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 . 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. Other complications that occur when a woman is carrying twins or multiples can be resolved by a selective reduction, or abortion, of one of the fetuses so that the other has a better chance to live. "He and I kept telling each other 'What is the whole point of the Hippocratic oath to do no harm?'" Cedar River offers specialty care for patients facing lethal fetal abnormalities like anencephaly. 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. Medical v. legal . Immediately, they sensed hesitation from the doctor. Last month, an Austin woman had the medical equivalent of a ticking time bomb in her body. Doctors and experts also worry that patients with pregnancy complications may be too afraid of being accused of inducing an abortion to seek care. Amplify your impact and donate now. Recently passed laws make abortion illegal after about six weeks into a pregnancy. 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. 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. Mark Felix/AFP via Getty Images But when she called, they told her that nausea and vomiting weren't among the symptoms they were looking for. . 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. Elizabeth could not receive the medical care she needed until several days later because of a Texas law that banned abortion after six weeks. Such testing is done late in pregnancy, beyond the six-week limit, noted Crescenda Uhles, a genetic counselor in Dallas. Treatments for miscarriages and ectopic pregnancies are still legal under the states abortion ban, according to state law and legal experts. And so they don't even know what the rules are.". "It's this woman who was saying 'Hi Miss Weller, you're at the 19 week mark. Frustrated with her experience on hormonal birth control, she and her husband decided it was time for her to get off of it. . Halls entire vision of this pregnancy giving birth, becoming a mom, watching her daughter grow up evaporated in an instant. "I told her 'Look, Doctor, people around me are telling me to keep hope. She and her husband began trying in late 2021. Nitashia Johnson for The New York Times. Now she wants those sentiments translated into action. "The pharmacy has said, 'We don't know whether or not you might be using this medication for the purposes of abortion,'" she said. Elizabeth touches the urn of her daughter. This represents more confusion around state policy. Julia Robinson for NPR For example, last year's Texas Heartbeat Law incorporated Texas' Health & Safety Code 245.002, which states (emphasis added): 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. Her mental health spiraled to the point that she considered checking herself into the hospital. Hall had to travel to Washington state for an abortion after receiving a lethal fetal diagnosis, for which Texas abortion laws make no exception. Treatments for miscarriages and ectopic pregnancies are still legal under Texas abortion ban. 8, which encourages private citizens to file lawsuits against anyone who facilitates an abortion, will proliferate, giving self-appointed vigilantes no shortage of . But the Wellers and 28 million other Texans had already been living under a de facto abortion ban for 8 months, since September 2021. Initially, the patient may not be in danger, and under the law physicians may be prohibited from taking action, even though the baby will not survive. After Hall made it through the protesters and the clinics security screening, the clinic itself was an oasis, she said. Sept. 1, 1989. ABACA. 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. We both have good jobs, weve got a house and we were at a place where if it happens, it happens, she said. 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. 245.001. "I said 'Well, is there a heartbeat still?' But as has been true in Texas and in many of the 12 other states where abortion is banned . Took no time at all.. There was still a fetal heartbeat, but it could stop at any moment. 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. The staff remained vague about what came next, Elizabeth recalls. I had not been put in the crossroads of this issue.". Or hell honestly it shouldn't even get to the point where you're having to save a woman's life. An ectopic pregnancy, which occurs when a fertilized egg . "That's torture to have to carry a pregnancy which has such a low chance of survival," says Dr. Peaceman. For a fetus at 18 weeks, the chance of survival in that state is almost nonexistent, according to Peaceman: "This is probably about as close to zero as you'll ever get in medicine.". I think most people would give tremendously leeway to that. 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 . 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. Elizabeth touches the urn of her daughter. Sign up for The Brief, our daily newsletter that keeps readers up to speed on the most essential Texas news. Or you wait till your baby's heartbeat stops.'". Marlena Stell always wanted a big family. These are the patients that are the most affected.. If someone is hemorrhaging while miscarrying, how long do I have to wait?. 