Greg Abbott, who signed it, and on the inflamed political rhetoric, which Elizabeth says only sees abortion "as one thing, a black-and-white issue, when abortion has all of these gray areas. About 10% to 20% of confirmed . 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 . They also have abortion is permitted to protect the life of the mother or her from serious bodily harm that would result if an abortion is not performed. This can occur as early as two weeks after a missed period, when most women do not yet know they are pregnant. Their conundrum became painfully, distressingly clear: wait to get sicker, or wait until the fetal heartbeat ceased. 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. Methotrexate, another abortion-inducing medication, is used to treat ectopic pregnancies as well as rheumatic illnesses, inflammatory bowel disease, psoriasis and cancer. 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.. Other times patients don't report the problem and miscarry on their own, she said, but without medication they risk additional bleeding. Sept. 1, 1989. 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 . As a subscriber, you have 10 gift articles to give each month. An ectopic pregnancy is 100% fatal if . They had savings to fund this last-minute trip, and because her company is based in Illinois, her insurance covered the procedure. Acts 1989, 71st Leg., ch. "I just cried and screamed in the parking lot," she recalls. Elizabeth stood up to get some lunch. 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. Mark Felix/AFP via Getty Images 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 . She just put her arms around me and took my hand and she was like, I know you dont want to be here, but youre in good hands. And she said, If you do that, dont tell anybody why youre traveling, dont tell your jobs, dont tell anyone at the airport, Hall remembers. If an ectopic pregnancy has ruptured, the pregnant person needs care immediately because they could start bleeding and lose up to 2 liters up blood very quickly. 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. I'm so sorry,'" Elizabeth says. For example, last year's Texas Heartbeat Law incorporated Texas' Health & Safety Code 245.002, which states (emphasis added): 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. 245.001. hide caption. "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. "It's hard to form a relationship to say, 'Hey look, I'm not using this for an elective abortion,'" she said. An attendee holds her child during A Texas Rally for Abortion Rights at Discovery Green in Houston, Texas, on May 7. 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. James rushed home from work and drove Elizabeth to the nearby Woodlands Hospital, part of the Houston Methodist hospital system. But the hospital staff told her that those weren't the right symptoms, yet, of a growing infection in her uterus. Double your gift when you give by 6 p.m. Thursday. But interpretation of the laws is still causing challenges to care. The New Texas Abortion Law Is Putting Some Patients In Danger, A Michigan law from 1931 would make abortion a felony if Roe falls. Down in the kitchen, images from recent scans and ultrasounds were stuck to the fridge. Double your gift when you give by 6 p.m. Thursday. She had cramps, and was passing clots of blood. It is disingenuous to allege that this law prevents obstetricians from following the medical standard of care, she said. Hall shelled out thousands of dollars to abruptly travel out of state while grieving a lost pregnancy. 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. The crisis the Wellers endured is emblematic of the vast and perhaps unintended medical impacts of the criminalization of abortion in Republican-led states. ", "Because that doesn't really exist right now," he added. Such a rupture can be life-threatening. 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. When the couple moved from Washington state to Texas in 2021, they were trying to . For example, in rare cases an infection can make the amniotic sac rupture before the fetus is viable. Dr. Palmer, the obstetrician in Fort Worth, said that one of her patients was trying to get pregnant after the new law went into effect, and she had consensual sex with her partner. At that point, the patient can opt to wait until the bleeding starts and the pregnancy tissue is naturally released, Briggs said. She said Houston Methodist had convened an ethics panel of doctors, but her doctor didn't seem very optimistic. 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.'". And surprisingly, both of their families sent money to help pay for the trip, despite their anti-abortion sentiments. hide caption. Midnight came and went in a blur. Texas' "trigger" law, which outlaws abortion "wholly or partly", is set to be in effect 30 days following the . Cheng did not treat Hall, but has counseled patients facing similar situations. Elizabeth and James look at clothes that were meant for their baby, whom they lost in the second trimester of pregnancy. The next day, a Thursday, she started throwing up. 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. 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. 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. We usually have our moms register for delivery at this point. Delays in care particularly for first-trimester conditions such as bleeding, hemorrhaging, septic miscarriages and ectopic pregnancies can become lethal, said Dr. Natalie Crawford, an OB/GYN and cofounder of a fertility clinic. 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.. hide caption. Treatments for miscarriages and ectopic pregnancies are still legal under Texas' abortion ban.<br/> By: By Mara Mndez, The Texas Tribune Posted at 10:06 PM, Jul 20, 2022 "'I'm just using this because this is not a viable pregnancy.'". This represents more confusion around state policy. With abortion laws in Texas about to change, The Dallas Morning News is answering your questions about what to expect without the protections established in Roe vs . The patient lost liters of blood and had to be put on a breathing machine because of the 24-hour delay in care. 9:42 AM on Jul 1, 2022 CDT. 