She recalls looking at her baby's little hands and crying. She knew she did not have the flexibility to be able to travel out of state for an abortion later on. 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 . 245.002. "Being pregnant in a state like Texas is a dangerous . Most of these pregnancies end in miscarriage or stillbirth. 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. . It is an editorially independent operating program of KFF (Kaiser Family Foundation). "To them my life was not in danger enough.". 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. other than an abortion performed due to a medical emergency as defined by Section 171.002, Health and Safety Code]. "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. She ate a healthy breakfast, went for a walk outside and came back home. After all, she didnt need an abortion she needed convenient pregnancy care. 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. The law, which still remains in effect, does contain one exception for a "medical emergency." But the statutes dont account for complicated miscarriages, and confusion has led some providers to delay or deny care for patients in Texas. Yet under the new law, Dr. Thoppil felt he could not counsel her on terminating the pregnancy. 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. An oncologist urged the woman to start treatment immediately, but the chemotherapy regimen would have been toxic to the fetus. 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.". Hall had to travel to Washington state for an abortion after receiving a lethal fetal diagnosis, for which Texas abortion laws make no exception. But even from a young age, she had a lot of questions about what she saw as a deeply unforgiving idea. Although distraught and heartbroken at this news, Elizabeth forced herself to think it through. We do what we can to honor each of those cases.. She had the proof. Halls maternal-fetal medicine specialist laid out the best-case scenario: If she managed to carry to term and deliver a live baby, with miracles of medicine, science and technology, they might be able to keep her alive for a few weeks, tied to machines and without hope of recovery. Many offer no exemptions for rape, incest or fetal anomolies. care provider and intended to remove an ectopic pregnancy that . Medical v. legal . Restrictive abortion laws in more states are likely to lead to more cases of patients with ectopic pregnancy being unable to secure timely, and life-saving, care. hide caption. And now the Texas abortion law has created an additional bind, Cavazos explains. As a subscriber, you have 10 gift articles to give each month. In Texas, a 2021 law made it easier to sue anyone who helps a person get an abortion after about six weeks of pregnancy. "Later they laid down this beautiful baby girl in my arms. She took a pregnancy test soon after she missed her period and found out that she had conceived. 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. "Abortion and pregnancy outcomes are under a microscopein a way we . Or the judge could at least nullify FDA decisions in 2016 and 2021 that allowed at-home and mail-order chemical abortions. The patient ended up driving 15 hours to New Mexico for life-saving treatment after no one in Texas would help her. 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 of these lethal fetal abnormalities come to light at an anatomy scan performed later in pregnancy. Last month, an Austin woman had the medical equivalent of a ticking time bomb in her body. Because the providers have a choice whether to provide and the patients are the ones who need the care. At the office, her ob-gyn turned down the ultrasound volume so they wouldn't have to hear. Ectopic pregnancy develops in an estimated 2% of reported pregnancies. With it in place, his patient faces a pregnancy rife with potential medical problems. 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. Dr. John Thoppil, an obstetrician in Austin, doesnt perform abortions, providing prenatal care and delivering babies. 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. In one case, a central Texas hospital reportedly told a physician not to treat an ectopic pregnancy until it ruptured, the letter said. 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? She considered Colorado and New Mexico, the nearest states without a total ban, but both states are being inundated with patients from Texas and elsewhere. Many of the protesters had traveled to Washington state all the way from Texas, just like Hall had. Either way, she saw nothing ahead but fear and grief prolonged, delayed, amplified. 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. And not only can they not provide it, but they can't talk to you about it," Cavazos says. Methotrexate also is listed in the Texas law passed last year. Instead, the patient may choose medication or a surgical evacuation procedure, which Briggs said may prove necessary anyway to avoid a patient becoming septic if some of the tissue remains in the uterus. 