This current law excludes treatment for miscarriage or ectopic pregnancy. This chapter contains a variety of laws related to abortion. It went into effect on Sept. 1. "And they decide to sue for malpractice," she said. Notably, under Texas' law, at least one patient was told to wait until her ectopic pregnancy ruptured her fallopian tubewhich would have put her at immediate risk of death from hemorrhage . I'm so sorry,'" Elizabeth says. But then an overwhelming sense of calm washed over her. 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. This law will prohibit almost all abortions. Crescenda Uhles, a genetic counselor in Dallas, said the Texas law puts people like her in a bind when advising patients. 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. You're not going to tell me that what I'm experiencing isn't real, again.". Sept. 20, 2022 Many of the protesters had traveled to Washington state all the way from Texas, just like Hall had. I knew something was wrong.. 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. It was May 10, 2022. ", 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. She and her husband immediately jumped into planning mode, scheduling an appointment at one of the only OB-GYN practices in town. But things can be murkier when it comes to treating miscarriages, she said. Julia Robinson for NPR ", State abortion laws are complicating other types of obstetric care. ", The Wellers do want to try again, but first they need to get to a "mentally healthier place," Elizabeth says. We see patients from many different religions and cultures, and how they grieve is unique to each patient, Sanchez said. by Mara Mndez 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. 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.. They don't want to get sucked into a legal morass. 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. But she was too scared to tell health care providers what was going on for fear that they would know she was considering an abortion. After she got through the first trimester, Hall and her husband both heaved a sigh of relief and got to work telling their friends and family. 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. Many physicians disagree, pointing out that the law can disrupt care for pregnant women who have underlying health problems that are not immediately life-threatening, such as pulmonary hypertension or certain types of cancer. 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. 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. For some, that's too difficult, given the emotions surrounding the pregnancy loss, she said. Elizabeth was 18 weeks pregnant. 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. The law makes no exceptions for nonviable pregnancies in which the fetus has no chance of survival. Cheng did not treat Hall, but has counseled patients facing similar situations. I personally would never get one. ", Her waters had broken, launching her into what she calls a "dystopian nightmare" of "physical, emotional and mental anguish." forbids dispensing and shipping abortion-inducing medications, rheumatic illnesses, inflammatory bowel disease, psoriasis and cancer. It is not currently possible in any way to 'reimplant' an ectopic pregnancy. He said the association has been in communication with some pharmacy leaders to help clarify proper interpretation of the rules.. Aborting the embryo is often the best treatment for an ectopic . Coming back to Texas a few days later only amplified those feelings. 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. 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. 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. In the nursery upstairs, they had already stashed some baby clothes and new cans of paint. She took a swipe of the new discharge, and placed the toilet paper in a Ziploc bag to carry with her. An ectopic pregnancy is when a fertilized egg implants outside the uterus, typically in one of the woman's fallopian tubes. And it had to smell foul, really bad. 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. I couldnt do that.. Her doctor said she had been calling other hospitals, but none of them would help. Your donation keeps our trusted reporting free and accessible for all Texans and during a legislative session when lawmakers are set to tackle issues from school choice for K-12 students to school safety improvements to changes in property taxes, its critical that Texans know what lawmakers decisions mean for their futures. 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 . Elizabeth and James look at clothes that were meant for their baby, whom they lost in the second trimester of pregnancy. And it's strong. Nitashia Johnson for The New York Times. 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.". 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. John Seago, legislative director for Texas Right to Life, described this type of hesitation as "an awful misunderstanding of the law." Hall managed not to scream any of this at the protesters, instead just silently flipping them off. 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. Elizabeth Weller never dreamed that her own hopes for a child would become ensnared in the web of Texas abortion law. Then Elizabeth felt another sudden, forceful gush of fluid leave her body. "At first I was really enraged at the hospital and administration," she says. hide caption. Lauren Hall stands for a portrait on Sept. 10, 2022, in the room that she and her husband had prepared as a nursery. "You have to ask yourself, would I put any living thing through the pain, and the horrors, of having to try to fight for their life the minute that they're born?". 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. Right there in the office, James pulled out his cell phone, and started looking for flights to states with less restrictive abortion laws. When she first saw that positive pregnancy test, she panicked even at 27, she said, her first reaction was that of a 15-year-old, worried about telling her parents. "It's going to take a while before the medical community comes to some kind of consensus on where you draw this line, and where you say enough is enough. But Im still so angry I had to leave.. To the extent anybody is delaying or denying care for ectopic pregnancy, they are simply misunderstanding the law, Grossman said. If someone is hemorrhaging while miscarrying, how long do I have to wait?. You dont get a lot of time to respond, and if you dont respond quickly enough, your patient expires.. 