other than an abortion performed due to a medical emergency as defined by Section 171.002, Health and Safety Code]. The slew of anti-abortion legislation comes on the heels of a Texas law, passed in June, which banned abortions after about six weeks into a pregnancybefore most people realize they are pregnant. '", "It was devastating to hear that," Elizabeth says. I would always say, What if it was necessary to save the life of the mother? One Texas law passed last year lists several medications as abortion-inducing drugs and largely bars their use for abortion after the seventh week of pregnancy. An attendee holds her child during A Texas Rally for Abortion Rights at Discovery Green in Houston, Texas, on May 7. Doctors can clearly legally save a woman's . They had bought a house in Kingwood, a lakeside development in Houston. ", "Because that doesn't really exist right now," he added. 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. Were going to take care of you, and youre going to be OK, Hall remembers. Because at this point, I'm in survival mode. 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. She had the proof. hide caption. John Seago, legislative director for Texas Right to Life, described this type of hesitation as "an awful misunderstanding of the law." Whether an ectopic pregnancy is legal will depend on individual state laws. Treatment of ectopic pregnancy is not prohibited by Texas' abortion laws. It is disingenuous to allege that this law prevents obstetricians from following the medical standard of care, she said. "I said 'Well, is there a heartbeat still?' 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. She was diagnosed with an aggressive lymphoma, a cancer of the immune system. When they called the doctor's office back, they were told to go straight to the emergency room. First she said, I cant, I want this baby so badly, Dr. Gunby recalled. Like other physicians, Dr. Palmer said she was uncertain whether counseling that patient about all of her options, including terminating the pregnancy outside Texas, would have been considered aiding and abetting., The law is murky, but heres the bottom line, she said. Elizabeth could not receive the medical care she needed until several days later because of a Texas law that banned abortion after six weeks. Treatments for miscarriages and ectopic pregnancies are still legal under Texas' abortion ban.<br/> By: By Mara Mndez, The Texas Tribune Posted at 10:06 PM, Jul 20, 2022 Miscarriages occur in roughly 1 out of 10 pregnancies. Dr. John Thoppil, an obstetrician in Austin, doesnt perform abortions, providing prenatal care and delivering babies. Among other risks, both the fetus and Elizabeth were now highly vulnerable to a uterine infection called chorioamnionitis. As a subscriber, you have 10 gift articles to give each month. Rather than warmth and sympathy, she was met with fear, hesitation and, worst of all, silence. Quite the opposite, many state laws explicitly exempt treatment of ectopic pregnancy from their definitions of abortion. 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. You cant even mention what someones choices would be, because of fear that talking about options would be considered aiding and abetting someone getting an abortion, he said. They stood up in the middle of the ER and embraced. 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. 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. It is life-threatening to the mother and is not viable and needs to be removed. [1/2] Pro-choice and anti-abortion both demonstrate outside the United States Supreme Court as the court hears arguments over a challenge to a Texas law that bans abortion after six weeks in . The case spurred a movement that led to the overturning of Ireland's abortion ban in 2018. 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. To the extent anybody is delaying or denying care for ectopic pregnancy, they are simply misunderstanding the law, Grossman said. Grumet: Fears over Texas' abortion laws interfere with urgent, life-saving care. And I told her 'No, ma'am. And not only can they not provide it, but they can't talk to you about it," Cavazos says. Julie Ann Nitsch, a sexual assault survivor and community college trustee in Austin, Texas, is among many women in states with restrictive abortion laws who are taking drastic steps. There was still a fetal heartbeat, but it could stop at any moment. 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.. "It's terrible," says Dr. Alan Peaceman, a professor of maternal-fetal medicine at Northwestern University's Feinberg School of Medicine. That's when a new state law banned all abortions after fetal cardiac activity is detected usually at about six weeks of pregnancy. 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. 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 . From Thursday through Saturday, Sept. 22-24, in downtown Austin, TribFest attendees will enjoy three days full of mind-expanding events, conversations and panels featuring more than 350 big names including Chris Bosh, Pete Buttigieg, Liz Cheney, Annette Gordon-Reed and many others. Find a complete list of them here. 