Since the Supreme Court ruling of June 24, 2022 that overturned Roe v. Wade, many states have banned abortion, or severely restricted abortion access. But the point will be made by the Christian Taliban that women have only the value their reading of the Bible ascribed to them and no more. October 22, 2021. They don't want to get sucked into a legal morass. But it is also affecting women who have no desire for termination but are experiencing medically risky pregnancies. She was through with being dismissed, being told to wait. The bill makes no exceptions for pregnancies that resulted from rape or incest. July 20, 20225 PM Central. "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. I looked at her little hands and I just cried. Among other risks, both the fetus and Elizabeth were now highly vulnerable to a uterine infection called chorioamnionitis. Many offer no exemptions for rape, incest or fetal anomolies. Their conundrum became painfully, distressingly clear: wait to get sicker, or wait until the fetal heartbeat ceased. 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. Even with the slim chance of survival to 24 weeks, the newborn would face intense physical challenges and aggressive medical interventions. She never had to use that bag. 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. Elizabeth touches the urn of her daughter. hide caption. the U.S. that have trigger laws in place banning abortion in the . Financial supporters play no role in the Tribune's journalism. Elizabeth and James Weller at their home in Houston two months after losing their baby girl due to a premature rupture of membranes. I think most people would give tremendously leeway to that. And it had to smell foul, really bad. ", "Let's say I do have to go through this situation again. 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. 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. The women who will be forced to carry these babies are the women with less resources, he said. "That's torture to have to carry a pregnancy which has such a low chance of survival," says Dr. Peaceman. oral contrace ptives." The term "abortion" in Texas law does not apply when these acts are done to "(A) save the life or preserve the health of an unborn child; (B) remove a dead, unborn child whose death was caused by spontaneous abortion; or (C) remove an ectopic pregnancy." Tex. She was so tiny. You're not going to tell me that what I'm experiencing isn't real, again.". In Texas it's literally written in the law that an act is not an abortion to remove an ectopic pregnancy. 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. Hall has struggled with depression, and as the weekend wore on, her mental health deteriorated. But the new Texas law has profoundly affected his ability to practice. not include an abortion that uses suction to dismember the body of an unborn child by sucking pieces of the unborn child into a . 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 emotional toll was what worried Hall most of all. When they learned they were having a girl, Hall and her husband even picked out a name: Amelia. Dr. Ingrid Skop, an obstetrician in San Antonio who belongs to the American Association of Pro-Life Obstetricians and Gynecologists, said that even a girl as young as 9 or 10, impregnated by a father or a brother, could carry a baby to term without health risks. It went into effect on Sept. 1. After her initial miscarriage in 2018, Stell and her husband had their first child, a daughter, in April 2020. But there is no definition for that term in the statute. Many doctors say they are unable to discuss the procedure as an option until the patients condition deteriorates and her life is at risk. If you do something to prevent that, you might be in fact performing an illegal abortion.. Recently passed laws make abortion illegal after about six weeks into a pregnancy. Because at this point, I'm in survival mode. There was an infection, and she did need treatment. Aborting the embryo is often the best treatment for an ectopic . The Oklahoma Senate last week passed six abortion-limiting bills, including one that mirrors the law passed in Texas and another that would ban abortions after 30 days from a woman's last period . I'm actually headed home right now because I have to await my dead baby's delivery.' The other miscarriage treatment is a procedure described as surgical uterine evacuation to remove the pregnancy tissue the same approach as for an abortion. 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. Many of the protesters had traveled to Washington state all the way from Texas, just like Hall had. Or you wait till your baby's heartbeat stops.'". 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. So when Roe v . "Because I didn't want anybody to tell me they did not believe me," she says. "Ectopic pregnancy" means the implantation of a fertilized egg or embryo outside of the uterus. Pregnancies can be complicated by any number of medical conditions. I knew something was wrong.. One reason is that amniotic fluid plays a key role in fetal lung development. "I told her 'I'm so sorry. A doctor sat down and told her: "There's very little amniotic fluid left. But its not just the physical changes, but the emotional toll of knowing their baby is not going to survive and just waiting for something to happen so they can get the care they need.. Their daughter, as expected, was stillborn. 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. An oncologist urged the woman to start treatment immediately, but the chemotherapy regimen would have been toxic to the fetus. 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 . He said the association has been in communication with some pharmacy leaders to help clarify proper interpretation of the rules.. Texas law reflects this important distinction. After talking with James, they both agreed they should end the pregnancy. An ultrasound confirmed that she had suffered premature rupture of membranes, which affects about 3% of pregnancies. 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. ABACA. To Elizabeth, it seemed obvious that things were deteriorating. 