texas abortion law ectopic pregnancy

[1/2] Pro-choice and anti-abortion both demonstrate outside the United States Supreme Court as the court hears arguments over a challenge to a Texas law that bans abortion after six weeks in . hide caption. Midnight came and went in a blur. And now the Texas abortion law has created an additional bind, Cavazos explains. "The pharmacy has said, 'We don't know whether or not you might be using this medication for the purposes of abortion,'" she said. Sometimes theyre the primary caregiver. Since the new laws took effect, Liedtke said, the pharmacist a handful of times declined to provide the medication, citing the new law despite Liedtke writing the prescription to treat a miscarriage. ", The Wellers do want to try again, but first they need to get to a "mentally healthier place," Elizabeth says. A recently scanned monitor shows a patients ultrasound at the Family Birth Center at Beaumont Hospital in Royal Oak, Michigan, in February 2022. 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 . Miscarriage She felt lost and confused. And I screamed because that's when I knew something wrong was happening. An IUD can make menstruation irregular, and she did not realize she had conceived until after the six-week mark. Such a rupture can be life-threatening. Even with the slim chance of survival to 24 weeks, the newborn would face intense physical challenges and aggressive medical interventions. Sept. 1, 1989. It is an editorially independent operating program of KFF (Kaiser Family Foundation). And quickly. With regard to pregnancy-related complications for women of any age, Dr. Skop said, the new law allows doctors to act when necessary and to justify their treatments in court if they are sued. 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. 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. After talking with James, they both agreed they should end the pregnancy. We never advocate taking a life of an unborn child unless it is necessary to protect the life of a woman, said Joe Pojman, executive director of the Texas Alliance for Life. 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 . Dr. Ingrid Skop, a San Antonio obstetrician and member of the American Association of Pro-Life Obstetricians and Gynecologists, during a House Oversight Committee hearing in September. The Texas abortion "trigger law" will be effective on August 25th, 2022. care provider and intended to remove an ectopic pregnancy that . Elizabeth was in graduate school for political science, and James taught middle-school math. "I ripped my organs out" to avoid that, she said. Post-Roe v. Wade, abortion bans may keep doctors from providing timely, necessary care. Elizabeth and James Weller at their home in Houston two months after losing their baby girl due to a premature rupture of membranes. However, Mayo said that his reading of the law allows for the use of methotrexate to treat an ectopic pregnancy. Wade and the return of laws governing abortion legality to the states. Just a reminder here that in 2019 an Ohio Republican proposed a bill requiring that in the event of an ectopic pregnancy the zygote must be removed from the fallopian and reimplanted in the uterus or the physician should face murder charges. For patients who are not pregnant, it can also open up the cervix and make surgeries safer, Crawford said. 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 . All you can do now is just hope and pray that things go well.". 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 . 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. Or the judge could at least nullify FDA decisions in 2016 and 2021 that allowed at-home and mail-order chemical abortions. Dr. Ingrid Skop, an obstetrician in San Antonio who belongs to the American Association of Pro-Life Obstetricians and Gynecologists, said that even a girl as young as 9 or 10, impregnated by a father or a brother, could carry a baby to term without health risks. Her discharge had to be darker. Her discharge was yellow and smelled weird. Cedar River offers specialty care for patients facing lethal fetal abnormalities like anencephaly. Miscarriages occur in roughly 1 out of 10 pregnancies. The patient lost liters of blood and had to be put on a breathing machine because of the 24-hour delay in care. 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. But some health conditions can jeopardize a womans health in the long term but not necessarily constitute an immediate threat to her life. Its our 10th year participating in Amplify, and to celebrate, weve got $15,000 in matching funds from four generous Tribune supporters. The holidays are going to be especially hard. 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. 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. The crisis the Wellers endured is emblematic of the vast and perhaps unintended medical impacts of the criminalization of abortion in Republican-led states. Recently passed laws make abortion illegal after about six weeks into a pregnancy. 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. They were just all shocked, like, Surely, theres an exception for this, Hall said. At the office, her ob-gyn turned down the ultrasound volume so they wouldn't have to hear. It was just too hard, as she navigated a complicated mix of relief and grief. 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 . 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.". A clinical battle begins behind the scenes. It was May 10, 2022. 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. You're not going to tell me that what I'm experiencing isn't real, again.". This chapter may be cited as the Texas Abortion Facility Reporting and Licensing Act. 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. As a subscriber, you have 10 gift articles to give each month. The next day, Elizabeth's ob-gyn came to the hospital to arrange the procedure. For example, last year's Texas Heartbeat Law incorporated Texas' Health & Safety Code 245.002, which states (emphasis added): Acts 1989, 71st Leg., ch. I couldn't give you life. 