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. ", "Let's say I do have to go through this situation again. The new law in Texas bans abortion at 6 weeks when a fetal "heartbeat" can be detected. If patients run into trouble filling prescriptions, Thoppil and Crawford say they should try to find another pharmacy or talk to their health care provider. Not only will the fetus not survive long-term, but "eventually, it ruptures the tube and the tube doesn't have the ability to contract like the uterus does to shut off the flow of blood, and so it keeps bleeding and bleeding," says Dr. Ingrid Skop, an OB-GYN in Texas . 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. 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. 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. For doctors treating such patients, the Texas law creates quite a conundrum, Dr. Snyder said. 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. Then Elizabeth felt another sudden, forceful gush of fluid leave her body. If the lawsuit is successful, plaintiffs can receive up to $10,000. Or in cases of rape or incest? "Later they laid down this beautiful baby girl in my arms. It is a horrible gamble that we are making Texas women go through.". Hall has struggled with depression, and as the weekend wore on, her mental health deteriorated. Elizabeth and James Weller at their home in Houston two months after losing their baby girl due to a premature rupture of membranes. It doesnt take a huge leap to see that our rates of complications will go up because we have a selection bias on who is going to have to continue more complicated pregnancies.. the U.S. that have trigger laws in place banning abortion in the . 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. In Texas' anti-abortion . ", Elizabeth thought of abortion rights in broad terms: "I have said throughout my life I believe that women should have the access to the right to an abortion. "Because I didn't want anybody to tell me they did not believe me," she says. If she wanted to stay in Texas, Halls only choice was to continue with a pregnancy that would not yield a healthy, living baby. "To them my life was not in danger enough.". Losing a pregnancy is a particular kind of loss, one that tends to make other people even health professionals uncomfortable. "I told her 'I'm so sorry. Laws modelled on Texas's S.B. 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 in her second trimester when the U.S. Supreme Court overturned Roe v. Wade. Greg Abbott signed a heartbeat bill into law in May, barring abortions in the state as early as six weeks. The associations say these women should be given the option of termination if they become pregnant. 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 . If a woman's life is in danger, she will be able to have an abortion. Enough to make her retch. "I wouldn't say this is true for our practice," he said. Sign up for The Brief, our daily newsletter that keeps readers up to speed on the most essential Texas news. But when membranes rupture earlier in pregnancy, particularly before 24 weeks, the chance of a fetus surviving plummets. And it just occurred to me that the people Ive been told my whole life are going to hell for their actions were the most kind and angelic individuals through this whole thing.. The Texas abortion "trigger law" will be effective on August 25th, 2022. She places the blame for the ensuing medical trauma on the Republican legislators who passed the state's anti-abortion law, on Texas Gov. 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. The patient ended up driving 15 hours to New Mexico for life-saving treatment after no one in Texas would help her. See the growing speaker list and buy tickets. But Im still so angry I had to leave.. But even from a young age, she had a lot of questions about what she saw as a deeply unforgiving idea. Due to her history of hemorrhaging, Seewald added that passing the pregnancy at home didn't seem like a good option. And she just recklessly and negligently goes out and gets abortions all willy-nilly, left and right," she says. Dr. Jennifer Liedtke, a family physician in Sweetwater, Texas, who delivers about 175 babies annually, no longer sends misoprostol prescriptions to the local Walmart. "It's just really unimaginable to be in a position of having to think: How close to death am I before somebody is going to take action and help me?". Julia Robinson for NPR I knew something was wrong.. other than an abortion performed due to a medical emergency as defined by Section 171.002, Health and Safety Code]. First she said, I cant, I want this baby so badly, Dr. Gunby recalled. Methotrexate or surgery are the only two options listed in the medical guidelines to prevent the fallopian tubes from rupturing and causing dangerous bleeding. But in early May, not long after the uneventful anatomy scan, the Wellers suddenly arrived at that crossroads. 