Or what if the pregnancy wasnt viable? she said. The only way to stop the heavy bleeding is to end the pregnancy and contract the uterus, Dr. Moayedi said. 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. On Friday, when she woke up, she was still passing blood and discharge, still feeling sick, and feeling strange things in her uterus. They're not allowed to do that in Texas. 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. 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. 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, said 27-year-old Lauren Hall. Health & Safety Code 245.002(1)(A)-(C). 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 . She had the proof. 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 . 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. 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. Almost immediately, though, Texas conflicting and confusing laws on abortion started to cause problems for pregnancy care. And I screamed because that's when I knew something wrong was happening. Doctors can clearly legally save a woman's . It includes laws about. Earlier this month, Gov. "It's hard to form a relationship to say, 'Hey look, I'm not using this for an elective abortion,'" she said. "I remember hearing her, from my room, speaking loudly about how nothing is being done here.". Now she wants those sentiments translated into action. Once she made her way through the clinics stringent security, the nurses took her into a private room. The pink-sheeted crib is still set up in the nursery, filled with all the baby supplies theyd bought or been gifted that they now have no use for. (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). 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 . Took no time at all.. And I told her 'No, ma'am. 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. Dr. John Thoppil, president of the Texas Association of Obstetricians and Gynecologists, said doctors usually note a diagnosis when prescribing medicines, and prescription rejections dont appear to be widespread. (Texas Hospital Licensing Law); (3) an institution required to be licensed under . 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. I was losing my mind, Hall said. Or in cases of rape or incest? And I told her 'I'm so sorry. Texas is the state weve seen the biggest increase from, Sanchez said. You're not going to tell me that what I'm experiencing isn't real, again.". 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. One persons emergency may not be another persons emergency, said Dr. Robert Carpenter Jr., an obstetrician in Houston. Once inside the car, they both burst into tears, for their baby and the terrible choices they were now left to navigate. Depending on the medical circumstances, one of those options may be abortion. 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. 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. 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. But Texas's medical exception is narrower, and less defined . In Texas' anti-abortion . An attendee holds her child during A Texas Rally for Abortion Rights at Discovery Green in Houston, Texas, on May 7. "I was just laying in bed, you know, wondering: Am I pregnant or am I not pregnant? 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. I couldnt do that.. Whether terminating an ectopic pregnancy is legal will depend on individual state laws. Because once they reached Methodist, while they were still checking in at the emergency room, her doctor called. 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. 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.. With it in place, his patient faces a pregnancy rife with potential medical problems. a letter from the Texas Medical Association. She called her doctor and begged to get in. Even with the slim chance of survival to 24 weeks, the newborn would face intense physical challenges and aggressive medical interventions. Her discharge had to be darker. We physically watched her get sicker and sicker and sicker, he told the AP. Elizabeth and James Weller at their home in Houston two months after losing their baby girl due to a premature rupture of membranes. 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. But some health conditions can jeopardize a womans health in the long term but not necessarily constitute an immediate threat to her life. An ectopic pregnancy occurs when the fertilized egg is implanted outside the uterus, most commonly in a fallopian tube. The ob-gyn, who said she could not speak to the media, laid out two options, according to Elizabeth. Not doing so can, in some circumstances, kill all of the fetuses. 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). Acts 1989, 71st Leg., ch. But the new Texas law has profoundly affected his ability to practice. You smell it yourself. This current law excludes treatment for miscarriage or ectopic pregnancy. other than an abortion performed due to a medical emergency as defined by Section 171.002, Health and Safety Code]. Because at this point, I'm in survival mode. "I wouldn't say this is true for our practice," he said. However, Mayo said that his reading of the law allows for the use of methotrexate to treat an ectopic pregnancy. Question women in America now have to ask. Crawford, the OB/GYN and fertility clinic co-founder, said shes seen instances of pharmacies not wanting to fill prescriptions for certain medications that are related to abortions but being used for other treatments. Dr. Jennifer Liedtke, a family physician in Sweetwater, Texas, who delivers about 175 babies annually, no longer sends misoprostol prescriptions to the local Walmart. "That's torture to have to carry a pregnancy which has such a low chance of survival," says Dr. Peaceman. In September, the justices turned down an emergency request to block the law. Texas has a trigger law on the books that will outlaw abortion almost universally beginning 30 days after the Supreme Court . The new abortion bans or the old laws being resurrected in a post-Roe world are rigidly written and untested in the courts. The new law does not apply to removing ectopic pregnancies that implant outside the uterus, which are not considered abortions under state law. As a subscriber, you have 10 gift articles to give each month. Under another new Texas abortion law, someone who "aids or abets" an abortion after cardiac activity can be detected typically around six weeks can be subject to at least a $10,000 fine per occurrence. "Because I didn't want anybody to tell me they did not believe me," she says. 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. 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. Elizabeth and James look at clothes that were meant for their baby, whom they lost in the second trimester of pregnancy. Frustrated with her experience on hormonal birth control, she and her husband decided it was time for her to get off of it. 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. In one case, a central Texas hospital reportedly told a physician not to treat an ectopic pregnancy until it ruptured, the letter said. "I was born with a physical disability. If a woman's life is in danger, she will be able to have an abortion. They had savings to fund this last-minute trip, and because her company is based in Illinois, her insurance covered the procedure. Most recently, the Oklahoma Senate passed six abortion-limiting bills , including one that would ban abortions after 30 days from a woman's last . But the patient was past six weeks gestation, and under the new law, an abortion was not an option in Texas because the woman was not immediately facing a life-threatening medical crisis or risk of permanent disability. That's when she felt something "shift" in her uterus, down low, and then "this burst of water just falls out of my body. And it's strong. 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. 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. And it's this stupid, like, distinction that you're just making in this grief. Her doctor said she had been calling other hospitals, but none of them would help. Physically watched her get sicker and sicker, he told the AP Mayo said that reading! Life of a pregnant patient or prevent substantial impairment of major bodily function private room in survival mode choices were. 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texas abortion law ectopic pregnancy