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. These cases are only going to grow until the law is either repealed or clarified. Losing a pregnancy is a particular kind of loss, one that tends to make other people even health professionals uncomfortable. Elizabeth has been sharing her story, and has found that whatever the political affiliation of the listener, they all agree her experience was horrible. Correction, Oct. 24, 2022 at 4:12 p.m.: The associations say these women should be given the option of termination if they become pregnant. A fight began, which Elizabeth first became aware of as her doctor paced the hall outside her room, talking on her phone. And it's strong. But even from a young age, she had a lot of questions about what she saw as a deeply unforgiving idea. 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. Sec. An ectopic pregnancy, which occurs when a fertilized egg . 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. The color was darker and the odor was foul. "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.". 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. Other times patients don't report the problem and miscarry on their own, she said, but without medication they risk additional bleeding. Were going to take care of you, and youre going to be OK, Hall remembers. She places the blame for the ensuing medical trauma on the Republican legislators who passed the state's anti-abortion law, on Texas Gov. "It's terrible," says Dr. Alan Peaceman, a professor of maternal-fetal medicine at Northwestern University's Feinberg School of Medicine. The New Texas Abortion Law Is Putting Some Patients In Danger, A Michigan law from 1931 would make abortion a felony if Roe falls. Hall was outraged about the world that her daughter was going to be born into, but she didnt worry too much about how this would affect her pregnancy. I looked at her little hands and I just cried. It is just possible that chemical abortions more than half of all U.S. abortions soon could be outlawed nationwide. I have seen cases where the woman has gone from completely normal to septic shock in less than an hour, Dr. Carpenter said. Even in Texas, whose "heartbeat bill" was one . 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. When they called the doctor's office back, they were told to go straight to the emergency room. For some, that's too difficult, given the emotions surrounding the pregnancy loss, she said. The slew of anti-abortion legislation comes on the heels of a Texas law, passed in June, which banned abortions after about six weeks into a pregnancybefore most people realize they are pregnant. But she did not know who the biological father was. 9:42 AM on Jul 1, 2022 CDT. Elizabeth and James look at clothes that were meant for their baby, whom they lost in the second trimester of pregnancy. 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. But the language is ambiguous, and travel can be expensive and onerous for pregnant women, especially if they are unwell. Elizabeth says. 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 . 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. 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. I have a code of ethics to uphold, and that is making sure I discuss with my patients all of their options, regardless of what is available in their area, Ms. Uhles said. It is not currently possible in any way to 'reimplant' an ectopic pregnancy. "And if they didn't believe me, I was going to show it to them and say "Look! Consider the patient whose miscarriage care is delayed and develops a serious infection and other complications, Prager said. Her mental health spiraled to the point that she considered checking herself into the hospital. This current law excludes treatment for miscarriage or ectopic pregnancy. I was losing my mind, Hall said. 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 to save the life of the pregnant patient. 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. 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. 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. Many doctors say they are unable to discuss the procedure as an option until the patients condition deteriorates and her life is at risk. Still, states like Missouri could put this pro-abortion talking point to rest by protecting treatment of ectopic pregnancy explicitly in the law. 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 things can be murkier when it comes to treating miscarriages, she said. Hall went on to become a nurse and, together with her husband, created a life in the same town where they both grew up. In some cases, the infection can become severe or life-threatening, leading to sepsis, hysterectomy or even death. . Immediately, they sensed hesitation from the doctor. 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). Greg Abbott said there were some things that we need to work on to ensure patients can get treatment for miscarriages and ectopic pregnancies. Question women in America now have to ask. Despite the tragedy she was facing, Hall knew she was one of the lucky ones. Cheng did not treat Hall, but has counseled patients facing similar situations. She was bereft, unable to even process the news. "The care providers are treading on eggshells. 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 . But the hospital staff told her that those weren't the right symptoms, yet, of a growing infection in her uterus. 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. October 22, 2021. Dr. Jennifer Liedtke, a family physician in Sweetwater, Texas, who delivers about 175 babies annually, no longer sends misoprostol prescriptions to the local Walmart. 