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. But the language is ambiguous, and travel can be expensive and onerous for pregnant women, especially if they are unwell. And a tubal ectopic pregnancy, let's say, is clearly excluded. Or hell honestly it shouldn't even get to the point where you're having to save a woman's life. Her doctor said she had been calling other hospitals, but none of them would help. The emotional toll was what worried Hall most of all. This law will prohibit almost all abortions. Doctors in Texas say they cannot head off life-threatening medical crises in pregnant women if abortions cannot be offered or even discussed. Methotrexate also is listed in the Texas law passed last year. I knew something was wrong.. But as has been true in Texas and in many of the 12 other states where abortion is currently . 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.. Texas law reflects this important distinction. As a clinic that offers second-trimester abortions, Cedar River Clinics in the Renton, Washington has always seen a good number of patients from states with more restrictive laws, said clinic communications director Mercedes Sanchez. 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. Texas Gov. Under the current text, any doctor who removes an ectopic pregnancy that is not actively causing the patient to bleed to death faces dire consequences. "Most women would find it extremely difficult and emotionally very challenging. As Friday dragged on, Elizabeth started wondering if maybe the heartbeat had stopped. But the most confusing development involves the exemptions that exist for the woman's life or health, or because of a "medical emergency." But two of those drugs, misoprostol and mifepristone, are the only drugs recommended in the American College of Obstetricians and Gynecologists guidelines for treating a patient after an early pregnancy loss. So we look at them like a ticking time bomb and wait for the complications to develop.. It is not currently possible in any way to 'reimplant' an ectopic pregnancy. Maybe they could get the abortion in Denver or Albuquerque. 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. All you can do now is just hope and pray that things go well.". It was because of the state law which forbids termination of a pregnancy as long as there is fetal cardiac activity. 245.002. hide caption. a letter from the Texas Medical Association. 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. It is the Cedar River Clinics in Renton, Washington, not the Cedar River Clinic in Seattle. Patients experiencing miscarriage have also struggled to get prescriptions filled for misoprostol, which is used both to treat miscarriages and induce abortions. I think most people would give tremendously leeway to that. The holidays are going to be especially hard. 678, Sec. They told her the signs of a more severe infection would include a fever of 100.4 degrees and chills. Yet under the new law, Dr. Thoppil felt he could not counsel her on terminating the pregnancy. Frustrated with her experience on hormonal birth control, she and her husband decided it was time for her to get off of it. "I told her 'I'm so sorry. . She said Houston Methodist had convened an ethics panel of doctors, but her doctor didn't seem very optimistic. "partial-birth" abortions, medical abortions, the stage of a pregnancy at which an abortion can be performed, and informed consent related to abortions. forbids dispensing and shipping abortion-inducing medications, rheumatic illnesses, inflammatory bowel disease, psoriasis and cancer. They have private waiting rooms for these patients and offer grief support, genetic counseling and even bereavement services, including ways to memorialize the lost pregnancy. Her discharge had to be darker. I'm trying to mentally survive this.". 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. Elizabeth touches the urn of her daughter. But Im still so angry I had to leave.. You're trying to understand exactly what's going on. But Prager believes that the laws in Texas and perhaps elsewhere soon could boost physicians' vulnerability to medical malpractice lawsuits. These cases are only going to grow until the law is either repealed or clarified. "To them my life was not in danger enough.". She knew she did not have the flexibility to be able to travel out of state for an abortion later on. 9:42 AM on Jul 1, 2022 CDT. The Biden administration last week told hospitals they must treat pregnant patients who need an abortion to stabilize a life-threatening condition. Which sounds extreme, but Roe had just been overturned. SHORT TITLE. For example, last year's Texas Heartbeat Law incorporated Texas' Health & Safety Code 245.002, which states (emphasis added): Texas' current heartbeat ban enables private citizens to sue anyone who helps someone get an abortion after about six weeks. But there is no definition for that term in the statute. Earlier this month, Gov. 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.. If she wanted to stay in Texas, Halls only choice was to continue with a pregnancy that would not yield a healthy, living baby. Recently passed laws make abortion illegal after about six weeks into a pregnancy. Sign up for The Brief, our daily newsletter that keeps readers up to speed on the most essential Texas news. SB 8, which was signed into law by Texas Gov. Supporters of the law say their goal is to save the life of every embryo, regardless of the circumstances of conception. If I dont provide my patient the standard of care, which they are due, I could be sued.. Things did go fairly smooth at first. 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. "Being pregnant in a state like Texas is a dangerous . 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. "I just cried and screamed in the parking lot," she recalls. Hall was outraged about the world that her daughter was going to be born into, but she didnt worry too much about how this would affect her pregnancy. 