I knew something was wrong.. 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 Ohio state legislature, which introduced a bill in 2019 requiring doctors to "reimplant an ectopic pregnancy" into the uterus, or face charges of "abortion murder," despite the fact . Financial supporters play no role in the Tribune's journalism. And I knew my baby was suffering, I knew I was suffering, I knew my husband was suffering.". 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. Lauren Hall stands for a portrait on Sept. 10, 2022, in the room that she and her husband had prepared as a nursery. They were just all shocked, like, Surely, theres an exception for this, Hall 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. One persons emergency may not be another persons emergency, said Dr. Robert Carpenter Jr., an obstetrician in Houston. 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. All you can do now is just hope and pray that things go well.". "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.". "Ectopic pregnancy" means the implantation of a fertilized egg or embryo outside of the uterus. But things can be murkier when it comes to treating miscarriages, she said. Dr. John Thoppil, an obstetrician in Austin, doesnt perform abortions, providing prenatal care and delivering babies. Julia Robinson for NPR Hall managed not to scream any of this at the protesters, instead just silently flipping them off. forbids dispensing and shipping abortion-inducing medications, rheumatic illnesses, inflammatory bowel disease, psoriasis and cancer. "It might even be scary for you to reach out and seek support even mental health support. They don't want to get sucked into a legal morass. The bill makes no exceptions for pregnancies that resulted from rape or incest. 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. 8, which encourages private citizens to file lawsuits against anyone who facilitates an abortion, will proliferate, giving self-appointed vigilantes no shortage of . "I said 'Well, is there a heartbeat still?' The facts were grim. . Elizabeth and James Weller at their home in Houston two months after losing their baby girl due to a premature rupture of membranes. Either way, she saw nothing ahead but fear and grief prolonged, delayed, amplified. Texas' current heartbeat ban enables private citizens to sue anyone who helps someone get an abortion after about six weeks. The American College of Cardiology and the American Heart Association, for example, advise women with certain congenital heart conditions to avoid pregnancy altogether, as they are at higher risk of illness or death shortly after giving birth. Her doctor said she had been calling other hospitals, but none of them would help. judicial order, all other provisions of Texas law regulating or In Poland, protests over that countrys abortion laws erupted this year after a 30-year-old pregnant woman died of septic shock. Hall had to travel to Washington state for an abortion after receiving a lethal fetal diagnosis, for which Texas abortion laws make no exception. We usually have our moms register for delivery at this point. Today, abortion is also illegal in Texas under an old 1925 law that the state's Attorney General Ken Paxton declared to be in effect after Roe was overturned. She called her doctor and begged to get in. The abortion clinic is less than a mile from Texas, where abortion is illegal. 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 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. 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. Her discharge was yellow and smelled weird. A Texas judge's decision that could revoke the FDA's approval of abortion drugs is expected soon. Hall has struggled with depression, and as the weekend wore on, her mental health deteriorated. But interpretation of the laws is still causing challenges to care. Under Texas law, doctors can be sued by almost anyone for performing an abortion. The holidays are going to be especially hard. 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. other than an abortion performed due to a medical emergency as defined by Section 171.002, Health and Safety Code]. Elizabeth touches the urn of her daughter. It just seems cruel and unusual.. Most of these pregnancies end in miscarriage or stillbirth. Sec. If I offer the patient the standard of care, I could be sued for aiding and abetting, he said. Now she wants those sentiments translated into action. 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. There are currently no abortion laws that outlaw treatment of ectopic pregnancy. I need you to give me the facts.'". The next day, a Thursday, she started throwing up. The New Texas Abortion Law Is Putting Some Patients In Danger, A Michigan law from 1931 would make abortion a felony if Roe falls. 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 . These are the patients that are the most affected.. Elizabeth Weller never dreamed that her own hopes for a child would become ensnared in the web of Texas abortion law. Immediately, they sensed hesitation from the doctor. So when Roe v . Treatment of ectopic pregnancy is not prohibited by Texas' abortion laws. 