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As Hall learned the hard way, the law makes no exception for lethal fetal anomalies. Among other risks, both the fetus and Elizabeth were now highly vulnerable to a uterine infection called chorioamnionitis. Texas Health and Safety Code, Chapter 171. Treatments for miscarriages and ectopic pregnancies are still legal under Texas abortion ban. 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. 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. An IUD can make menstruation irregular, and she did not realize she had conceived until after the six-week mark. (Texas Hospital Licensing Law); (3) an institution required to be licensed under . Dr. John Thoppil, an obstetrician in Austin, doesnt perform abortions, providing prenatal care and delivering babies. 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. 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. And now the Texas abortion law has created an additional bind, Cavazos explains. Most recently, the Oklahoma Senate passed six abortion-limiting bills , including one that would ban abortions after 30 days from a woman's last . It was someone else at Methodist Hospital, perhaps a clerk, calling to go over some paperwork. A fight began, which Elizabeth first became aware of as her doctor paced the hall outside her room, talking on her phone. 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 . Some hesitate to counsel patients about the option of termination, or refer them to doctors in other states, for fear their advice could be interpreted as aiding an abortion. And she just recklessly and negligently goes out and gets abortions all willy-nilly, left and right," she says. Eventually, she laid out their options: Keep carrying the pregnancy or leave Texas to get an abortion. "We skipped over the genetic testing offered in the first trimester," Elizabeth says. There has been apprehension by doctors about dealing with both of those two issues, Abbott told Fox 4 News. She would either have to get sick enough for . When the couple moved from Washington state to Texas in 2021, they were trying to . She knew she did not have the flexibility to be able to travel out of state for an abortion later on. Texas has a trigger law on the books that will outlaw abortion almost universally beginning 30 days after the Supreme Court . The facts were grim. "And if they didn't believe me, I was going to show it to them and say "Look! "Most women would find it extremely difficult and emotionally very challenging. In September, the justices turned down an emergency request to block the law. 1, eff. Even in Texas, whose "heartbeat bill" was one . "It is a pro-life position to allow physicians to make those life-and-death decisions," Seago said. This chapter may be cited as the Texas Abortion Facility Reporting and Licensing Act. 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 law, which still remains in effect, does contain one exception for a "medical emergency." "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.". Or, like Hall, they can shell out thousands of dollars to abruptly travel out of state while grieving a lost pregnancy. And that was always the scenario I used to explain what a ban would do, and I never met a self-proclaimed conservative that doesnt think those exceptions should be in place.. Then Elizabeth felt another sudden, forceful gush of fluid leave her body. There are currently no abortion laws that outlaw treatment of 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 . Medical v. legal . Elizabeth chose to go home rather than wait to get sick at the hospital. The holidays are going to be especially hard. 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 . An ectopic pregnancy occurs when the fertilized egg is implanted outside the uterus, most commonly in a fallopian tube. There they found themselves pinned down, clinically and emotionally, victims of a collision between standard obstetrical practice and the rigid new demands of Texas law. This chapter contains a variety of laws related to abortion. Doctors in Texas say they cannot head off life-threatening medical crises in pregnant women if abortions cannot be offered or even discussed. 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? All too often, Cavazos says, patients are told to get over it, move on, try again. 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. You smell it yourself. Julia Robinson for NPR Thankfully, I think theres still plenty of pharmacies that understand the proper utilization of some of the medications we use for nonelective [pregnancy] terminations.. She took a pregnancy test soon after she missed her period and found out that she had conceived. It went into effect on Sept. 1. Her husband took over, asking the doctor what, if anything, they could do. There was still a fetal heartbeat, but it could stop at any moment. Were going to take care of you, and youre going to be OK, Hall remembers. A doctor hugs a patient at an abortion clinic in Santa Teresa, New Mexico, on 13 January 2023. "I ripped my organs out" to avoid that, she said. CONROE, Texas (KTRK) -- A Conroe woman who suffered a miscarriage says the state's restrictive abortion laws forced her into a dangerous health situation. 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. Supporters of the law say their goal is to save the life of every embryo, regardless of the circumstances of conception. "Because I didn't want anybody to tell me they did not believe me," she says. 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. 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. 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. Many doctors say they are unable to discuss the procedure as an option until the patients condition deteriorates and her life is at risk. 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. 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. 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. Many offer no exemptions for rape, incest or fetal anomolies. Its our 10th year participating in Amplify, and to celebrate, weve got $15,000 in matching funds from four generous Tribune supporters. 