And for a few tense . That's not a good thing. 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. ", State abortion laws are complicating other types of obstetric care. AUSTIN (KXAN) Amanda and Josh Zurawski have been trying to have a baby for more than a year now. 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. Wade and the return of laws governing abortion legality to the states. Halls entire vision of this pregnancy giving birth, becoming a mom, watching her daughter grow up evaporated in an instant. "It's this woman who was saying 'Hi Miss Weller, you're at the 19 week mark. Seventeen weeks into the pregnancy, they learned they were expecting a girl. To the extent anybody is delaying or denying care for ectopic pregnancy, they are simply misunderstanding the law, Grossman said. 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 Prager believes that the laws in Texas and perhaps elsewhere soon could boost physicians' vulnerability to medical malpractice lawsuits. When they called the doctor's office back, they were told to go straight to the emergency room. And it had to smell foul, really bad. A previous version of this story incorrectly reported the name and location of a clinic. 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.". ", Her waters had broken, launching her into what she calls a "dystopian nightmare" of "physical, emotional and mental anguish." The new abortion bans or the old laws being resurrected in a post-Roe world are rigidly written and untested in the courts. Elizabeth and James look at clothes that were meant for their baby, whom they lost in the second trimester of pregnancy. That's when she felt something "shift" in her uterus, down low, and then "this burst of water just falls out of my body. An ectopic pregnancy is when a fertilized egg implants outside the uterus, typically in one of the woman's fallopian tubes. It is just possible that chemical abortions more than half of all U.S. abortions soon could be outlawed nationwide. "'I'm just using this because this is not a viable pregnancy.'". Due to her history of hemorrhaging, Seewald added that passing the pregnancy at home didn't seem like a good option. At 6 weeks, many people . The law makes no exceptions for nonviable pregnancies in which the fetus has no chance of survival. Many doctors say they are unable to discuss the procedure as an option until the patients condition deteriorates and her life is at risk. Quite the opposite, many state laws explicitly exempt treatment of ectopic pregnancy from their definitions of abortion. An ultrasound confirmed that she had suffered premature rupture of membranes, which affects about 3% of pregnancies. Its been a difficult few weeks since the procedure. Sometimes theyre the primary caregiver. She places the blame for the ensuing medical trauma on the Republican legislators who passed the state's anti-abortion law, on Texas Gov. 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. Lauren Hall, 27, fought the urge to scream back and tell them just how badly she wished life was a choice she could have made. 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. A Texas judge's decision that could revoke the FDA's approval of abortion drugs is expected soon. "Because I didn't want anybody to tell me they did not believe me," she says. We want to keep you safe.. A wait for fetal death, or her own encroaching illness. Either way, she saw nothing ahead but fear and grief prolonged, delayed, amplified. They had to call their OB/GYN repeatedly to get the $500 delivery deposit refunded. We havent seen a large issue, but there are certainly anecdotes, Thoppil said. The associations say these women should be given the option of termination if they become pregnant. "Any law that creates a hesitancy for physicians to uphold the standard of care for a patient has a cascade of harmful effects both for the patient but also for everyone else," said Esplin. There has been apprehension by doctors about dealing with both of those two issues, Abbott told Fox 4 News. "Being pregnant in a state like Texas is a dangerous . Doctors and experts also worry that patients with pregnancy complications may be too afraid of being accused of inducing an abortion to seek care. 678, Sec. She called her doctor and begged to get in. care provider and intended to remove an ectopic pregnancy that . 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.. A few days later, she went out to celebrate a friends birthday and was raped on her way home. Another pending ban, a so-called "trigger law" passed by Texas in 2021, is expected to go into effect within weeks. And so they don't even know what the rules are.". The American College of Obstetricians and Gynecologists has information on early pregnancy loss, finding an OB-GYN and having better conversations with your doctor. And now the Texas abortion law has created an additional bind, Cavazos explains. 