By LAURA UNGAR and HEATHER HOLLINGSWORTH, Associated Press
Weeks after Roe v. Wade was overturned, Dr. Grace Ferguson treated a lady whose water had broken halfway through pregnancy. The newborn would never survive, and the patient’s probability of developing a potentially life-threatening infection grew with every hour.
By the point she made it to Pittsburgh to see Ferguson, the girl had spent two days in a West Virginia hospital, unable to have an abortion due to a state ban. The law makes an exception for medical emergencies, however the patient’s life wasn’t in peril at that moment.
“She was just sort of standing on the sting of the cliff,” Ferguson said, “waiting for an emergency to occur or for the child to pass away.”
In Pennsylvania, on the hospital a four-hour drive away, Ferguson was capable of induce labor to finish the pregnancy.
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A growing variety of physicians and families tell similar stories as a post-Roe fear involves pass: Pregnant women with dangerous medical conditions are showing up in hospitals and doctors’ offices only to be denied the abortions that would help treat them. Some doctors in states with restrictive abortion laws say they’ve referred or suggested more patients go elsewhere than ever. Some women are facing harmful, potentially deadly delays.
Doctors say they’re forced to balance medical judgment with potential punishments, including prison time. Although even the strictest laws allow abortion to avoid wasting a mother’s life, a weighty query lingers: How near death must the patient be?
“You don’t mechanically go from living to dead,” Ferguson said. “You slowly get sicker and sicker.”
It’s unimaginable to say when that line is crossed, said Dr. Alison Haddock, who’s on the board of the American College of Emergency Physicians. “There’s just no moment where I’m standing in front of a critically ailing patient where I do know: OK, before their health was just in peril. But now, their life is in peril,” she said.
Experts say it’s hard to pinpoint data on abortion denials when serious complications arise. Employers often discourage health care staff from speaking about them, though The Associated Press reached greater than a dozen doctors and patients who shared stories of such denials.
And plenty of doctors and researchers agree that evidence, even when largely anecdotal, shows a widespread problem. In Texas, for instance, a doctors’ association sent a letter to the state’s medical board saying some hospitals refused to treat patients with major complications due to state’s abortion ban.
And on the University of California, San Francisco, researchers who invited health care staff nationwide to anonymously send examples of poor-quality care brought on by abortion restrictions say they were surprised by the initial volume of responses. Twenty-five submissions got here in the primary six weeks. Amongst them were descriptions of patients sent home after their water broke within the second trimester who later returned with serious infections. One told of an ectopic pregnancy that was allowed to grow on a scar left by a previous cesarean section – which may cause uterine rupture, hemorrhage and death.
“The legislators are fiddling with fire,” said Dr. Dan Grossman, the project’s leader.
Dr. Cara Heuser, a maternal-fetal specialist in Utah, recalled one patient denied an abortion in Idaho despite developing a serious heart condition midway through pregnancy. The girl needed to be transported to Utah for the procedure.
Dr. Lauren Miller, a maternal-fetal specialist in Boise, said she repeatedly sees patients whose water breaks at 15 through 19 weeks’ gestation, and all doctors can do is help them make the tough decision: “Do they stay here for his or her care and just wait until something bad happens, or will we facilitate them finding care out of state?”
Dr. David Eisenberg, an associate professor at Washington University in St. Louis, said Missouri doctors and hospitals are repeatedly “punting that responsibility for care” when people show up with serious complications. They wind up on the university-affiliated medical center where he works — one among the few in Missouri that performs abortions in such cases.
He said patients in crisis are told: “I’ve got to call the lawyer for the hospital before I can work out what I can do.
“That’s just totally insane and totally inappropriate and really unlucky.”
The stories are similar when pregnancy is complicated by cancer — diagnosed in about 1 in 1,000 pregnant women annually.
Dr. Karen Knudsen, CEO of the American Cancer Society, said some oncologists are confused about treating pregnant cancer patients, particularly when therapies may induce miscarriage. Dr. Kristina Tocce, medical director for Planned Parenthood of the Rocky Mountains, said she’s seen patients with life-threatening diagnoses forced to drive 10 hours or more, or fly out of state, to get abortions so that they can begin chemotherapy or radiation treatment.
Tocce said she recently treated a Texas woman whose cancer had gone into remission but got here back aggressively after she became pregnant along with her second child. She sought an abortion to resume the cancer treatment that promised to maintain her alive for her toddler. Through the visit, she thanked Tocce repeatedly.
“I finally told the patient: ‘You possibly can’t thank us anymore. We’re doing our jobs,’” Tocce said. “I said, ‘I’m so disturbed that you simply needed to travel to date together with your family and the hurdles you will have had to beat.’”
Some abortion opponents say doctors could also be unnecessarily denying abortions in life-threatening situations out of fear. Dr. Patti Giebink, a former abortion doctor who described changing her views in her book “Unexpected Selection: An Abortion Doctor’s Journey to Pro-Life,” said it comes right down to intent. For those who intend to avoid wasting the mother and never end the lifetime of the fetus, she said, “you’re doing good medicine.”
“We’re kind of in a time frame where all these questions come up,” she said. “The legislatures are going to be working to unravel a few of these problems.”
Dr. Paul LaRose, a member of the American Association of Pro-Life Obstetricians and Gynecologists, said he thinks the problem is overstated and people raising concerns are exaggerating.
“Or they could be they misinformed,” he said. “Most professional-life physicians would deal with the mother and do what’s essential without purposely taking the lifetime of the unborn baby.”
But some women say restrictive abortion laws have put them in peril.
Kristina Cruickshank of Rosenberg, Texas, thought her life was in jeopardy after a diagnosis of a nonviable “partial molar pregnancy,” through which the fetus has too many chromosomes and develops incompletely. Cruickshank, 35, had thyroid problems and big cysts around each ovaries. She was vomiting, bleeding and in pain.
It was early June, shortly before Roe fell, when Texas banned nearly all abortions after roughly six weeks of pregnancy. She endured three days of agony in a single hospital before her doctor could find one other that agreed to the termination procedure. She thought: “What am I alleged to do, just lay here and die?’”
Mylissa Farmer of Joplin, Missouri, faced similar delays in August. Her water broke at 17 1/2 weeks’ gestation, sending her to the emergency room. Tests showed she’d lost all her amniotic fluid. The fetus she and her boyfriend had named Maeve wasn’t expected to survive.
Despite risks of infection and blood loss, she couldn’t get an abortion. The fetus still had a heartbeat. Doctors told her Missouri law superseded their judgment, medical records show.
She tried for days to get an out-of-state abortion, but many hospitals said they couldn’t take her. Ultimately, an abortion helpline connected Farmer with a clinic in Granite City, Illinois. She drove 4 ½ hours from home — while in labor — and had the procedure.
After news outlets covered Farmer’s story and she or he appeared in a political ad, the Missouri health department began an investigation into whether the Joplin hospital, which declined to comment on the case, violated federal law. The state has shared its preliminary findings with the federal government .
Farmer said the experience was so traumatic that she took a everlasting step to make sure nothing like this happens to her again.
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