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. 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. The near-total ban on abortion in Texas meant that the doctors couldn't do anything to remove the unviable fetus unless Amanda's life was at risk. 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. Still, states like Missouri could put this pro-abortion talking point to rest by protecting treatment of ectopic pregnancy explicitly in the law. "'I'm just using this because this is not a viable pregnancy.'". They stood up in the middle of the ER and embraced. 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 . 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 . Patients experiencing miscarriage have also struggled to get prescriptions filled for misoprostol, which is used both to treat miscarriages and induce abortions. These are the patients that are the most affected.. But it is also affecting women who have no desire for termination but are experiencing medically risky pregnancies. 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. "Because I didn't want anybody to tell me they did not believe me," she says. Yet under the new law, Dr. Thoppil felt he could not counsel her on terminating the pregnancy. The law, which still remains in effect, does contain one exception for a "medical emergency." Since the Supreme Court ruling of June 24, 2022 that overturned Roe v. Wade, many states have banned abortion, or severely restricted abortion access. Question women in America now have to ask. After one conversation, the doctor returned to her bedside. But the language is ambiguous, and travel can be expensive and onerous for pregnant women, especially if they are unwell. With it in place, his patient faces a pregnancy rife with potential medical problems. AUSTIN (KXAN) Amanda and Josh Zurawski have been trying to have a baby for more than a year now. Idaho, Tennessee and Texas will implement abortion bans in 30 days, according to the text of the laws. Its one of the most egregious invasions of the physician-patient relationship that weve ever seen, said Dr. Rick Snyder, a cardiologist in Dallas who is chair of the board of trustees of the Texas Medical Association. And she goes 'I'm so sorry, I'm so sorry, I didn't know.'". Texas Attorney General Ken Paxton quickly sued the Biden administration over the federal guidance. These terms are left vague or undefined. Elizabeth has been sharing her story, and has found that whatever the political affiliation of the listener, they all agree her experience was horrible. Hall and her husband would like to try again at some point. It was just the most tender moment, she said. If I dont provide my patient the standard of care, which they are due, I could be sued.. Methotrexate, another abortion-inducing medication, is used to treat ectopic pregnancies as well as rheumatic illnesses, inflammatory bowel disease, psoriasis and cancer. One study showed they were four times as likely to develop an infection and 2.4 times as likely to experience a postpartum hemorrhage, compared with women who terminated the pregnancy. Doctors in Texas say they cannot head off life-threatening medical crises in pregnant women if abortions cannot be offered or even discussed. 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.. ", "Let's say I do have to go through this situation again. There are currently no abortion laws that outlaw treatment of ectopic pregnancy. And that 'you can either stay here and wait to get sick where we can monitor you, or we discharge you and you monitor yourself. Pregnant people are now required to just wait, endangering their own lives with no hope of ever bringing home a baby. At 18 weeks, the watery, protective cushion of amniotic fluid was gone. Disclosure: Southern Methodist University, Texas Medical Association and New York Times 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. I need you to give me the facts.'". 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. The Texas Tribune Festival is almost here! When they learned they were having a girl, Hall and her husband even picked out a name: Amelia. I couldn't give you life. The associations say these women should be given the option of termination if they become pregnant. A few days later, she went out to celebrate a friends birthday and was raped on her way home. Almost immediately, though, Texas conflicting and confusing laws on abortion started to cause problems for pregnancy care. Elizabeth says. 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). Texas' current heartbeat ban enables private citizens to sue anyone who helps someone get an abortion after about six weeks. It was like an evidence bag. She ate a healthy breakfast, went for a walk outside and came back home. (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). And at least one Texas pharmacy has let area physicians know that they would no longer dispense methotrexate, the medication used to treat ectopic pregnancy, citing the law. 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. No one really knows what the legislature means by that, and they are afraid of overstepping. But she was barely out the door, still in the parking lot, when her phone rang. "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.". Your donation keeps our trusted reporting free and accessible for all Texans and during a legislative session when lawmakers are set to tackle issues from school choice for K-12 students to school safety improvements to changes in property taxes, its critical that Texans know what lawmakers decisions mean for their futures. Laws modelled on Texas's S.B. Halls fetus was diagnosed with anencephaly, a neural tube defect in which the brain, skull and scalp do not develop properly in the womb. For example, last year's Texas Heartbeat Law incorporated Texas' Health & Safety Code 245.002, which states (emphasis added): She had cramps, and was passing clots of blood. a letter from the Texas Medical Association. 