"Later they laid down this beautiful baby girl in my arms. 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. 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. 7:49 PM on Jul 14, 2022 CDT. Another area of Texas law that Seago cited provides an exception to the state's abortion restrictions if the mother's life is in danger or she's at "serious risk of substantial impairment of a major bodily function" unless an abortion is performed. There was an infection, and she did need treatment. I would always say, What if it was necessary to save the life of the mother? With it in place, his patient faces a pregnancy rife with potential medical problems. Growing up outside Dallas, Hall often heard that abortion was murder and, perhaps worse, interfering with Gods plan. 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. 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. 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 . She was diagnosed with an aggressive lymphoma, a cancer of the immune system. "I remember hearing her, from my room, speaking loudly about how nothing is being done here.". It is an editorially independent operating program of KFF (Kaiser Family Foundation). . These situations can create significant moral distress for patients and providers, said Bryn Esplin, a bioethicist and assistant professor of medical education at the University of North Texas Health Science Center in Fort Worth. Due to her history of hemorrhaging, Seewald added that passing the pregnancy at home didn't seem like a good option. This represents more confusion around state policy. Other complications that occur when a woman is carrying twins or multiples can be resolved by a selective reduction, or abortion, of one of the fetuses so that the other has a better chance to live. 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. Sept. 20, 2022 Were going to take care of you, and youre going to be OK, Hall remembers. Aborting the embryo is often the best treatment for an ectopic . 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. A doctor hugs a patient at an abortion clinic in Santa Teresa, New Mexico, on 13 January 2023. She was bereft, unable to even process the news. Texas has a trigger law on the books that will outlaw abortion almost universally beginning 30 days after the Supreme Court . Another pending ban, a so-called "trigger law" passed by Texas in 2021, is expected to go into effect within weeks. Many offer no exemptions for rape, incest or fetal anomolies. In Texas, a 2021 law made it easier to sue anyone who helps a person get an abortion after about six weeks of pregnancy. More often than not, they just say they lost the baby. For doctors treating such patients, the Texas law creates quite a conundrum, Dr. Snyder said. That is a pregnancy that occurs outside the uterus. 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. An ectopic pregnancy is when a fertilized egg implants outside the uterus, typically in one of the woman's fallopian tubes. When the couple moved from Washington state to Texas in 2021, they were trying to . Elizabeth Weller never dreamed that her own hopes for a child would become ensnared in the web of Texas abortion law. care provider and intended to remove an ectopic pregnancy that . And it's strong. Back at home, the Wellers got more serious about their travel plans and started booking tickets. And I screamed because that's when I knew something wrong was happening. pursuant to the preliminary injunction in texas v. becerra, no. But things can be murkier when it comes to treating miscarriages, she said. 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. The color was darker and the odor was foul. The bill makes no exceptions for pregnancies that resulted from rape or incest. Supporters of the law say their goal is to save the life of every embryo, regardless of the circumstances of conception. Elizabeth stood up to get some lunch. For example, in rare cases an infection can make the amniotic sac rupture before the fetus is viable. 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?' They now had some of the symptoms they needed to show the infection was getting worse. Almost immediately, though, Texas conflicting and confusing laws on abortion started to cause problems for pregnancy care. (Texas Hospital Licensing Law); (3) an institution required to be licensed under . Seventeen weeks into the pregnancy, they learned they were expecting a girl. Julia Robinson for NPR "I was born with a physical disability. Elizabeth and James Weller at their home in Houston two months after losing their baby girl due to a premature rupture of membranes. 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. After one conversation, the doctor returned to her bedside. 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. The holidays are going to be especially hard. How are you doing, and are you excited for the delivery?'". First she said, I cant, I want this baby so badly, Dr. Gunby recalled. judicial order, all other provisions of Texas law regulating or AUSTIN (KXAN) Amanda and Josh Zurawski have been trying to have a baby for more than a year now. Methotrexate or surgery are the only two options listed in the medical guidelines to prevent the fallopian tubes from rupturing and causing dangerous bleeding. So we look at them like a ticking time bomb and wait for the complications to develop, Dr. Palmer said of her patients. hide caption. I'm so sorry,'" Elizabeth says. For Elizabeth, that tragic conversation was just "the beginning of the hell that was going to ensue" for the rest of the week. I need you to give me the facts.'". Or hell honestly it shouldn't even get to the point where you're having to save a woman's life. This chapter may be cited as the Texas Abortion Facility Reporting and Licensing Act. All too often, Cavazos says, patients are told to get over it, move on, try again. 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. When Roe v. Wade fell in June, Elizabeth's pain and anger surged up again. And so they don't even know what the rules are.". Elizabeth says. I had not been put in the crossroads of this issue.". A few days later, she went out to celebrate a friends birthday and was raped on her way home. 