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. Her doctor said she had been calling other hospitals, but none of them would help. The ob-gyn, who said she could not speak to the media, laid out two options, according to Elizabeth. Or you wait till your baby's heartbeat stops.'". Which sounds extreme, but Roe had just been overturned. Even with the slim chance of survival to 24 weeks, the newborn would face intense physical challenges and aggressive medical interventions. 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. Immediately, they sensed hesitation from the doctor. You can reach them at 212-255-9252. In Texas it's literally written in the law that an act is not an abortion to remove an ectopic pregnancy. But the language is ambiguous, and travel can be expensive and onerous for pregnant women, especially if they are unwell. The law makes no exceptions for nonviable pregnancies in which the fetus has no chance of survival. ", State abortion laws are complicating other types of obstetric care. Federal law typically trumps state laws, but it will now be up to courts to decide whether that will be the case in this instance. The other miscarriage treatment is a procedure described as surgical uterine evacuation to remove the pregnancy tissue the same approach as for an abortion. Nitashia Johnson for The New York Times. AUSTIN (KXAN) Amanda and Josh Zurawski have been trying to have a baby for more than a year now. Coming back to Texas a few days later only amplified those feelings. They had bought a house in Kingwood, a lakeside development in Houston. ", 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. "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?". An ectopic pregnancy is when a fertilized egg implants outside the uterus, typically in one of the woman's fallopian tubes. The bill makes no exceptions for pregnancies that resulted from rape or incest. A doctor hugs a patient at an abortion clinic in Santa Teresa, New Mexico, on 13 January 2023. "Later they laid down this beautiful baby girl in my arms. 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. In the nursery upstairs, they had already stashed some baby clothes and new cans of paint. She knew she did not have the flexibility to be able to travel out of state for an abortion later on. A few days later, she went out to celebrate a friends birthday and was raped on her way home. 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. ABACA. 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. But first, shes focused on her mental health and getting through the next few months. And now the Texas abortion law has created an additional bind, Cavazos explains. You open it. 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. Sec. Sometimes theyre the primary caregiver. Laws modelled on Texas's S.B. (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). "Not because I wanted my baby to die, but because I needed this hell to end. "And she starts to cry and she tells me: 'They're not going to touch you.' And it's this stupid, like, distinction that you're just making in this grief. Or, like Hall, they can shell out thousands of dollars to abruptly travel out of state while grieving a lost pregnancy. Texas Health and Safety Code, Chapter 245. The ethics panel had reached a decision, the doctor told them. Many doctors say they are unable to discuss the procedure as an option until the patients condition deteriorates and her life is at risk. other than an abortion performed due to a medical emergency as defined by Section 171.002, Health and Safety Code]. From Thursday through Saturday, Sept. 22-24, in downtown Austin, TribFest attendees will enjoy three days full of mind-expanding events, conversations and panels featuring more than 350 big names including Chris Bosh, Pete Buttigieg, Liz Cheney, Annette Gordon-Reed and many others. For doctors treating such patients, the Texas law creates quite a conundrum, Dr. Snyder said. 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. Recently passed laws make abortion illegal after about six weeks into a pregnancy. This law will prohibit almost all abortions. A more common scenario also raises difficult questions, said Dr. Ghazaleh Moayedi, an obstetrician and gynecologist in Texas who provides abortions. Dr. John Thoppil, an obstetrician in Austin who is president of the Texas Association of Obstetricians and Gynecologists, said that shortly after the new law went into effect in September, a patient who relied on an intrauterine device for birth control became pregnant. Because the state has made it very clear that if you talk about this, you're vulnerable to being sued," she added. Elizabeth and James look at clothes that were meant for their baby, whom they lost in the second trimester of pregnancy. The earliest time that any genetic testing could be done would be at seven weeks, Dr. Palmer said, so the patient decided to terminate her pregnancy before the six-week mark, in Texas. "The care providers are treading on eggshells. If she is developed enough to be menstruating and become pregnant, and reached sexual maturity, she can safely give birth to a baby, Dr. Skop said. Seek help right away for signs of ectopic pregnancy your doctor can talk you through next steps. But Prager believes that the laws in Texas and perhaps elsewhere soon could boost physicians' vulnerability to medical malpractice lawsuits. Not doing so can, in some circumstances, kill all of the fetuses. They were just all shocked, like, Surely, theres an exception for this, Hall said. Even in Texas, whose "heartbeat bill" was one . 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. When she first saw that positive pregnancy test, she panicked even at 27, she said, her first reaction was that of a 15-year-old, worried about telling her parents. A few weeks after Texas adopted the most restrictive abortion law in the nation, Dr. Andrea Palmer delivered terrible news to a Fort Worth patient who was midway through her pregnancy. Elizabeth touches the urn of her daughter. She took a pregnancy test soon after she missed her period and found out that she had conceived. But Im still so angry I had to leave.. Very young rape victims tend to seek prenatal care late, and they are more likely to have small babies that score poorly on tests of heart rate and muscle tone given immediately after birth. 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