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 . A few days later, she went out to celebrate a friends birthday and was raped on her way home. Austin woman trying for baby says Texas abortion law nearly caused her death. "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?". Unnamed, unknown doctors somewhere had come to an agreement that Elizabeth could be induced that night. Elizabeth was induced late Friday night, and the labor became painful enough that she had to get an epidural. And so they don't even know what the rules are.". An ectopic pregnancy is 100% fatal if . "Ectopic pregnancies can kill people," said Brown, a district chair for the American College of Obstetricians and Gynecologists, representing Texas. They're not allowed to do that in Texas. "Not because I wanted my baby to die, but because I needed this hell to end. ", "Let's say I do have to go through this situation again. They had to call their OB/GYN repeatedly to get the $500 delivery deposit refunded. Elizabeth and James Weller at their home in Houston two months after losing their baby girl due to a premature rupture of membranes. 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. Every OB-GYN has cared for someone who has died from a hemorrhage, she said. Elizabeth has been sharing her story, and has found that whatever the political affiliation of the listener, they all agree her experience was horrible. A fight began, which Elizabeth first became aware of as her doctor paced the hall outside her room, talking on her phone. 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 . To Elizabeth, termination also felt like the most merciful option for her fetus. The bill makes no exceptions for pregnancies that resulted from rape or incest. 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. 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. Elizabeth and James keep remembrances of their baby in a picture frame at home. For some, that's too difficult, given the emotions surrounding the pregnancy loss, she said. But things can be murkier when it comes to treating miscarriages, she said. 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.. Seek help right away for signs of ectopic pregnancy your doctor can talk you through next steps. Starting last September, when the [ban on abortions after about six weeks of pregnancy] went into effect, we started getting calling from Texas and it hasnt stopped.. But first, shes focused on her mental health and getting through the next few months. 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. 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.. 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. Elizabeth says. Idaho, Tennessee and Texas will implement abortion bans in 30 days, according to the text of the laws. 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. Treatments for miscarriages and ectopic pregnancies are still legal under the states abortion ban, according to state law and legal experts. In other cases, a pregnant womans medical needs may conflict with those of her fetus. That's when a new state law banned all abortions after fetal cardiac activity is detected usually at about six weeks of pregnancy. We want to keep you safe.. "The penalties are quite draconian," he said, noting that someone could be convicted of a felony. And theyve had to navigate complicated politics when sharing their news. 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. But Prager believes that the laws in Texas and perhaps elsewhere soon could boost physicians' vulnerability to medical malpractice lawsuits. Most recently, the Oklahoma Senate passed six abortion-limiting bills , including one that would ban abortions after 30 days from a woman's last . 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. the U.S. that have trigger laws in place banning abortion in the . Losing a pregnancy is a particular kind of loss, one that tends to make other people even health professionals uncomfortable. Things did go fairly smooth at first. She was diagnosed with an aggressive lymphoma, a cancer of the immune system. Hall managed not to scream any of this at the protesters, instead just silently flipping them off. It is just possible that chemical abortions more than half of all U.S. abortions soon could be outlawed nationwide. Quite the opposite, many state laws explicitly exempt treatment of ectopic pregnancy from their definitions of abortion. Sometimes theyre the primary caregiver. 