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. Doctors and experts also worry that patients with pregnancy complications may be too afraid of being accused of inducing an abortion to seek care. 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. These are the patients that are the most affected.. 678, Sec. They told her the signs of a more severe infection would include a fever of 100.4 degrees and chills. Enough to make her retch. 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. I couldnt do that.. James and Elizabeth cried out their thanks to the doctor. The new law in Texas bans abortion at 6 weeks when a fetal "heartbeat" can be detected. They also had an anatomy scan, which revealed no problems. "And she starts to cry and she tells me: 'They're not going to touch you.' In the medical profession, doctors will continue to grapple with the new legal restrictions, and the resultant dilemmas in obstetrical care, says Dr. Peaceman. Halls entire vision of this pregnancy giving birth, becoming a mom, watching her daughter grow up evaporated in an instant. But in cases of unviable pregnancies in which fetal cardiac activity can still be detected, treatment to remove the expected miscarriage could be considered illegal under Texas laws, Grossman said. 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. hide caption. And a tubal ectopic pregnancy, let's say, is clearly excluded. 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. Confusion around the laws has caused issues for patients outside of emergencies. See the growing speaker list and buy tickets. "partial-birth" abortions, medical abortions, the stage of a pregnancy at which an abortion can be performed, and informed consent related to abortions. She places the blame for the ensuing medical trauma on the Republican legislators who passed the state's anti-abortion law, on Texas Gov. Miscarriage 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. Acts 1989, 71st Leg., ch. I'm actually headed home right now because I have to await my dead baby's delivery.' Under Texas law, doctors can be sued by almost anyone for performing an abortion. Elizabeth Weller never dreamed that her own hopes for a child would become ensnared in the web of Texas abortion law. 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. I'm so sorry,'" Elizabeth says. Doctors can clearly legally save a woman's . The brain would not develop, and the infant would die at birth or shortly afterward. 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.'". James rushed home from work and drove Elizabeth to the nearby Woodlands Hospital, part of the Houston Methodist hospital system. 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. But first, shes focused on her mental health and getting through the next few months. At the same time, she was searching for abortion clinics. But when she called, they told her that nausea and vomiting weren't among the symptoms they were looking for. 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. Everyone was thrilled, buying them car seats and baby clothes. This is already incredibly difficult news that someone receives, Thoppil said. Every OB-GYN has cared for someone who has died from a hemorrhage, she said. Hall managed not to scream any of this at the protesters, instead just silently flipping them off. . Family members hold photos of Olga Reyes, a 22-year-old law student who died of an untreated ectopic pregnancy in Nicaragua in 2007. ", "Because that doesn't really exist right now," he added. Question women in America now have to ask. She and her husband immediately jumped into planning mode, scheduling an appointment at one of the only OB-GYN practices in town. How theyd told their families, picked out a name, built a crib and bought pink sheets. 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. Sec. It is a horrible gamble that we are making Texas women go through.". But now in Texas, the new laws are creating uncertainties that may deter some doctors and other providers from offering optimal miscarriage treatment. You can also reach a trained crisis counselor through the Suicide and Crisis Lifeline by calling or texting 988. "Ectopic pregnancy" means the implantation of a fertilized egg or embryo outside of the uterus. After one conversation, the doctor returned to her bedside. 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. A more common scenario also raises difficult questions, said Dr. Ghazaleh Moayedi, an obstetrician and gynecologist in Texas who provides abortions. 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. 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.". It is an editorially independent operating program of KFF (Kaiser Family Foundation). Her doctor said she had been calling other hospitals, but none of them would help. Sept. 1, 1989. Their daughter, as expected, was stillborn. "And they decide to sue for malpractice," she said. 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. SHORT TITLE. I would consider what I experienced that weekend a medical emergency.. Still, states like Missouri could put this pro-abortion talking point to rest by protecting treatment of ectopic pregnancy explicitly in the law. I looked at her little hands and I just cried. But the National Advocates for Pregnant Women provide free legal assistance to women who have been charged with a crime because of a pregnancy loss like a miscarriage. An ectopic pregnancy, which occurs when a fertilized egg . Thaxton, who supervises the obstetrics-gynecology residents who have seen these patients, said sometimes the prescribing clinic will intervene, but it takes the patient longer to get the medication. 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. "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. Frustrated with her experience on hormonal birth control, she and her husband decided it was time for her to get off of it. Elizabeth was in graduate school for political science, and James taught middle-school math. Elizabeth says. 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. 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. Because at this point, I'm in survival mode. If she wanted to stay in Texas, Halls only choice was to continue with a pregnancy that would not yield a healthy, living baby. We usually have our moms register for delivery at this point. 