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. Her mental health spiraled to the point that she considered checking herself into the hospital. 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. Last month, an Austin woman had the medical equivalent of a ticking time bomb in her body. And now the Texas abortion law has created an additional bind, Cavazos explains. 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. 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. 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.'". Treatments for miscarriages and ectopic pregnancies are still legal under Texas abortion ban. ), hhs may not enforce the following interpretations contained in the july 11, 2022, cms guidance (and the corresponding letter sent the same day by hhs secretary becerra): (1) hhs may not enforce the guidance and letter's interpretation that texas abortion laws are preempted by emtala; and (2) hhs may . In Texas' anti-abortion . And theyve had to navigate complicated politics when sharing their news. 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. We both have good jobs, weve got a house and we were at a place where if it happens, it happens, she said. And quickly. 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 . We want to keep you safe.. If youre having severe pain, if youre getting a fever, you need to keep your medical team in the loop, Crawford 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. 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 more common scenario also raises difficult questions, said Dr. Ghazaleh Moayedi, an obstetrician and gynecologist in Texas who provides abortions. 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. Photograph: Esteban Flix/AP ", 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. 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. The patient ended up driving 15 hours to New Mexico for life-saving treatment after no one in Texas would help her. 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 . "Ectopic pregnancy" means the implantation of a fertilized egg or embryo outside of the uterus. Julia Robinson for NPR So when Roe v . In the meantime, Grossman said the delay and denial of care will likely become more common. Recently passed laws make abortion illegal after about six weeks into a pregnancy. The crisis the Wellers endured is emblematic of the vast and perhaps unintended medical impacts of the criminalization of abortion in Republican-led states. They're not allowed to do that in Texas. Elizabeth and James look at clothes that were meant for their baby, whom they lost in the second trimester of pregnancy. Texas laws banning abortions make narrow exceptions only to save the life of a pregnant patient or prevent substantial impairment of major bodily function. And lawmakers in recent years have clarified state statutes to say treatments for miscarriages, known as spontaneous abortions in medicine, and ectopic pregnancies, in which a fertilized egg grows outside of the uterus and becomes unviable, do not count as abortions. See the growing speaker list and buy tickets. 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. "I told her 'I'm so sorry. The associations say these women should be given the option of termination if they become pregnant. An ectopic pregnancy occurs when the fertilized egg is implanted outside the uterus, most commonly in a fallopian tube. Dr. Ingrid Skop, a San Antonio obstetrician and member of the American Association of Pro-Life Obstetricians and Gynecologists, during a House Oversight Committee hearing in September. Texas new measure was intended to impose stringent limits on abortion. But then an overwhelming sense of calm washed over her. Eventually, she laid out their options: Keep carrying the pregnancy or leave Texas to get an abortion. And for a few tense . Updated: Oct. 24, 2022. James and Elizabeth cried out their thanks to the doctor. But Texas's medical exception is narrower, and less defined . Depending on the medical circumstances, one of those options may be abortion. And she just recklessly and negligently goes out and gets abortions all willy-nilly, left and right," she says. And she goes 'I'm so sorry, I'm so sorry, I didn't know.'". 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. 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. If someone is hemorrhaging while miscarrying, how long do I have to wait?. They had savings to fund this last-minute trip, and because her company is based in Illinois, her insurance covered the procedure. But she did not know who the biological father was. 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. Instead, the patient may choose medication or a surgical evacuation procedure, which Briggs said may prove necessary anyway to avoid a patient becoming septic if some of the tissue remains in the uterus. In Texas, the second-largest state in the nation, legal abortion immediately ceased to be an option except to save the life of the pregnant patient. pursuant to the preliminary injunction in texas v. becerra, no. 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. Now she wants those sentiments translated into action. If an ectopic pregnancy has ruptured, the pregnant person needs care immediately because they could start bleeding and lose up to 2 liters up blood very quickly. 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