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. A doctor sat down and told her: "There's very little amniotic fluid left. Many offer no exemptions for rape, incest or fetal anomolies. Misoprostol is used to help prevent stomach ulcers, but it can induce abortions, particularly if taken along with mifepristone. And I told her 'I'm so sorry. Frustrated with her experience on hormonal birth control, she and her husband decided it was time for her to get off of it. The risks to Elizabeth's health were simply too high. Marlena Stell always wanted a big family. A doctor she had never met entered the room. 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. 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 . But there is no definition for that term in the statute. Because the state has made it very clear that if you talk about this, you're vulnerable to being sued," she added. Double your gift when you give by 6 p.m. Thursday. "Not because I wanted my baby to die, but because I needed this hell to end. Join us for Texas biggest politics and policy event when you buy your tickets today. The New Texas Abortion Law Is Putting Some Patients In Danger, A Michigan law from 1931 would make abortion a felony if Roe falls. "The penalties are quite draconian," he said, noting that someone could be convicted of a felony. other than an abortion performed due to a medical emergency as defined by Section 171.002, Health and Safety Code]. But for patients facing a medical emergency, or low-income or uninsured Texans, seeking a second opinion may not be possible. 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 . 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. Now she wants those sentiments translated into action. Even if the mothers life is saved, Dr. Moayedi added, she could require an emergency hysterectomy, or removal of the uterus, which would leave her infertile. 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. She would either have to get sick enough for . 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 . You have to suddenly leave for a medical procedure, and you dont know whats going to happen, so despite everything that made me leave, it was a relief to be back home, she said. The case spurred a movement that led to the overturning of Ireland's abortion ban in 2018. The new law does not apply to removing ectopic pregnancies that implant outside the uterus, which are not considered abortions under state law. 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. Find a complete list of them here. It just seems cruel and unusual.. 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. Her discharge was yellow and smelled weird. Or you wait till your baby's heartbeat stops.'". Pregnancies can be complicated by any number of medical conditions. One option was to end the pregnancy; that's called "a termination for medical reasons." She called her doctor and begged to get in. Enough to make her retch. Methotrexate or surgery are the only two options listed in the medical guidelines to prevent the fallopian tubes from rupturing and causing dangerous bleeding. hide caption. As Hall learned the hard way, the law makes no exception for lethal fetal anomalies. 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 . We do what we can to honor each of those cases.. In Texas' anti-abortion . But interpretation of the laws is still causing challenges to care. "I told her 'I'm so sorry. They also had an anatomy scan, which revealed no problems. Carrying the pregnancy to term would be emotionally grueling and would also raise the mothers risk of blood clots and severe postpartum bleeding, the doctor warned. Elizabeth could not receive the medical care she needed until several days later because of a Texas law that banned abortion after six weeks. Texas' "trigger" law, which outlaws abortion "wholly or partly", is set to be in effect 30 days following . For patients who are not pregnant, it can also open up the cervix and make surgeries safer, Crawford said. And theyve had to navigate complicated politics when sharing their news. Time is of the essence. Since Sept. 1, abortion has been illegal in Texas after six weeks gestation, with one exception: If a doctor determines that a patient will face a " medical emergency " if the pregnancy continues, they can perform an abortion later on without breaking the law. She was bereft, unable to even process the news. 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. 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. 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. Since that time, thousands of women have left Texas to obtain abortions in other states. 1, eff. Every OB-GYN has cared for someone who has died from a hemorrhage, she said. "I said 'Well, is there a heartbeat still?' But the new Texas law has profoundly affected his ability to practice. And she just recklessly and negligently goes out and gets abortions all willy-nilly, left and right," she says. I couldn't give you life. And I told her 'No, ma'am. 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. 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. 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. Mark Felix/AFP via Getty Images "Abortions are sometimes needed out of an act of an emergency, out of an act of saving a woman's life. Im a nurse. Texas Health and Safety Code, Chapter 245. At the same time, she was searching for abortion clinics. "It's hard to form a relationship to say, 'Hey look, I'm not using this for an elective abortion,'" she said. ), 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 . "That's torture to have to carry a pregnancy which has such a low chance of survival," says Dr. Peaceman. 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. But the statutes dont account for complicated miscarriages, and confusion has led some providers to delay or deny care for patients in Texas. The other option is called expectant management, in which Elizabeth would stay in the hospital and try to stay pregnant until 24 weeks, which is considered the beginning of "viability" outside the womb. "We shouldn't have been celebrating," Elizabeth says.

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