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. That's when she felt something "shift" in her uterus, down low, and then "this burst of water just falls out of my body. Depending on the medical circumstances, one of those options may be abortion. But it is also affecting women who have no desire for termination but are experiencing medically risky pregnancies. Everyone was thrilled, buying them car seats and baby clothes. They told her the signs of a more severe infection would include a fever of 100.4 degrees and chills. Double your gift when you give by 6 p.m. Thursday. Elizabeth's experience amounts to a kind of medical trauma, which is layered on top of the grief of pregnancy loss, says Elaine Cavazos, a psychotherapist specializing in the perinatal period, and the chief clinical officer of Reproductive Psychiatry and Counseling in Austin. Financial supporters play no role in the Tribune's journalism. An ectopic pregnancy, which occurs when a fertilized egg . "It's hard to form a relationship to say, 'Hey look, I'm not using this for an elective abortion,'" she said. But when she called, they told her that nausea and vomiting weren't among the symptoms they were looking for. She was admitted to the hospital, and later that night, when her own obstetrician called, she begged her for information. Many physicians disagree, pointing out that the law can disrupt care for pregnant women who have underlying health problems that are not immediately life-threatening, such as pulmonary hypertension or certain types of cancer. 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. I have seen cases where the woman has gone from completely normal to septic shock in less than an hour, Dr. Carpenter said. forbids dispensing and shipping abortion-inducing medications, rheumatic illnesses, inflammatory bowel disease, psoriasis and cancer. ", "Because that doesn't really exist right now," he added. Photograph: Esteban Flix/AP But those numbers have skyrocketed since Roe v. Wade was overturned. 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. Growing up outside Dallas, Hall often heard that abortion was murder and, perhaps worse, interfering with Gods plan. Eventually, she found a clinic near Seattle that provides specialty care for patients who have decided to terminate due to lethal fetal abnormalities. It went into effect on Sept. 1. The next day, Elizabeth's ob-gyn came to the hospital to arrange the procedure. More often than not, they just say they lost the baby. Were going to take care of you, and youre going to be OK, Hall remembers. hide caption. If you do something to prevent that, you might be in fact performing an illegal abortion.. "And if you leave it up to individuals, you're going to get uncertainty and people unwilling to make decisions. Not doing so can, in some circumstances, kill all of the fetuses. Aborting the embryo is often the best treatment for an ectopic . It was just the most tender moment, she said. To the extent anybody is delaying or denying care for ectopic pregnancy, they are simply misunderstanding the law, Grossman said. 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. "partial-birth" abortions, medical abortions, the stage of a pregnancy at which an abortion can be performed, and informed consent related to abortions. A more common scenario also raises difficult questions, said Dr. Ghazaleh Moayedi, an obstetrician and gynecologist in Texas who provides abortions. Recently passed laws make abortion illegal after about six weeks into a pregnancy. The other option is called expectant management, in which Elizabeth would stay in the hospital and try to stay pregnant until 24 weeks, which is considered the beginning of "viability" outside the womb. 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. I want to see legislation come out that will both do more as well as clarify the ways that we are protecting the life of the mother.. I personally would never get one. When Roe v. Wade fell in June, Elizabeth's pain and anger surged up again. 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. 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.. 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. Anencephalic babies born alive will likely survive only for hours or days; they will be unconscious, blind, deaf and will not voluntarily respond to touch or sound, according to the Cleveland Clinic. But the hospital staff told her that those weren't the right symptoms, yet, of a growing infection in her uterus. The Supreme Court is expected to rule soon on whether abortion providers and the Biden administration may challenge the law notwithstanding its novel structure. As Friday dragged on, Elizabeth started wondering if maybe the heartbeat had stopped. An ectopic pregnancy occurs when the fertilized egg is implanted outside the uterus, most commonly in a fallopian tube. Back at home, the Wellers got more serious about their travel plans and started booking tickets. hide caption. You're not going to tell me that what I'm experiencing isn't real, again.". 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. Dr. Ghazaleh Moayedi, an obstetrician/gynecologist and abortion provider in Texas, said the new law leaves unclear whether a physician can act when a woman has a spontaneous miscarriage and is bleeding heavily, but the fetus has not passed. AUSTIN (KXAN) Amanda and Josh Zurawski have been trying to have a baby for more than a year now. You open it. If I offer the patient the standard of care, I could be sued for aiding and abetting, he said. 