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. It was because of the state law which forbids termination of a pregnancy as long as there is fetal cardiac activity. The Supreme Court is expected to rule soon on whether abortion providers and the Biden administration may challenge the law notwithstanding its novel structure. "The challenge is that the treatment for an abortion and the treatment for a miscarriage are exactly the same," said Dr. Sarah Prager, a professor of obstetrics and gynecology at the University of Washington in Seattle and an expert in early pregnancy loss. Thankfully, I think theres still plenty of pharmacies that understand the proper utilization of some of the medications we use for nonelective [pregnancy] terminations.. Greg Abbott, who signed it, and on the inflamed political rhetoric, which Elizabeth says only sees abortion "as one thing, a black-and-white issue, when abortion has all of these gray areas. It was like an evidence bag. "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.". An ectopic pregnancy, which occurs when a fertilized egg . 1, eff. 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. With abortion laws in Texas about to change, The Dallas Morning News is answering your questions about what to expect without the protections established in Roe vs . Back at home, the Wellers got more serious about their travel plans and started booking tickets. At least several OB-GYNs in the Austin 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, said Dr. Charlie Brown, an Austin-based obstetrician-gynecologist who provided a copy to KHN. 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. Confusion around the laws has caused issues for patients outside of emergencies. 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. It is life-threatening to the mother and is not viable and needs to be removed. She knew the doctors at the practice were both proud members of the American Association of Pro-Life Obstetricians and Gynecologists, but she waved it off. If a woman's life is in danger, she will be able to have an abortion. The ethics panel had reached a decision, the doctor told them. But Im still so angry I had to leave.. "I told her 'Look, Doctor, people around me are telling me to keep hope. judicial order, all other provisions of Texas law regulating or 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. They were just all shocked, like, Surely, theres an exception for this, Hall said. Under Texas law, doctors can be sued by almost anyone for performing an abortion. Since pharmacists rotate through that Walmart, Liedtke decided to send those prescriptions to other pharmacies rather than attempt to sort out the misunderstanding anew each time. I was losing my mind, Hall said. 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. Disclosure: Texas Medical Association and University of Texas at Austin 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. A Texas judge's decision that could revoke the FDA's approval of abortion drugs is expected soon. Still, states like Missouri could put this pro-abortion talking point to rest by protecting treatment of ectopic pregnancy explicitly in the law. 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. Idaho, Tennessee and Texas will implement abortion bans in 30 days, according to the text of the laws. You can reach them at 212-255-9252. An attendee holds her child during A Texas Rally for Abortion Rights at Discovery Green in Houston, Texas, on May 7. Texas abortion laws penalize the person who performs an abortion and, under a state law from 1925, anyone who furnishes the means for an abortion. And she just recklessly and negligently goes out and gets abortions all willy-nilly, left and right," she says. Even before the passage of the two bills, existing Texas law stated that the act is not an abortion if it involves the treatment of an ectopic pregnancy which most commonly occurs when the pregnancy grows in the fallopian tube or to "remove a dead, unborn child whose death was caused by spontaneous abortion," he said, pointing to the statute. ", Elizabeth thought of abortion rights in broad terms: "I have said throughout my life I believe that women should have the access to the right to an abortion. Even in Texas, whose "heartbeat bill" was one . "And they decide to sue for malpractice," she said. And for a few tense . 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 . I have seen cases where the woman has gone from completely normal to septic shock in less than an hour, Dr. Carpenter said. 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 . The color was darker and the odor was foul. She recalls looking at her baby's little hands and crying. In some cases, the infection can become severe or life-threatening, leading to sepsis, hysterectomy or even death. A doctor hugs a patient at an abortion clinic in Santa Teresa, New Mexico, on 13 January 2023. Double your gift when you give by 6 p.m. Thursday. 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. This law will prohibit almost all abortions. 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. What youre really worried about is that period of time when whats going to be a miscarriage, if you let it take a natural course, might cause severe suffering, and/or death to the mother, to the pregnant person, she said. With it in place, his patient faces a pregnancy rife with potential medical problems. 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. For example, in rare cases an infection can make the amniotic sac rupture before the fetus is viable. Immediately, they sensed hesitation from the doctor. In 2012, a woman died in Ireland after her waters broke at 17 weeks and doctors refused to give her an abortion. For the women, expectant management after premature rupture of membranes comes with its own health risks. To Elizabeth, termination also felt like the most merciful option for her fetus. 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 . "It's not just the fear that it could happen again, but also the added fear of what if it happens again and I can't get help? . If I offer the patient the standard of care, I could be sued for aiding and abetting, he said. "Abortion and pregnancy outcomes are under a microscopein a way we . Lauren Hall stands for a portrait on Sept. 10, 2022, in the room that she and her husband had prepared as a nursery. The risks to Elizabeth's health were simply too high. 