Since states like Missouri and Texas rushed to ban abortion, using language that is vague and with narrow exceptions, hospitals and physicians across the South and in other areas with abortion bans are denying health-saving care to pregnant patients in crisis.1
Physicians and women who experienced pregnancy crises in Texas because of its abortion ban are suing suspended Texas Attorney General Ken Paxton, the Texas Medical Board, and Stephen Brint Carlton, executive director of the Texas Medical Board. The plaintiffs argued they were denied necessary and potentially life-saving obstetrical care because medical professionals throughout Texas fear liability under the state’s abortion bans.2
The plaintiffs alleged abortion bans are hindering or delaying necessary obstetric care and are exposing pregnant patients to risks of death, injury, and illness, including loss of fertility. “Medical professionals are now telling patients that if they want to become pregnant, they should leave Texas,” they noted.2
In 2022, Mylissa Farmer and the National Women’s Law Center (NWLC) filed a complaint with the Centers for Medicare & Medicaid Services (CMS), saying two hospitals did not follow federal requirements under EMTALA.
Here are summaries of the stories:
• Mylissa Farmer: On Aug. 1, 2022, Farmer was 18 weeks pregnant when she attended a routine maternity care appointment with her OB/GYN in Joplin, MO. The next morning, she felt a large gush of fluid from her vagina, bleeding, abdominal pressure, pain, and cramping. Farmer called her physician, who told her to rush to the ED at Freeman Hospital West, where she was taken to the labor and delivery unit.1
Clinicians discovered she was leaking amniotic fluid, her cervix was dilated, and membranes were ruptured. Her symptoms meant there would be no chance of saving the pregnancy. Since Farmer faced health issues related to a prior COVID-19 infection, she was at “risk of maternal thrombosis given her history with DVT [deep vein thrombosis], infection/sepsis, severe blood loss, hysterotomy, hysterectomy, and even mortality.”
Physicians told Farmer she could either undergo medical intervention or wait and jeopardize her health and life. But the doctors also said they could not provide medically necessary abortion care, based on the hospital’s legal department’s assessment of Missouri law. In Missouri, it is a Class B felony to perform abortion care when a positive fetal heart tone is detectable.1
At her physician’s instructions, Farmer left the hospital. She was still bleeding and fatigued, and first went home to rest. After calling multiple hospitals in Illinois and Kansas, she drove three hours to the University of Kansas Hospital’s ED, where she was taken to the labor and delivery room.
An ultrasound revealed that Farmer no longer had any amniotic fluid. Her symptoms worsened, including intense fatigue, mental fog, and serious pain. The physician recommended Farmer end her pregnancy through induced labor or an abortion procedure. But 20 minutes later, the physician informed Farmer the hospital’s legal counsel said they could not provide her with any treatment because it would be “too risky in this heated political environment to intervene.”1
Farmer was discharged on Aug. 3, 2022, with substandard pain relief and medical treatment. Farmer decided to return to Freeman Hospital West for monitoring overnight. A neonatal ICU physician told Farmer that her fetus would not survive and her uterus was constricting, crushing the fetus’ tender bones. Other providers told her they were afraid she and other women would die because of the state’s abortion laws.
Again, Farmer was discharged without receiving more than Tylenol for her pain. Farmer and her boyfriend traveled 4.5 hours north to an Illinois clinic that would offer her urgent care. They left at 3 a.m. with only $45 in cash. Farmer was in active labor when she arrived, and the Illinois clinic’s doctor immediately provided abortion care, saving her health and life.
Because of the days she spent trying to find physicians who would provide the necessary miscarriage care, she missed work and lost a week’s pay, and her boyfriend was fired. His new job pays significantly less. Plus, Farmer’s insurance company refused to pay for the treatment she received in Illinois. They are struggling to make ends meet and pay their medical bills.
“Some days, she is unable to leave her bed, and she is worried that she will lose her job because she cannot sleep, cannot eat, and cannot focus,” according to the complaint. “She has sought psychiatric care, however, and she was recently prescribed four medications to treat her severe emotional distress related to these experiences.”1
• Amanda Zurawski: Zurawski and her husband had been trying to conceive for years. They underwent 1.5 years of fertility treatments before she finally became pregnant. But at nearly 18 weeks, the Austin, TX, woman was diagnosed with incompetent cervix and was told her fetus would not survive.2
Zurawski asked about cerclage, in which a patient’s cervix is stitched close to prevent preterm birth, but her doctors said it would not work in her case and was too risky. Zurawski’s water broke on Aug. 23, 2022. She returned to the ED that night and was diagnosed with preterm prelabor rupture of membranes. They kept Zurawski overnight, but did not offer her an abortion or transfer her to a facility that could provide the procedure.