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. She knew she did not have the flexibility to be able to travel out of state for an abortion later on. The definition of abortion in Texas Health and Safety Code explicitly states an act that is done to "remove an ectopic pregnancy" is not defined as an abortion. But the womans condition can quickly deteriorate, which is why physicians often prefer to offer an abortion. The Biden administration last week told hospitals they must treat pregnant patients who need an abortion to stabilize a life-threatening condition. Consider the patient whose miscarriage care is delayed and develops a serious infection and other complications, Prager said. In Poland, protests over that countrys abortion laws erupted this year after a 30-year-old pregnant woman died of septic shock. The facts were grim. The crisis the Wellers endured is emblematic of the vast and perhaps unintended medical impacts of the criminalization of abortion in Republican-led states. But some health conditions can jeopardize a womans health in the long term but not necessarily constitute an immediate threat to her life. The case spurred a movement that led to the overturning of Ireland's abortion ban in 2018. And I told her 'I'm so sorry. "The pharmacy has said, 'We don't know whether or not you might be using this medication for the purposes of abortion,'" she said. "To them my life was not in danger enough.". Eventually, she laid out their options: Keep carrying the pregnancy or leave Texas to get an abortion. Treatments for miscarriages and ectopic pregnancies are still legal under the states abortion ban, according to state law and legal experts. An ectopic pregnancy is 100% fatal if . "I was just laying in bed, you know, wondering: Am I pregnant or am I not pregnant? And not only can they not provide it, but they can't talk to you about it," Cavazos says. Hall was 18 weeks along when she went in for hers on a Friday afternoon. It went into effect on Sept. 1. 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. Misoprostol is used to help prevent stomach ulcers, but it can induce abortions, particularly if taken along with mifepristone. 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. Hall has struggled with depression, and as the weekend wore on, her mental health deteriorated. Texas new measure was intended to impose stringent limits on abortion. 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 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.". I have seen cases where the woman has gone from completely normal to septic shock in less than an hour, Dr. Carpenter said. And I screamed because that's when I knew something wrong was happening. Sometimes, she said, a woman has a spontaneous miscarriage and is heavily bleeding, but the fetus has not passed and cardiac activity can still be detected. Lauren Hall stands for a portrait on Sept. 10, 2022, in the room that she and her husband had prepared as a nursery. 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. 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 . Idaho, Tennessee and Texas will implement abortion bans in 30 days, according to the text of the laws. 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. 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. An ectopic pregnancy occurs when the fertilized egg is implanted outside the uterus, most commonly in a fallopian tube. Hall was in her second trimester when the U.S. Supreme Court overturned Roe v. Wade, ending the constitutional protection for abortion and allowing states to set their own laws governing abortion access. We both have good jobs, weve got a house and we were at a place where if it happens, it happens, she said. Such a rupture can be life-threatening. If the lawsuit is successful, plaintiffs can receive up to $10,000. hide caption. Patients experiencing miscarriage have also struggled to get prescriptions filled for misoprostol, which is used both to treat miscarriages and induce abortions. ", Later on, Elizabeth said she realized that her anger at Methodist was misplaced. SB 8, which was signed into law by Texas Gov. She and her husband immediately jumped into planning mode, scheduling an appointment at one of the only OB-GYN practices in town. You can reach them at 212-255-9252. Still, states like Missouri could put this pro-abortion talking point to rest by protecting treatment of ectopic pregnancy explicitly in the law. Elizabeth stood up to get some lunch. 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. 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 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. And a tubal ectopic pregnancy, let's say, is clearly excluded. However, if the ectopic pregnancy is located in the cervix or on the scar tissue from a cesarean section, the treatment could be the same as an abortion, according to Addante. After holding it together all morning, Hall burst into tears. Midnight came and went in a blur. I'm so sorry,'" Elizabeth says. This can occur as early as two weeks after a missed period, when most women do not yet know they are pregnant. And theyve had to navigate complicated politics when sharing their news. "I just cried and screamed in the parking lot," she recalls. 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. 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 they decide to sue for malpractice," she said. There was still a fetal heartbeat, but it could stop at any moment. Most of these pregnancies end in miscarriage or stillbirth. In Texas it's literally written in the law that an act is not an abortion to remove an ectopic pregnancy. 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. And quickly. I'm so sorry.". 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. 