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. And surprisingly, both of their families sent money to help pay for the trip, despite their anti-abortion sentiments. Its our 10th year participating in Amplify, and to celebrate, weve got $15,000 in matching funds from four generous Tribune supporters. In September, the justices turned down an emergency request to block the law. Abortion bans in Mississippi, North Dakota and Wyoming go into effect after the attorney . At the office, her ob-gyn turned down the ultrasound volume so they wouldn't have to hear. Texas has a trigger law on the books that will outlaw abortion almost universally beginning 30 days after the Supreme Court . Sept. 20, 2022 Although distraught and heartbroken at this news, Elizabeth forced herself to think it through. Texas new measure was intended to impose stringent limits on abortion. 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. I'm so sorry.". Texas' current heartbeat ban enables private citizens to sue anyone who helps someone get an abortion after about six weeks. KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. "I was just laying in bed, you know, wondering: Am I pregnant or am I not pregnant? Medical v. legal . 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. The maternal fetal medicine specialist at the University of Texas Southwestern Medical Center in Dallas published a blog post last August to inform patients that treatment for cesarean scar ectopic pregnancies are legal under Texas's abortion law. In cases in which a medical provider may be hesitant to conduct a needed treatment, itll be critical for patients to stay informed, seek help or get more than one medical opinion, said Joanna Grossman, a professor at Southern Methodist Universitys Dedman School of Law. Financial supporters play no role in the Tribune's journalism. Which sounds extreme, but Roe had just been overturned. The Wellers were pleasantly surprised when they got pregnant early in 2022. Now she wants those sentiments translated into action. 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.. 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. 7:49 PM on Jul 14, 2022 CDT. Some people experience loss of pregnancy at home and don't require additional care, other than emotional support, said Dr. Tony Ogburn, who chairs the OB-GYN department at the University of Texas-Rio Grande Valley School of Medicine. The law does not make an exception for pregnant women who learn that the fetus has chromosomal abnormalities or anomalies that will cause the baby to die soon after birth. 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. Not doing so can, in some circumstances, kill all of the fetuses. "To them my life was not in danger enough.". Nitsch says she chose sterilization at age 36 rather than risk getting pregnant by another rapist. Hall shelled out thousands of dollars to abruptly travel out of state while grieving a lost pregnancy. Those can be acute life-threatening emergencies, she said. Ilana Panich-Linsman for The New York Times. 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. Outcomes from expectant management vary greatly depending on when the waters break. 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. 678, Sec. 245.001. The Texas abortion "trigger law" will be effective on August 25th, 2022. The result has been disarray and confusion for doctors and hospitals in multiple states, and risky delays and complications for patients facing obstetrical conditions such as ectopic pregnancies, incomplete miscarriages, placental problems, and premature rupture of membanes. Its also had to heighten security since Roe was overturned, Sanchez said, the clinics have seen more and more aggressive protesters, including people from out-of-state like those Hall faced. Cedar River offers specialty care for patients facing lethal fetal abnormalities like anencephaly. Or what if the pregnancy wasnt viable? she said. Post-Roe v. Wade, abortion bans may keep doctors from providing timely, necessary care. A more common scenario also raises difficult questions, said Dr. Ghazaleh Moayedi, an obstetrician and gynecologist in Texas who provides abortions. 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. I couldn't give you life. On September 1, 2021, Texas Senate Bill 8 (SB 8) went into effect, banning virtually all abortions and medical counseling and support related to abortion after six weeks. Amplify your impact and donate now. In Texas' anti-abortion . 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. It includes laws about. Took no time at all.. We physically watched her get sicker and sicker and sicker, he told the AP. 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.. 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 American College of Obstetricians and Gynecologists has information on early pregnancy loss, finding an OB-GYN and having better conversations with your doctor. ", 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. Elizabeth was induced late Friday night, and the labor became painful enough that she had to get an epidural. (1) the immediate abortion of her pregnancy without the delay necessary to determine the probable post-fertilization age of the unborn child; (2) the abortion of her pregnancy even though the post-fertilization age of the unborn child is 20 or more weeks; or (3) the use of a method of abortion other than a method described by Section 171.045(b). Most recently, the Oklahoma Senate passed six abortion-limiting bills , including one that would ban abortions after 30 days from a woman's last . 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. "I remember hearing her, from my room, speaking loudly about how nothing is being done here.". Sometimes theyre the primary caregiver. You dont get a lot of time to respond, and if you dont respond quickly enough, your patient expires.. 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. You can also reach a trained crisis counselor through the Suicide and Crisis Lifeline by calling or texting 988. Ectopic pregnancy develops in an estimated 2% of reported pregnancies. 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. 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. Elizabeth's experience amounts to a kind of medical trauma, which is layered on top of the grief of pregnancy loss, says Elaine Cavazos, a psychotherapist specializing in the perinatal period, and the chief clinical officer of Reproductive Psychiatry and Counseling in Austin. Dr. Lauren Thaxton, an OB-GYN and assistant professor at the Dell Medical School at the University of Texas-Austin, has already heard about local patients who have been miscarrying, and couldn't get a pharmacy to fill their misoprostol prescription. 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