But for patients facing a medical emergency, or low-income or uninsured Texans, seeking a second opinion may not be possible. 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 . The new law in Texas bans abortion at 6 weeks when a fetal "heartbeat" can be detected. ", 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. 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. "That's torture to have to carry a pregnancy which has such a low chance of survival," says Dr. Peaceman. A recent study also reported 28 women with dangerous pregnancies at two Texas hospitals faced delays for care because fetal cardiac activity was detected, according to the AP. Treatments for miscarriages and ectopic pregnancies are still legal under Texas abortion ban. 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. And I screamed because that's when I knew something wrong was happening. 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. Elizabeth could not receive the medical care she needed until several days later because of a Texas law that banned abortion after six weeks. Then Elizabeth felt another sudden, forceful gush of fluid leave her body. A clinical battle begins behind the scenes. But its not just the physical changes, but the emotional toll of knowing their baby is not going to survive and just waiting for something to happen so they can get the care they need.. 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 . 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. 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. 245.001. "But I have certainly heard discussion among physicians that they're very hesitant to do any kind of intervention until they're absolutely certain that this is not possibly a viable pregnancy even though the amount of bleeding would warrant intervening because it's a threat to the mother's life.". Everyone was so scared.. A Texas judge's decision that could revoke the FDA's approval of abortion drugs is expected soon. Her discharge was yellow and smelled weird. An attendee holds her child during A Texas Rally for Abortion Rights at Discovery Green in Houston, Texas, on May 7. The holidays are going to be especially hard. "I told her 'I'm so sorry. At 18 weeks, the watery, protective cushion of amniotic fluid was gone. A more common scenario also raises difficult questions, said Dr. Ghazaleh Moayedi, an obstetrician and gynecologist in Texas who provides abortions. "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. When they called the doctor's office back, they were told to go straight to the emergency room. 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. Which sounds extreme, but Roe had just been overturned. Their daughter, as expected, was stillborn. "We skipped over the genetic testing offered in the first trimester," Elizabeth says. That's when a new state law banned all abortions after fetal cardiac activity is detected usually at about six weeks of 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. Or the judge could at least nullify FDA decisions in 2016 and 2021 that allowed at-home and mail-order chemical abortions. Another pending ban, a so-called "trigger law" passed by Texas in 2021, is expected to go into effect within weeks. We do what we can to honor each of those cases.. 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. "The penalties are quite draconian," he said, noting that someone could be convicted of a felony. 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. After all, she didnt need an abortion she needed convenient pregnancy care. So when Roe v . Either way, she saw nothing ahead but fear and grief prolonged, delayed, amplified. 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. Under Texas' Senate Bill 8, abortions are banned after six weeks of pregnancy, and the only exception is if a doctor determines a patient will face a "medical emergency" if the procedure isn't . Or, like Hall, they can shell out thousands of dollars to abruptly travel out of state while grieving a lost pregnancy. An IUD can make menstruation irregular, and she did not realize she had conceived until after the six-week mark. And it's this stupid, like, distinction that you're just making in this grief. 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. You can reach them at 212-255-9252. A miscarriage is generally defined as the loss of a fetus before the 20th week of pregnancy typically because of complications outside of a patients control. I would consider what I experienced that weekend a medical emergency.. Im a nurse. 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. They now had some of the symptoms they needed to show the infection was getting worse. The bill makes no exceptions for pregnancies that resulted from rape or incest. But as has been true in Texas and in many of the 12 other states where abortion is currently . Texas' new abortion laws . Elizabeth and James keep remembrances of their baby in a picture frame at home. All too often, Cavazos says, patients are told to get over it, move on, try again. 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. I need you to give me the facts.'". Many of these lethal fetal abnormalities come to light at an anatomy scan performed later in pregnancy. The protesters outside a Seattle-area abortion clinic waved pictures of bloody fetuses, shouting that she was a baby killer and begging her to choose life. But it is also affecting women who have no desire for termination but are experiencing medically risky pregnancies. Last month, an Austin woman had the medical equivalent of a ticking time bomb in her body. ", And at this particular point in her life, pregnant for the first time at age 26, it was still somewhat abstract: "I had not been put in a position to where I had to weigh the real nuances that went into this situation. 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. Financial supporters play no role in the Tribune's journalism. Back at home, the Wellers got more serious about their travel plans and started booking tickets. In Texas, a 2021 law made it easier to sue anyone who helps a person get an abortion after about six weeks of pregnancy. If I offer the patient the standard of care, I could be sued for aiding and abetting, he said. But he did not address the question of lethal fetal anomalies, which are fatal for the fetus during pregnancy or shortly after birth. Hall was in her second trimester when the U.S. Supreme Court overturned Roe v. Wade. John Seago, legislative director for Texas Right to Life, described this type of hesitation as "an awful misunderstanding of the law." Doctors and experts also worry that patients with pregnancy complications may be too afraid of being accused of inducing an abortion to seek care. 