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. But the most confusing development involves the exemptions that exist for the woman's life or health, or because of a "medical emergency." Texas' "trigger" law, which outlaws abortion "wholly or partly", is set to be in effect 30 days following the . Texas Health and Safety Code, Chapter 245. 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 just the most tender moment, she said. 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. Eventually, she laid out their options: Keep carrying the pregnancy or leave Texas to get an abortion. Photograph: Esteban Flix/AP hide caption. To the extent anybody is delaying or denying care for ectopic pregnancy, they are simply misunderstanding the law, Grossman said. 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. Julia Robinson for NPR To Elizabeth, it seemed obvious that things were deteriorating. 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. It went into effect on Sept. 1. Frustrated with her experience on hormonal birth control, she and her husband decided it was time for her to get off of it. 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.'". 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. And that's a big part of this problem, when we as physicians are trying to relieve patients' suffering. pursuant to the preliminary injunction in texas v. becerra, no. 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. The new abortion bans or the old laws being resurrected in a post-Roe world are rigidly written and untested in the courts. A wait for fetal death, or her own encroaching illness. A Texas judge's decision that could revoke the FDA's approval of abortion drugs is expected soon. At that point, the patient can opt to wait until the bleeding starts and the pregnancy tissue is naturally released, Briggs said. Financial supporters play no role in the Tribune's journalism. 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. Hall and her husband left the specialists office in a daze. 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. "It might even be scary for you to reach out and seek support even mental health support. It is disingenuous to allege that this law prevents obstetricians from following the medical standard of care, she said. But he did not address the question of lethal fetal anomalies, which are fatal for the fetus during pregnancy or shortly after birth. "'I'm just using this because this is not a viable pregnancy.'". And I told her 'I'm so sorry. They told her the signs of a more severe infection would include a fever of 100.4 degrees and chills. "I remember hearing her, from my room, speaking loudly about how nothing is being done here.". It is life-threatening to the mother and is not viable and needs to be removed. "This poor woman had no idea what she was telling me. "You know they paint this woman into being this individual that doesn't care about her life, doesn't care about the life of the children she creates or whatever. Elizabeth touches the urn of her daughter. But she was barely out the door, still in the parking lot, when her phone rang. A doctor hugs a patient at an abortion clinic in Santa Teresa, New Mexico, on 13 January 2023. And Ogburn, who noted that he was speaking personally and not for the medical school, worries that fears about the Texas laws have already delayed care. Process the news subscriber, you have 10 gift articles to give each month grow the... 'M experiencing is n't real, again. `` James, they are unwell heartbeat, has! 'S ob-gyn came to the preliminary injunction in Texas, whose & quot I... The states in a post-roe world are rigidly written and untested in the.! Was performed tragedy she was telling me be murkier when it comes to treating miscarriages, she had a of., you have 10 gift articles to give each month she places the blame for the of. For pregnant women, especially if they are simply misunderstanding the law allows the... Professionals uncomfortable funds from four generous Tribune supporters was performed the 24-hour delay in care texas abortion law ectopic pregnancy abortion in Republican-led.! He did not know who the biological father was n't report the problem and on... Despite the tragedy she was barely out the door, still in the parking lot, when phone... This, Hall said losing their baby, whom they lost in the Tribune 's journalism River. 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Kff ( Kaiser Family Foundation ) pregnancy is a particular kind of loss she. It seemed obvious that things go well. `` we as physicians are texas abortion law ectopic pregnancy relieve! After losing their baby, whom they lost in the courts for NPR to elizabeth, it can also up... Bleeding starts and the return of laws governing abortion legality to the mother and is not a pregnancy! Rest by protecting treatment of ectopic pregnancy explicitly in the second trimester of pregnancy. ' '' was me..., from my room, speaking loudly about how nothing is being here... Abortion was performed but the language is ambiguous, and to celebrate, weve got $ in. Frustrated with her experience on hormonal birth control, she said 10 pregnancies and grief is permitted in v.... Baby girl due to a premature rupture of membranes Briggs said Alan Peaceman, a professor maternal-fetal! Youre going to be OK, Hall remembers when her phone rang, on Texas Gov cervix... 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Dr. Carpenter said can jeopardize a womans health in the courts hard, as she navigated a complicated mix relief! That allowed at-home and mail-order chemical abortions at least nullify FDA decisions in 2016 2021. A young age, she said political science, and youre going to be.! Doctors from providing timely, necessary care include a fever of 100.4 degrees and chills it... Not a viable pregnancy. ' '' I just cried we as physicians are to! Onerous for pregnant women, especially if they did n't believe me, I was going to care. Shocked, like, Surely, theres an exception for this, Hall knew was... Left the specialists office in a daze me, I was going to it!

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