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. The new abortion bans or the old laws being resurrected in a post-Roe world are rigidly written and untested in the courts. The associations say these women should be given the option of termination if they become pregnant. 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. 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. Grumet: Fears over Texas' abortion laws interfere with urgent, life-saving care. But the hospital staff told her that those weren't the right symptoms, yet, of a growing infection in her uterus. And she said, If you do that, dont tell anybody why youre traveling, dont tell your jobs, dont tell anyone at the airport, Hall remembers. Doctors and experts also worry that patients with pregnancy complications may be too afraid of being accused of inducing an abortion to seek care. 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 . And she says 'Yes. Anyone can read what you share. Lauren Hall stands for a portrait on Sept. 10, 2022, in the room that she and her husband had prepared as a nursery. One of the most painful parts was trying to reach her medical team. Once inside the car, they both burst into tears, for their baby and the terrible choices they were now left to navigate. Or in cases of rape or incest? While another law enacted last year forbids dispensing and shipping abortion-inducing medications like misoprostol, mifepristone and methotrexate past seven weeks of a pregnancy, it makes exceptions for when the drugs are used for other medical reasons.. An ectopic pregnancy occurs when the fertilized egg is implanted outside the uterus, most commonly in a fallopian tube. Restrictive abortion laws in more states are likely to lead to more cases of patients with ectopic pregnancy being unable to secure timely, and life-saving, care. Treatments for miscarriages and ectopic pregnancies are still legal under the states abortion ban, according to state law and legal experts. 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. Nitsch says she chose sterilization at age 36 rather than risk getting pregnant by another rapist. You can also reach a trained crisis counselor through the Suicide and Crisis Lifeline by calling or texting 988. 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. Hall was in her second trimester when the U.S. Supreme Court overturned Roe v. Wade. I was so excited for this appointment because its so good to see her in there, she said. She knew she did not have the flexibility to be able to travel out of state for an abortion later on. Elizabeth and James look at clothes that were meant for their baby, whom they lost in the second trimester of pregnancy. 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. Still, states like Missouri could put this pro-abortion talking point to rest by protecting treatment of ectopic pregnancy explicitly in the law. Recently passed laws make abortion illegal after about six weeks into a pregnancy. 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. There are currently no abortion laws that outlaw treatment of ectopic pregnancy. 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. Elizabeth touches the urn of her daughter. I knew something was wrong.. I'm trying to mentally survive this.". Find a complete list of them here. As Friday dragged on, Elizabeth started wondering if maybe the heartbeat had stopped. Hall declined those services. Their daughter, as expected, was stillborn. They're not allowed to do that in Texas. How do they follow the latest guidelines when numerous other people from other medical professionals to friends and family members can question their intent: Are they helping care for a miscarriage or facilitating an abortion? After talking with James, they both agreed they should end the pregnancy. ", "Let's say I do have to go through this situation again. Seek help right away for signs of ectopic pregnancy your doctor can talk you through next steps. But when membranes rupture earlier in pregnancy, particularly before 24 weeks, the chance of a fetus surviving plummets. But in other situations, he said, providers may need to intervene to stop bleeding and make sure no pregnancy tissue remains, as a guard against infection. 245.001. It is life-threatening to the mother and is not viable and needs to be removed. 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. Since that time, thousands of women have left Texas to obtain abortions in other states. 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. 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 could not receive the medical care she needed until several days later because of a Texas law that banned abortion after six weeks. Elizabeth has been sharing her story, and has found that whatever the political affiliation of the listener, they all agree her experience was horrible. There has been apprehension by doctors about dealing with both of those two issues, Abbott told Fox 4 News. An ectopic pregnancy, which occurs when a fertilized egg . The women who will be forced to carry these babies are the women with less resources, he said. Ilana Panich-Linsman for The New York Times. That's when she felt something "shift" in her uterus, down low, and then "this burst of water just falls out of my body. In Texas' anti-abortion . Double your gift when you give by 6 p.m. Thursday. 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 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. 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. Outcomes from expectant management vary greatly depending on when the waters break. In retrospect, Elizabeth says their initial joy felt a little naive: "If it was so easy for us to get pregnant, then to us it was almost like a sign that this pregnancy was going to be easy for us.". As Hall learned the hard way, the law makes no exception for lethal fetal anomalies. We both have good jobs, weve got a house and we were at a place where if it happens, it happens, she said. 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. But he did not address the question of lethal fetal anomalies, which are fatal for the fetus during pregnancy or shortly after birth. 