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. Fetuses who do survive a premature delivery can die soon after birth, or, if they survive, may experience major problems with their lungs, or suffer strokes, blindness, cerebral palsy or other disabilities and illnesses. "'I'm just using this because this is not a viable pregnancy.'". An ultrasound confirmed that she had suffered premature rupture of membranes, which affects about 3% of pregnancies. But Prager believes that the laws in Texas and perhaps elsewhere soon . And they're telling me to think of the positives. Grumet: Fears over Texas' abortion laws interfere with urgent, life-saving care. They're not allowed to do that in Texas. But Im still so angry I had to leave.. 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 is legal under Texas's abortion law. 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, 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. "I was born with a physical disability. These cases are only going to grow until the law is either repealed or clarified. 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.. The other miscarriage treatment is a procedure described as surgical uterine evacuation to remove the pregnancy tissue the same approach as for an abortion. 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. Correction, Oct. 24, 2022 at 4:12 p.m.: 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. 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. I looked at her little hands and I just cried. 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. "Most women would find it extremely difficult and emotionally very challenging. No one really knows what the legislature means by that, and they are afraid of overstepping. She was through with being dismissed, being told to wait. At the office, her ob-gyn turned down the ultrasound volume so they wouldn't have to hear. 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. Julia Robinson for NPR ", "Because that doesn't really exist right now," he added. Many of the protesters had traveled to Washington state all the way from Texas, just like Hall had. (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). I'm so sorry,'" Elizabeth says. Hall declined those services. SHORT TITLE. 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. AUSTIN (KXAN) Amanda and Josh Zurawski have been trying to have a baby for more than a year now. In a sudden obstetrical emergency, a termination might be the least risky option, clinically. Given the states severe penalties, Grossman said medical professionals and their legal teams might err on the side of caution in regard to the law, even if it puts patients at risk. But those numbers have skyrocketed since Roe v. Wade was overturned. We havent seen a large issue, but there are certainly anecdotes, Thoppil said. 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.'". Sec. SB 8, which was signed into law by Texas Gov. The pregnancy made it impossible to remove the device, Dr. Thoppil said. Texas providers are still adjusting to other ripple effects that affect patient 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. Elizabeth and James Weller at their home in Houston two months after losing their baby girl due to a premature rupture of membranes. A fertilized egg can't survive an ectopic pregnancy and can result in life-threatening bleeding, according to the Mayo Clinic. Hall managed not to scream any of this at the protesters, instead just silently flipping them off. Texas new measure was intended to impose stringent limits on abortion. "The pharmacy has said, 'We don't know whether or not you might be using this medication for the purposes of abortion,'" she said. And she just recklessly and negligently goes out and gets abortions all willy-nilly, left and right," she says. Elizabeth was 18 weeks pregnant. 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. She places the blame for the ensuing medical trauma on the Republican legislators who passed the state's anti-abortion law, on Texas Gov. . When they learned they were having a girl, Hall and her husband even picked out a name: Amelia. Texas law reflects this important distinction. That's not a good thing. It just seems cruel and unusual.. The ethics panel had reached a decision, the doctor told them. Pro-Life policies in Texas do not prevent doctors from treating an ectopic pregnancy. hide caption. According to a letter from the Texas Medical Association, a physician in Central Texas was instructed not to treat an ectopic pregnancy until it ruptured, which can cause serious medical complications. Elizabeth touches the urn of her daughter. Enough to make her retch. Elizabeth says. There was still a fetal heartbeat, but it could stop at any moment. The case spurred a movement that led to the overturning of Ireland's abortion ban in 2018. For some, that's too difficult, given the emotions surrounding the pregnancy loss, she said. Elizabeth could not receive the medical care she needed until several days later because of a Texas law that banned abortion after six weeks. They have private waiting rooms for these patients and offer grief support, genetic counseling and even bereavement services, including ways to memorialize the lost pregnancy. Recently passed laws make abortion illegal after about six weeks into a pregnancy. Elizabeth touches the urn of her daughter. In Poland, protests over that countrys abortion laws erupted this year after a 30-year-old pregnant woman died of septic shock. 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. And so they don't even know what the rules are.". Consider the patient whose miscarriage care is delayed and develops a serious infection and other complications, Prager said. Before they drove off, Elizabeth paused to do something. Mark Felix/AFP via Getty Images Treatment of ectopic pregnancy is not prohibited by Texas' abortion laws. Walmart officials did not respond to multiple requests for comment. 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. 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. 7:49 PM on Jul 14, 2022 CDT. Halls entire vision of this pregnancy giving birth, becoming a mom, watching her daughter grow up evaporated in an instant. She had cramps, and was passing clots of blood. It is not currently possible in any way to 'reimplant' an ectopic pregnancy. 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. The Texas Tribune Festival is almost here! To deal with the increased demand, Cedar River has reopened a previously shuttered location, enhanced its telemedicine services and worked to find ways to help patients pay for travel and procedures. 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. Texas' "trigger" law, which outlaws abortion "wholly or partly", is set to be in effect 30 days following . 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