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. tex. That's not a good thing. It is just possible that chemical abortions more than half of all U.S. abortions soon could be outlawed nationwide. 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. We want to keep you safe.. An ultrasound confirmed that she had suffered premature rupture of membranes, which affects about 3% of pregnancies. An attendee holds her child during A Texas Rally for Abortion Rights at Discovery Green in Houston, Texas, on May 7. Cheng did not treat Hall, but has counseled patients facing similar situations. 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. 7:49 PM on Jul 14, 2022 CDT. Idaho, Tennessee and Texas will implement abortion bans in 30 days, according to the text of the laws. You're not going to tell me that what I'm experiencing isn't real, again.". "I was just laying in bed, you know, wondering: Am I pregnant or am I not pregnant? 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. The law does not make an exception for pregnant women who learn that the fetus has chromosomal abnormalities or anomalies that will cause the baby to die soon after birth. 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. Not doing so can, in some circumstances, kill all of the fetuses. She said Houston Methodist had convened an ethics panel of doctors, but her doctor didn't seem very optimistic. 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. Sept. 20, 2022 If I dont provide my patient the standard of care, which they are due, I could be sued.. not include an abortion that uses suction to dismember the body of an unborn child by sucking pieces of the unborn child into a . On Friday, when she woke up, she was still passing blood and discharge, still feeling sick, and feeling strange things in her uterus. She took a pregnancy test soon after she missed her period and found out that she had conceived. Such a rupture can be life-threatening. That is a pregnancy that occurs outside the uterus. 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. The Texas law, which is also called Senate Bill 8, carves out an exception for termination in a medical emergency, which is defined in the states health code as a life-threatening physical condition caused or aggravated by pregnancy that places the woman in danger of death or a serious risk of substantial impairment of a major bodily function.. When Roe v. Wade fell in June, Elizabeth's pain and anger surged up again. SB 8, which was signed into law by Texas Gov. The Oklahoma Senate last week passed six abortion-limiting bills, including one that mirrors the law passed in Texas and another that would ban abortions after 30 days from a woman's last period . The risks to Elizabeth's health were simply too high. We havent seen a large issue, but there are certainly anecdotes, Thoppil said. Elizabeth and James keep remembrances of their baby in a picture frame at home. Amplify your impact and donate now. Most recently, the Oklahoma Senate passed six abortion-limiting bills , including one that would ban abortions after 30 days from a woman's last . She was through with being dismissed, being told to wait. "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.". Confusion around the laws has caused issues for patients outside of emergencies. More than ever, I think people, patients really need to be extremely well-informed and really aggressive about advocating for their own health because the system right now is basically designed to fail, she said. A more common scenario also raises difficult questions, said Dr. Ghazaleh Moayedi, an obstetrician and gynecologist in Texas who provides abortions. And they're telling me to think of the positives. But those numbers have skyrocketed since Roe v. Wade was overturned. Nitsch says she chose sterilization at age 36 rather than risk getting pregnant by another rapist. Whether an ectopic pregnancy is legal will depend on individual state laws. 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. Hall and her husband would like to try again at some point. To Elizabeth, it seemed obvious that things were deteriorating. Sometimes patients don't realize that they have lost the pregnancy until they come in for a checkup and no cardiac activity can be detected, said Dr. Emily Briggs, a family physician who delivers babies in New Braunfels, Texas. Because once they reached Methodist, while they were still checking in at the emergency room, her doctor called. 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. There has been apprehension by doctors about dealing with both of those two issues, Abbott told Fox 4 News. 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.. I would consider what I experienced that weekend a medical emergency.. Or, like Hall, they can shell out thousands of dollars to abruptly travel out of state while grieving a lost pregnancy. Elizabeth was induced late Friday night, and the labor became painful enough that she had to get an epidural. 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