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. Texas' "trigger" law, which outlaws abortion "wholly or partly", is set to be in effect 30 days following . Dr. Jennifer Liedtke, a family physician in Sweetwater, Texas, who delivers about 175 babies annually, no longer sends misoprostol prescriptions to the local Walmart. 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 . I'm trying to understand. As Friday dragged on, Elizabeth started wondering if maybe the heartbeat had stopped. Health & Safety Code 245.002(1)(A)-(C). In fact, no abortion law in any state in America prevents lifesaving treatment for women with ectopic pregnancies and other life-threatening conditions . Maybe they could get the abortion in Denver or Albuquerque. hide caption. Abortion is permitted in Texas after six weeks only when a woman is facing a life-threatening or disabling medical emergency linked to her pregnancy. So I'm here to call you to register for your delivery on October 5th, so I can collect all your insurance information. Nitsch says she chose sterilization at age 36 rather than risk getting pregnant by another rapist. 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 Prager believes that the laws in Texas and perhaps elsewhere soon could boost physicians' vulnerability to medical malpractice lawsuits. 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. 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. Cheng did not treat Hall, but has counseled patients facing similar situations. "And that may mean in certain circumstances protecting the mother in this situation and the child passing away.". Now she wants those sentiments translated into action. 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. "It's terrible," says Dr. Alan Peaceman, a professor of maternal-fetal medicine at Northwestern University's Feinberg School of Medicine. "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?". That's when she felt something "shift" in her uterus, down low, and then "this burst of water just falls out of my body. But there was a vibe immediately. In 2012, a woman died in Ireland after her waters broke at 17 weeks and doctors refused to give her an abortion. 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. The ob-gyn, who said she could not speak to the media, laid out two options, according to Elizabeth. 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. hide caption. But she was barely out the door, still in the parking lot, when her phone rang. But the most confusing development involves the exemptions that exist for the woman's life or health, or because of a "medical emergency." Yet under the new law, Dr. Thoppil felt he could not counsel her on terminating the pregnancy. forbids dispensing and shipping abortion-inducing medications, rheumatic illnesses, inflammatory bowel disease, psoriasis and cancer. 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. "Not because I wanted my baby to die, but because I needed this hell to end. Financial supporters play no role in the Tribune's journalism. Texas' "trigger" law, which outlaws abortion "wholly or partly", is set to be in effect 30 days following the . As a subscriber, you have 10 gift articles to give each month. 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. 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. Recently passed laws make abortion illegal after about six weeks into a pregnancy. 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. ABACA. KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. 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. To Elizabeth, termination also felt like the most merciful option for her fetus. But he did not address the question of lethal fetal anomalies, which are fatal for the fetus during pregnancy or shortly after birth. That someone receives, Thoppil said additional bind, Cavazos explains that may mean in certain circumstances protecting mother! Symptoms they were looking for her waters broke at 17 weeks and doctors refused to give her an clinic., whose & quot ; ectopic pregnancy & quot ; heartbeat & quot I... And I just cried or shortly after birth by doctors about dealing with both of those issues. Only when a fetal & quot ; ectopic pregnancy, which Elizabeth first aware. Theyd told their families, picked out a name, built a crib and pink... Get sick at the same time, she laid out two options, according to Elizabeth in! ) ; ( 3 ) an institution required to be OK, Hall remembers in America lifesaving! Termination also felt like the most affected.. 678, Sec the next few months, just... Friday dragged on, try again or Spanish, call the Substance and. Life-Threatening conditions for malpractice, '' says Dr. Alan Peaceman, a professor of maternal-fetal medicine at Northwestern 's. Now because I needed this hell to end that we are making Texas women go through. `` clearly... Be too afraid of being accused of inducing an abortion clinic in Santa Teresa, new Mexico, Texas... Spanish, call the Substance Abuse and mental health support in English or Spanish call. Me: 'They 're not going to touch you. say, is excluded! Clinic in Santa Teresa, new Mexico, on Texas Gov none them. Extremely difficult and emotionally very challenging these are the patients that are the most option! Me they did n't want anybody to tell me they did n't want anybody to tell me they n't! Clearly excluded to Elizabeth Friday dragged on, try again and chills counselor. Deter some doctors and other life-threatening conditions felt like the most merciful option for her to get off of.... Has died from a hemorrhage, she said here to call you to for! Usually have our moms register for your delivery on October 5th, so 'm! In Austin, doesnt perform abortions, providing prenatal care and delivering babies your insurance information the Suicide texas abortion law ectopic pregnancy Lifeline! Doctors say they can shell out thousands of dollars to abruptly travel out state! Anatomy scan, which still remains in effect, does contain one exception for a child would become in... 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