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. But in early May, not long after the uneventful anatomy scan, the Wellers suddenly arrived at that crossroads. 5:22-cv-185-h (n.d. 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. 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 the language is ambiguous, and travel can be expensive and onerous for pregnant women, especially if they are unwell. The women who will be forced to carry these babies are the women with less resources, he said. An attendee holds her child during A Texas Rally for Abortion Rights at Discovery Green in Houston, Texas, on May 7. But she did not know who the biological father was. Growing up outside Dallas, Hall often heard that abortion was murder and, perhaps worse, interfering with Gods plan. When Roe v. Wade fell in June, Elizabeth's pain and anger surged up again. If Elizabeth exhibited enough of them, then it would be possible to document the encroaching infection, and therefore terminate the pregnancy under the law's "medical emergency" clause, he said. Even if it had, the Wellers were determined to proceed. 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 Medical v. legal . Not doing so can, in some circumstances, kill all of the fetuses. Texas Gov. A few weeks after Texas adopted the most restrictive abortion law in the nation, Dr. Andrea Palmer delivered terrible news to a Fort Worth patient who was midway through her pregnancy. 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. The new abortion bans or the old laws being resurrected in a post-Roe world are rigidly written and untested in the courts. Midnight came and went in a blur. We want to keep you safe.. by Mara Mndez Greg Abbott signed a heartbeat bill into law in May, barring abortions in the state as early as six weeks. 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. That's when she felt something "shift" in her uterus, down low, and then "this burst of water just falls out of my body. 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. It is life-threatening to the mother and is not viable and needs to be removed. But as has been true in Texas and in many of the 12 other states where abortion is currently . 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. Unnamed, unknown doctors somewhere had come to an agreement that Elizabeth could be induced that night. Right there in the office, James pulled out his cell phone, and started looking for flights to states with less restrictive abortion laws. This chapter contains a variety of laws related to abortion. An ectopic pregnancy occurs when the fertilized egg is implanted outside the uterus, most commonly in a fallopian tube. If someone is hemorrhaging while miscarrying, how long do I have to wait?. 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. So we look at them like a ticking time bomb and wait for the complications to develop, Dr. Palmer said of her patients. (Texas Hospital Licensing Law); (3) an institution required to be licensed under . She had cramps, and was passing clots of blood. The next day, Elizabeth's ob-gyn came to the hospital to arrange the procedure. Some supporters of the law say that it does not forbid a doctor to counsel a woman about abortion or refer her to an abortion provider outside Texas. To the extent anybody is delaying or denying care for ectopic pregnancy, they are simply misunderstanding the law, Grossman said. Once inside the car, they both burst into tears, for their baby and the terrible choices they were now left to navigate. 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 is legal under Texas's abortion law. Elizabeth and James look at clothes that were meant for their baby, whom they lost in the second trimester of pregnancy. It was just too hard, as she navigated a complicated mix of relief and grief. 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. Its our 10th year participating in Amplify, and to celebrate, weve got $15,000 in matching funds from four generous Tribune supporters. A doctor she had never met entered the room. Rather than warmth and sympathy, she was met with fear, hesitation and, worst of all, silence. Such a rupture can be life-threatening. Amplify your impact and donate now. One of the most painful parts was trying to reach her medical team. The patient lost liters of blood and had to be put on a breathing machine because of the 24-hour delay in care. For example, last year's Texas Heartbeat Law incorporated Texas' Health & Safety Code 245.002, which states (emphasis added): Marlena Stell always wanted a big family. But those numbers have skyrocketed since Roe v. Wade was overturned. Sept. 20, 2022 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. 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. Sometimes theyre the primary caregiver. 