, he said. I would always say, What if it was necessary to save the life of the mother? Elizabeth stood up to get some lunch. It was someone else at Methodist Hospital, perhaps a clerk, calling to go over some paperwork. Some hesitate to counsel patients about the option of termination, or refer them to doctors in other states, for fear their advice could be interpreted as aiding an abortion. Medical v. legal . Even with the slim chance of survival to 24 weeks, the newborn would face intense physical challenges and aggressive medical interventions. She just put her arms around me and took my hand and she was like, I know you dont want to be here, but youre in good hands. But she was too scared to tell health care providers what was going on for fear that they would know she was considering an abortion. Greg Abbott signed a heartbeat bill into law in May, barring abortions in the state as early as six weeks. In some cases, the infection can become severe or life-threatening, leading to sepsis, hysterectomy or even death. "To them my life was not in danger enough.". In addition, he said, other Texas laws and the Roe v. Wade decision provide an exception to permit abortion if a pregnant person's life is in danger. hide caption. How theyd told their families, picked out a name, built a crib and bought pink sheets. "Abortions are sometimes needed out of an act of an emergency, out of an act of saving a woman's life. An attendee holds her child during A Texas Rally for Abortion Rights at Discovery Green in Houston, Texas, on May 7. If someone is hemorrhaging while miscarrying, how long do I have to wait?. And I knew my baby was suffering, I knew I was suffering, I knew my husband was suffering.". "partial-birth" abortions, medical abortions, the stage of a pregnancy at which an abortion can be performed, and informed consent related to abortions. Post-Roe v. Wade, abortion bans may keep doctors from providing timely, necessary care. 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. 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. Selective reductions are forbidden under the new state law. Once she made her way through the clinics stringent security, the nurses took her into a private room. "The pharmacy has said, 'We don't know whether or not you might be using this medication for the purposes of abortion,'" she said. 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. ", 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. Texas providers are still adjusting to other ripple effects that affect patient care. Julia Robinson for NPR The next day, a Thursday, she started throwing up. Hall went on to become a nurse and, together with her husband, created a life in the same town where they both grew up. But first, shes focused on her mental health and getting through the next few months. The Texas Tribune Festival is almost here! 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 . Hall managed not to scream any of this at the protesters, instead just silently flipping them off. And theyve had to navigate complicated politics when sharing their news. "We shouldn't have been celebrating," Elizabeth says. New, untested abortion bans have made doctors unsure about treating some pregnancy complications, which has led to life-threatening delays and trapped families in a limbo of grief and helplessness. Among other risks, both the fetus and Elizabeth were now highly vulnerable to a uterine infection called chorioamnionitis. Double your gift when you give by 6 p.m. Thursday. KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. In the nursery upstairs, they had already stashed some baby clothes and new cans of paint. There have been no criminal charges against providers since the U.S. Supreme Courts decision in late June to overturn the constitutional right to abortion access that was protected by Roe v. Wade, but anti-abortion groups and state lawmakers have threatened to ramp up the pressure against abortion providers and their allies. Julia Robinson for NPR But the womans condition can quickly deteriorate, which is why physicians often prefer to offer an abortion. You can also reach a trained crisis counselor through the Suicide and Crisis Lifeline by calling or texting 988. Even in cases of rape or incest, we dont advocate for taking the life of an unborn child for the crime of the father, he said. And how can I be so sure I'm not going to get too sick to the point where that's it now you can't have kids. 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 . "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. hide caption. 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 new measure was intended to impose stringent limits on abortion. This is already incredibly difficult news that someone receives, Thoppil said. 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. "I was born with a physical disability. I couldn't give you life. Crescenda Uhles, a genetic counselor in Dallas, said the Texas law puts people like her in a bind when advising patients. "Abortion and pregnancy outcomes are under a microscopein a way we . And not only can they not provide it, but they can't talk to you about it," Cavazos says. Elizabeth could not receive the medical care she needed until several days later because of a Texas law that banned abortion after six weeks. And for a few tense . Elizabeth touches the urn of her daughter. If she is developed enough to be menstruating and become pregnant, and reached sexual maturity, she can safely give birth to a baby, Dr. Skop said. 