Instead, clinicians told her that under Texas’ abortion ban, there was no other medical care the hospital could provide because Zurawski did not yet show signs of acute infection. They also told her that it may be hours or weeks before she went into labor and miscarried the fetus.
Zurawski feared she did not have time to travel 11 hours to Albuquerque, the location of the nearest abortion provider. Zurawski waited at home, and two days later she developed a fever and signs of sepsis. Her OB/GYN said she should go to the ED immediately. Her temperature peaked at 103.2° F which her medical team confirmed was septic. The hospital finally induced labor.
Zurawski developed a secondary infection, chorioamnionitis, and septic shock. She spent three days in the ICU, and her family flew across the country because they worried she would die before they could see her again. Zurawski survived the infections and was discharged, but the infections caused such severe scar tissue to develop in her uterus and on her fallopian tubes that she could only attempt a second pregnancy through in vitro fertilization.2
• Lauren Miller: Dallas resident Lauren Miller experienced hyperemesis gravidarum (extreme and persistent nausea) during her second pregnancy. Miller’s first ultrasound showed she was pregnant with twins. This was happy news until her 12-week ultrasound when clinicians told her one baby was not growing as fast.2
The ultrasound detected trisomy 18 and cysts near the brain of Baby B. This meant Miller would likely have a miscarriage or a stillborn child. Even if the baby was born, it would not live long. The fetus also had an abnormal heart and an incomplete abdominal wall. Miller likely would experience a health crisis and lose both fetuses if she did not seek a fetal reduction procedure to save the other twin’s life. Physicians told her she could not receive that care in Texas.
“In every interaction with their medical team in Texas, Lauren M. and her husband felt confused and frustrated and could not get direct answers. It was apparent that their doctors, nurses, and counselors were all fearful of speaking directly and openly about abortion for fear of liability under Texas’ abortion bans,” according to the complaint.2
The Millers traveled to Colorado, where she received a selective reduction abortion procedure at 15 weeks of pregnancy. It cost them thousands of dollars and kept them away from their son for several days. Her pregnancy continued with Baby A, although Miller said she feared for her safety as a pregnant woman in Texas.
• Lauren Hall: The 28-year-old Dallas woman’s first appointment with a maternal-fetal medicine (MFM) specialist occurred two weeks after Roe v. Wade was overturned. Hall learned her fetus had anencephaly, meaning no skull and an underdeveloped brain. The baby would never survive. Plus, if she continued the pregnancy, there was a risk she would hemorrhage from a preterm birth.2
“Lauren H. remembers thinking that she did not want to end up bleeding to death on the bathroom floor,” the complaint stated.2
Hall is a nurse and knew her safest option was to undergo an abortion. But the specialist said she could not help Hall — and was even afraid to provide information about Hall’s options.
“Roe had just been overturned, and everyone Lauren H. encountered was terrified. Her MFM [provider] urged her to go out of state and tell no one — not her family, not anyone at the airport — where she was going or what she was doing. Lauren H.’s MFM [specialist] said she could not provide a referral or even transfer her medical records to an abortion provider. No one knew how far the politicians in Texas would go to prosecute people involved in abortion care.”
Hall called abortion clinics in Colorado and New Mexico but could not get an appointment. She suffered from a mental health crisis but was afraid to seek help for it. Finally, Hall set an appointment in Seattle, traveling there with financial help from her family.
“On her way into the clinic for her appointment, protestors shouted at her that she was a baby killer,” the complaint noted.2
REFERENCES
- Centers for Medicare & Medicaid Services. Administrative complaint. Nov. 8, 2022. https://nwlc.org/wp-content/up...
- McCammon S. 5 Texas women denied abortions sue the state, saying the bans put them in danger. NPR. March 8, 2023. https://www.npr.org/2023/03/07...
Since states like Missouri and Texas rushed to ban abortion, using language that is vague and with narrow exceptions, hospitals and physicians across the South and in other areas with abortion bans are denying health-saving care to pregnant patients in crisis.
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