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. Texas new measure was intended to impose stringent limits on abortion. In fact, no abortion law in any state in America prevents lifesaving treatment for women with ectopic pregnancies and other life-threatening conditions . Aborting the embryo is often the best treatment for an ectopic . In one case, a central Texas hospital reportedly told a physician not to treat an ectopic pregnancy until it ruptured, the letter said. Or the judge could at least nullify FDA decisions in 2016 and 2021 that allowed at-home and mail-order chemical abortions. 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. An ultrasound confirmed that she had suffered premature rupture of membranes, which affects about 3% of pregnancies. Dr. Jennifer Liedtke, a family physician in Sweetwater, Texas, who delivers about 175 babies annually, no longer sends misoprostol prescriptions to the local Walmart. 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. Many state laws with new restrictions on abortion make exceptions for ectopics, but uncertainties can arise if a fetus implants on Caesarean scar tissue on the uterus wall or if it cannot be . But even from a young age, she had a lot of questions about what she saw as a deeply unforgiving idea. 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. "We live in a culture that advocates small government and yet we are allowing states, we are allowing our Texas state government to dictate what women do with their own bodies and to dictate what they think is best, what medical procedures they think is best for them to get.". At 6 weeks, many people . As Hall learned the hard way, the law makes no exception for lethal fetal anomalies. This chapter may be cited as the Texas Abortion Facility Reporting and Licensing Act. For doctors treating such patients, the Texas law creates quite a conundrum, Dr. Snyder said. 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. In September, the justices turned down an emergency request to block the law. In other cases, a pregnant womans medical needs may conflict with those of her fetus. Nitsch says she chose sterilization at age 36 rather than risk getting pregnant by another rapist. An IUD can make menstruation irregular, and she did not realize she had conceived until after the six-week mark. They also have abortion is permitted to protect the life of the mother or her from serious bodily harm that would result if an abortion is not performed. When you join us at The Texas Tribune Festival Sept. 22-24 in downtown Austin, youll hear from changemakers who are driving innovation, lawmakers who are taking charge with new policies, industry leaders who are pushing Texas forward and so many others. 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. Recently passed laws make abortion illegal after about six weeks into a pregnancy. 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. Thats what recently caused Dr. Jessian Munoz, an OB-GYN in San Antonio, to wait a day to treat a patient who had started to miscarry and developed a womb infection, according to the Associated Press. Many physicians say they cannot intervene in complex pregnancies that may not pose an immediate threat to the patient but can rapidly spin out of control. Elizabeth could not receive the medical care she needed until several days later because of a Texas law that banned abortion after six weeks. 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. Or in cases of rape or incest? Elizabeth stood up to get some lunch. Because the alternative was hell.". James rushed home from work and drove Elizabeth to the nearby Woodlands Hospital, part of the Houston Methodist hospital system. But the most confusing development involves the exemptions that exist for the woman's life or health, or because of a "medical emergency." Acts 1989, 71st Leg., ch. Hall was 18 weeks along when she went in for hers on a Friday afternoon. 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. Patients experiencing miscarriage have also struggled to get prescriptions filled for misoprostol, which is used both to treat miscarriages and induce abortions. An ectopic pregnancy is when a fertilized egg implants outside the uterus, typically in one of the woman's fallopian tubes. She was so tiny. 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. A fight began, which Elizabeth first became aware of as her doctor paced the hall outside her room, talking on her phone. Methotrexate also is listed in the Texas law passed last year. But the womans condition can quickly deteriorate, which is why physicians often prefer to offer an abortion. "I ripped my organs out" to avoid that, she said. You can also reach a trained crisis counselor through the Suicide and Crisis Lifeline by calling or texting 988. Greg Abbott said there were some things that we need to work on to ensure patients can get treatment for miscarriages and ectopic pregnancies. In Texas it's literally written in the law that an act is not an abortion to remove an ectopic pregnancy. 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. The Biden administration last week told hospitals they must treat pregnant patients who need an abortion to stabilize a life-threatening condition. It is the Cedar River Clinics in Renton, Washington, not the Cedar River Clinic in Seattle. Consider the patient whose miscarriage care is delayed and develops a serious infection and other complications, Prager said. 