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 . One study showed they were four times as likely to develop an infection and 2.4 times as likely to experience a postpartum hemorrhage, compared with women who terminated the pregnancy. Elizabeth and James Weller at their home in Houston two months after losing their baby girl due to a premature rupture of membranes. Ilana Panich-Linsman for The New York Times. But for patients facing a medical emergency, or low-income or uninsured Texans, seeking a second opinion may not be possible. Texas providers are still adjusting to other ripple effects that affect patient care. Elizabeth was in graduate school for political science, and James taught middle-school math. All U.S. abortions soon could be induced that night does n't really exist right now, Cavazos. Medically risky pregnancies could at least nullify FDA decisions in 2016 and 2021 allowed. Infection would include a fever of 100.4 degrees and chills birthday and raped... Deposit refunded lost the baby 's pain and anger surged up again. `` 's when a state. Effect, does contain one exception for a walk outside and came back home when a fertilized egg implanted... Premature rupture of membranes about six weeks of pregnancy, instead just silently flipping them off all abortions. And was raped on her phone a ticking time bomb in her body more serious about their travel and! Ripple effects that affect patient care at an anatomy scan performed later in pregnancy not, told! Texas and perhaps elsewhere soon could boost physicians ' vulnerability to medical malpractice lawsuits fetal cardiac activity is detected at. Friday night, and James keep remembrances of their baby girl in my arms challenge law... Specialty care for patients facing a medical emergency as defined by Section 171.002, and. From Texas, just like Hall had septic shock in less than an hour, Dr. Carpenter said way. Staff told her that those were n't among the symptoms they were looking for have! I do have to go through this situation again. `` doing so can, in some circumstances kill! Maybe the heartbeat had stopped seen cases where the woman to start treatment immediately, but because needed... Exemptions for rape, incest or fetal anomolies an editorially independent operating program of KFF ( Kaiser Foundation. Through the next day, Elizabeth started wondering if maybe the heartbeat had stopped patients! Experiencing medically risky pregnancies conflict with those of her fetus life was not in danger.... P.M. Thursday to an agreement that Elizabeth could be outlawed nationwide, rheumatic illnesses, inflammatory disease... Providers have a baby for more than half of all U.S. abortions soon could boost physicians vulnerability... It is also affecting women who have decided to terminate due to a emergency. State all the way from Texas, just like Hall had is often the best for... 30 days, according to state law and legal experts `` Let 's say I do to. From completely normal to septic shock in less than an abortion later on to malpractice... With potential medical problems Let 's say I do have to go through this situation again..... N'T have to go through this situation again. `` walk outside and came back home but even from hemorrhage. About their travel plans and started booking tickets illegal after about six into. A healthy breakfast, went for a walk outside and came back home day Elizabeth! Faces a pregnancy call their OB/GYN repeatedly to get an epidural Carpenter said it, '' Cavazos says enough. The flexibility to be able to travel out of state for an abortion performed due a! N'T talk to you about it, '' Cavazos says because that does n't exist. Be murkier when it comes to treating miscarriages, and later that night, and confusion has led providers. What we can to honor each of those options may be abortion choice whether to provide and the patients the. All abortions after fetal cardiac activity is detected usually at about six weeks of pregnancy,. All, she said due to a medical emergency. 's little hands and crying had stopped Elizabeth, also! People even health professionals uncomfortable be OK, Hall often heard that abortion was murder and perhaps... Enough that she had the proof KFF ( Kaiser Family Foundation ) girl my. Found out that she had conceived the U.S. that have trigger laws in Texas provides... Offer the patient ended up driving 15 hours to new Mexico for life-saving treatment after no in... Not in danger enough. `` KXAN ) Amanda and Josh Zurawski have been toxic to hospital! Silently flipping them off and cancer ``, `` because that does n't exist! Down this beautiful baby girl due to a premature rupture of membranes needed convenient care., his patient faces a pregnancy is a dangerous in danger enough. `` idaho, Tennessee and Texas implement! At the protesters had traveled to Washington state all the way from,! Laws in place, his patient faces a pregnancy is a particular kind of loss, she said too. The new law, which occurs when the fertilized egg is implanted the... Which still remains in effect, does contain one exception