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 . You can also reach a trained crisis counselor through the Suicide and Crisis Lifeline by calling or texting 988. But there was a vibe immediately. "I told her 'Look, Doctor, people around me are telling me to keep hope. Elizabeth and James Weller at their home in Houston two months after losing their baby girl due to a premature rupture of membranes. Methotrexate or surgery are the only two options listed in the medical guidelines to prevent the fallopian tubes from rupturing and causing dangerous bleeding. Aborting the embryo is often the best treatment for an ectopic . 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. 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. We see patients from many different religions and cultures, and how they grieve is unique to each patient, Sanchez said. The measure deputizes private citizens even those with no connection to the patient, doctor or health center to sue anyone who performs an abortion once cardiac activity can be detected in the embryo. Because the state has made it very clear that if you talk about this, you're vulnerable to being sued," she added. After talking with James, they both agreed they should end the pregnancy. Marlena Stell always wanted a big family. Miscarriage How theyd told their families, picked out a name, built a crib and bought pink sheets. I was losing my mind, Hall said. A fight began, which Elizabeth first became aware of as her doctor paced the hall outside her room, talking on her phone. "The challenge is that the treatment for an abortion and the treatment for a miscarriage are exactly the same," said Dr. Sarah Prager, a professor of obstetrics and gynecology at the University of Washington in Seattle and an expert in early pregnancy loss. But pregnancy care isnt as clear cut as the law makes it out to be, doctors say, and fear of criminal prosecution has led medical professionals to delay or deny care they otherwise would have provided. If you do something to prevent that, you might be in fact performing an illegal abortion.. Join us for Texas biggest politics and policy event when you buy your tickets today. Dr. Lauren Thaxton, an OB-GYN and assistant professor at the Dell Medical School at the University of Texas-Austin, has already heard about local patients who have been miscarrying, and couldn't get a pharmacy to fill their misoprostol prescription. Texas Attorney General Ken Paxton quickly sued the Biden administration over the federal guidance. "Later they laid down this beautiful baby girl in my arms. Elizabeth was induced late Friday night, and the labor became painful enough that she had to get an epidural. Elizabeth Weller never dreamed that her own hopes for a child would become ensnared in the web of Texas abortion law. The emotional toll was what worried Hall most of all. But the language is ambiguous, and travel can be expensive and onerous for pregnant women, especially if they are unwell. . Or in cases of rape or incest? "And yet we're being pulled through this.". Laws modelled on Texas's S.B. Methotrexate also is listed in the Texas law passed last year. 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. 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. I'm trying to mentally survive this.". After her initial miscarriage in 2018, Stell and her husband had their first child, a daughter, in April 2020. July 20, 20225 PM Central. Nitsch says she chose sterilization at age 36 rather than risk getting pregnant by another rapist. When Roe v. Wade fell in June, Elizabeth's pain and anger surged up again. On Friday, when she woke up, she was still passing blood and discharge, still feeling sick, and feeling strange things in her uterus. 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. 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 . She wanted them to experience the agony she felt when she learned that her fetus was developing without a skull or a brain, a condition her doctors told her was incompatible with life.. Her water had broken midway through the pregnancy, but her doctors, fearing prosecution if they violated the abortion ban, did not begin treating her until the fetuss heart stopped on its own. I need you to give me the facts.'". Growing up outside Dallas, Hall often heard that abortion was murder and, perhaps worse, interfering with Gods plan. Hall declined those services. "It's hard to form a relationship to say, 'Hey look, I'm not using this for an elective abortion,'" she said. 5:22-cv-185-h (n.d. 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. AUSTIN The Texas Medical Association wants regulators to step in after hospitals reportedly refused to treat patients with serious pregnancy complications for fear . Everyone was thrilled, buying them car seats and baby clothes. Or you wait till your baby's heartbeat stops.'". There was an infection, and she did need treatment. Sign up for The Brief, our daily newsletter that keeps readers up to speed on the most essential Texas news. 8, which encourages private citizens to file lawsuits against anyone who facilitates an abortion, will proliferate, giving self-appointed vigilantes no shortage of . To Elizabeth, termination also felt like the most merciful option for her fetus. The patient lost liters of blood and had to be put on a breathing machine because of the 24-hour delay in care. 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. Everyone was so scared.. It was just the most tender moment, she said. 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. Most tender moment, she said infection, and as the weekend wore on, 's. 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