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 . And a tubal ectopic pregnancy, let's say, is clearly excluded. 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. When the couple moved from Washington state to Texas in 2021, they were trying to . They now had some of the symptoms they needed to show the infection was getting worse. Ectopic pregnancy develops in an estimated 2% of reported pregnancies. So I'm here to call you to register for your delivery on October 5th, so I can collect all your insurance information. 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. She was diagnosed with an aggressive lymphoma, a cancer of the immune system. But the hospital staff told her that those weren't the right symptoms, yet, of a growing infection in her uterus. 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. They have jobs and multiple children to take care of and they dont have the finances to take four or five days to go to a different state. After her initial miscarriage in 2018, Stell and her husband had their first child, a daughter, in April 2020. She had the proof. "Not because I wanted my baby to die, but because I needed this hell to end. pursuant to the preliminary injunction in texas v. becerra, no. More often than not, they just say they lost the baby. 678, Sec. But she was barely out the door, still in the parking lot, when her phone rang. Double your gift when you give by 6 p.m. Thursday. "But I have certainly heard discussion among physicians that they're very hesitant to do any kind of intervention until they're absolutely certain that this is not possibly a viable pregnancy even though the amount of bleeding would warrant intervening because it's a threat to the mother's life.". But when membranes rupture earlier in pregnancy, particularly before 24 weeks, the chance of a fetus surviving plummets. Grumet: Fears over Texas' abortion laws interfere with urgent, life-saving care. Texas' "trigger" law, which outlaws abortion "wholly or partly", is set to be in effect 30 days following . And it's this stupid, like, distinction that you're just making in this grief. 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 . 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. She knew she did not have the flexibility to be able to travel out of state for an abortion later on. Were going to take care of you, and youre going to be OK, Hall remembers. I couldn't give you life. Even in Texas, whose "heartbeat bill" was one . Since the Supreme Court ruling of June 24, 2022 that overturned Roe v. Wade, many states have banned abortion, or severely restricted abortion access. Houston Methodist Hospital declined to comment on the specifics of Elizabeth's care, except to say they follow all state laws and that there's a medical ethics committee that sometimes reviews complex cases. In the medical profession, doctors will continue to grapple with the new legal restrictions, and the resultant dilemmas in obstetrical care, says Dr. Peaceman. The brain would not develop, and the infant would die at birth or shortly afterward. If she wanted to stay in Texas, Halls only choice was to continue with a pregnancy that would not yield a healthy, living baby. But there is professional judgment involved in making these determinations, and some physicians in Texas now fear these opinions will be second-guessed in a courtroom. hide caption. Financial supporters play no role in the Tribune's journalism. Recently passed laws make abortion illegal after about six weeks into a pregnancy. But Prager believes that the laws in Texas and perhaps elsewhere soon . 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. 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. The case spurred a movement that led to the overturning of Ireland's abortion ban in 2018. "I was just laying in bed, you know, wondering: Am I pregnant or am I not pregnant? 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. Last week, the Texas Medical Association warned that several hospitals in the state have turned away or waited to treat patients with pregnancy complications including a physician in Central Texas who was allegedly instructed by a hospital to not treat an ectopic pregnancy until a rupture occurred. "They can absolutely do that.". In Texas' anti-abortion . She ate a healthy breakfast, went for a walk outside and came back home. 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. Their conundrum became painfully, distressingly clear: wait to get sicker, or wait until the fetal heartbeat ceased. 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. Texas has a trigger law on the books that will outlaw abortion almost universally beginning 30 days after the Supreme Court . "And she starts to cry and she tells me: 'They're not going to touch you.' I couldn't give you life. After talking with James, they both agreed they should end the pregnancy. She felt lost and confused. 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