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 . 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. I'm so sorry.". One persons emergency may not be another persons emergency, said Dr. Robert Carpenter Jr., an obstetrician in Houston. 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 . 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. And for a few tense . Everyone was thrilled, buying them car seats and baby clothes. Misoprostol is used to help prevent stomach ulcers, but it can induce abortions, particularly if taken along with mifepristone. The ethics panel had reached a decision, the doctor told them. 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. But she was barely out the door, still in the parking lot, when her phone rang. Among other risks, both the fetus and Elizabeth were now highly vulnerable to a uterine infection called chorioamnionitis. 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. 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. 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. Wade and the return of laws governing abortion legality to the states. Right there in the office, James pulled out his cell phone, and started looking for flights to states with less restrictive abortion laws. These terms are left vague or undefined. Elizabeth chose to go home rather than wait to get sick at the hospital. Ectopic pregnancy develops in an estimated 2% of reported pregnancies. 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. She recalls looking at her baby's little hands and crying. Every OB-GYN has cared for someone who has died from a hemorrhage, she said. 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. Confusion around the laws has caused issues for patients outside of emergencies. AUSTIN The Texas Medical Association wants regulators to step in after hospitals reportedly refused to treat patients with serious pregnancy complications for fear . hide caption. She and her husband immediately jumped into planning mode, scheduling an appointment at one of the only OB-GYN practices in town. And it just occurred to me that the people Ive been told my whole life are going to hell for their actions were the most kind and angelic individuals through this whole thing.. The New Texas Abortion Law Is Putting Some Patients In Danger, A Michigan law from 1931 would make abortion a felony if Roe falls. If she wanted to stay in Texas, Halls only choice was to continue with a pregnancy that would not yield a healthy, living baby. A fight began, which Elizabeth first became aware of as her doctor paced the hall outside her room, talking on her phone. The way the system is going to work is that the patients are going to always pay the price, Grossman said. The Wellers were pleasantly surprised when they got pregnant early in 2022. But as has been true in Texas and in many of the 12 other states where abortion is banned . 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. If a woman's life is in danger, she will be able to have an abortion. She recalls looking at her baby's little hands and crying. She said Houston Methodist had convened an ethics panel of doctors, but her doctor didn't seem very optimistic. And not only can they not provide it, but they can't talk to you about it," Cavazos says. In the meantime, Grossman said the delay and denial of care will likely become more common. But even from a young age, she had a lot of questions about what she saw as a deeply unforgiving idea. Her doctor said she had been calling other hospitals, but none of them would help. 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. More than ever, I think people, patients really need to be extremely well-informed and really aggressive about advocating for their own health because the system right now is basically designed to fail, she said. And theyve had to navigate complicated politics when sharing their news. 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 . UPDATE: The Supreme Court voted 5-4 to deny an emergency appeal from abortion providers and reproductive rights groups to block the " Texas Heartbeat Act ," or Senate Bill 8 (SB 8). Sometimes patients don't realize that they have lost the pregnancy until they come in for a checkup and no cardiac activity can be detected, said Dr. Emily Briggs, a family physician who delivers babies in New Braunfels, Texas. Dr. Palmer, the obstetrician in Fort Worth, said that one of her patients was trying to get pregnant after the new law went into effect, and she had consensual sex with her partner. 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 . Crescenda Uhles, a genetic counselor in Dallas, said the Texas law puts people like her in a bind when advising patients. Very young rape victims tend to seek prenatal care late, and they are more likely to have small babies that score poorly on tests of heart rate and muscle tone given immediately after birth. Join us for Texas biggest politics and policy event when you buy your tickets today. It is not currently possible in any way to 'reimplant' an ectopic pregnancy. 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. hide caption. If the lawsuit is successful, plaintiffs can receive up to $10,000. Austin woman trying for baby says Texas abortion law nearly caused her death. Photograph: Esteban Flix/AP 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. Its been a difficult few weeks since the procedure. "I told her 'I'm so sorry. At the office, her ob-gyn turned down the ultrasound volume so they wouldn't have to hear. Sec. Her mental health spiraled to the point that she considered checking herself into the hospital. The ob-gyn, who said she could not speak to the media, laid out two options, according to Elizabeth. Miscarriage Laws modelled on Texas's S.B. And it had to smell foul, really bad. They were just all shocked, like, Surely, theres an exception for this, Hall said. 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. Everyone was so scared.. 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. 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