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. Dr. John Thoppil, an obstetrician in Austin, doesnt perform abortions, providing prenatal care and delivering babies. Elizabeth was in graduate school for political science, and James taught middle-school math. Doctors in Texas say they cannot head off life-threatening medical crises in pregnant women if abortions cannot be offered or even discussed. I'm trying to mentally survive this.". 245.001. Your donation keeps our trusted reporting free and accessible for all Texans and during a legislative session when lawmakers are set to tackle issues from school choice for K-12 students to school safety improvements to changes in property taxes, its critical that Texans know what lawmakers decisions mean for their futures. We see patients from many different religions and cultures, and how they grieve is unique to each patient, Sanchez said. I'm so sorry,'" Elizabeth says. ABACA. John Seago, legislative director for Texas Right to Life, described this type of hesitation as "an awful misunderstanding of the law." In 2012, a woman died in Ireland after her waters broke at 17 weeks and doctors refused to give her an abortion. Julia Robinson for NPR Hall had to travel to Washington state for an abortion after receiving a lethal fetal diagnosis, for which Texas abortion laws make no exception. Walmart officials did not respond to multiple requests for comment. hide caption. Her mental health spiraled to the point that she considered checking herself into the hospital. 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 . They were just all shocked, like, Surely, theres an exception for this, Hall said. Enough to make her retch. 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. "They can absolutely do that.". If you do something to prevent that, you might be in fact performing an illegal abortion.. 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. Just a few months before the Texas legislature passed the new law, Dr. Robert Gunby Jr., an obstetrician in Dallas, was caring for a pregnant newlywed who suddenly started losing weight. 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. Its been a difficult few weeks since the procedure. Halls maternal-fetal medicine specialist laid out the best-case scenario: If she managed to carry to term and deliver a live baby, with miracles of medicine, science and technology, they might be able to keep her alive for a few weeks, tied to machines and without hope of recovery. That is a pregnancy that occurs outside the uterus. But the hospital staff told her that those weren't the right symptoms, yet, of a growing infection in her uterus. Her discharge was yellow and smelled weird. 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. Missouri legislators held a hearing on a bill that, if signed into law, would make it a felony to "perform or induce an abortion" to treat ectopic pregnancy. 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 . "I just cried and screamed in the parking lot," she recalls. She took a swipe of the new discharge, and placed the toilet paper in a Ziploc bag to carry with her. These terms are left vague or undefined. Crawford, the OB/GYN and fertility clinic co-founder, said shes seen instances of pharmacies not wanting to fill prescriptions for certain medications that are related to abortions but being used for other treatments. ", As states ban abortion, the Texas bounty law offers a way to survive legal challenges, Texas conservatives have a plan to get around DAs who won't enforce abortion laws. A previous version of this story incorrectly reported the name and location of a clinic. 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 . With it in place, his patient faces a pregnancy rife with potential medical problems. She ate a healthy breakfast, went for a walk outside and came back home. But now "your medical provider says that it's illegal and they can't provide it. As Hall learned the hard way, the law makes no exception for lethal fetal anomalies. Elizabeth and James Weller at their home in Houston two months after losing their baby girl due to a premature rupture of membranes. But in early May, not long after the uneventful anatomy scan, the Wellers suddenly arrived at that crossroads. Dr. John Thoppil, an obstetrician in Austin who is president of the Texas Association of Obstetricians and Gynecologists, said that shortly after the new law went into effect in September, a patient who relied on an intrauterine device for birth control became pregnant. The law makes no exceptions for nonviable pregnancies in which the fetus has no chance of survival. One of the most painful parts was trying to reach her medical team. It also sets out civil, criminal, and professional penalties for abortion providers who violate the law. Sign up for The Brief, our daily newsletter that keeps readers up to speed on the most essential Texas news. 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