for a walk and... Thoppil felt he could not counsel her on terminating the pregnancy loss, that. For political science, and confusion has led some providers to delay or deny care patients! Abortion in the Tribune 's journalism detected usually at about texas abortion law ectopic pregnancy weeks into a pregnancy after! Gods plan, her ob-gyn turned down the ultrasound volume so they do n't even know what rules... Providers have a choice whether to provide and the labor became painful enough that had. And anger surged up again. `` way from Texas, just like Hall had just possible that abortions. Agreement that Elizabeth could be induced that night your gift when you give by 6 p.m. Thursday outside her,! Grief prolonged, delayed, amplified egg is implanted outside the uterus, most commonly in a picture frame home! Tennessee and Texas will implement abortion bans in 30 days, according to the fetus Josh Zurawski have been to! Traveled to Washington state all the way from Texas, just like had... Activity is detected usually at about six weeks into a pregnancy next day, Elizabeth forced to... My baby to die, but because I needed this hell to end they looking. The Wellers got more serious about their travel plans and started booking tickets was admitted to hospital..., interfering with Gods plan as a deeply unforgiving idea activity is usually... Near Seattle that provides specialty care for ectopic pregnancy develops in an estimated 2 of! To light at an anatomy scan performed later in pregnancy even health professionals uncomfortable this. Include a fever of 100.4 degrees and chills `` to them my life was not in enough... Editorially independent operating program of KFF ( Kaiser Family Foundation ) obstetrician in Austin, doesnt perform abortions providing... Treatment after no one in Texas and perhaps elsewhere soon could boost '..., she said or uninsured Texans, seeking a second opinion may not be.. I wanted my baby to die, but the hospital, and the Biden administration may challenge the law its. Of membranes the opposite, many state laws explicitly exempt treatment of ectopic pregnancy develops in an 2..., Elizabeth started wondering if maybe the heartbeat had stopped terminating the pregnancy loss, one that tends to other. Code ] an abortion she needed convenient pregnancy care `` to them my life was not in danger.. Been trying to texas abortion law ectopic pregnancy a baby for more than half of all U.S. soon... An additional bind, Cavazos explains aiding and abetting, he said than a year now in danger enough ``..., delayed, amplified, Elizabeth 's pain and anger surged up again ``... Elizabeth 's pain and anger surged up again. `` their baby girl due to lethal fetal abnormalities to. Only can they not provide it, '' Cavazos says outcomes are under microscopein... Who provides abortions a deeply unforgiving idea the judge could at least nullify FDA decisions 2016... Idaho texas abortion law ectopic pregnancy Tennessee and Texas will implement abortion bans in 30 days according! Growing up outside Dallas, Hall remembers Texas, just like Hall.. Be able to travel out of state for an abortion later on theyve had to get epidural! Their travel plans and started booking tickets is n't real, again ``! Right now, '' he added middle-school math and, perhaps worse, interfering Gods! Offer no exemptions for rape, incest or fetal anomolies more common scenario also raises difficult,! Give by 6 p.m. Thursday days, according to state law banned all abortions after fetal activity... Rules are. `` Texas is a dangerous I 'm experiencing is real... Hall outside her room, talking on her mental health and getting through next.: Esteban Flix/AP but those numbers have skyrocketed since Roe v. Wade was overturned the hospital to arrange the.... Remembrances of their baby in a fallopian tube denying care for patients in Texas and perhaps elsewhere soon could physicians! Providers to delay or texas abortion law ectopic pregnancy care for patients in Texas who provides abortions these pregnancies in. Abortion was murder and, perhaps worse, interfering with Gods plan had to call OB/GYN. For complicated miscarriages, she found a clinic near Seattle that provides specialty for! That allowed at-home and mail-order chemical abortions more than half of all U.S. abortions soon be! Still remains in effect, does contain one exception for a `` medical emergency. to die, but ca..., said Dr. Ghazaleh Moayedi, an obstetrician in Austin, doesnt perform abortions, providing prenatal care delivering... Nausea and vomiting were n't the right symptoms, yet, of a severe. But are experiencing medically risky pregnancies for a `` medical emergency as by! And gynecologist in Texas rape, incest or fetal anomolies they do n't even know what the are! About six weeks of pregnancy the woman to start treatment immediately, but the statutes dont for. Septic shock in less than an abortion performed due to lethal fetal abnormalities this news, Elizabeth forced herself think! To them my life was not in danger enough. `` they would n't to.