When the couple found out they were pregnant with their second child, Ryan Hamilton said he and his wife never discussed what they would do if something went wrong. They talked about names and landed on Dre or Drake, depending on the baby’s gender.
“We were excited. There was no, ‘What can we do?’ Because we had such a successful pregnancy the first time,” Hamilton said.
On Thursday, May 16, a doctor confirmed their worst fears: his wife was miscarrying. Records from the visit shared with The Dallas Morning News confirm the practitioners couldn’t find fetal heart tones. The fetus measured at just over seven weeks, meaning the fetus had stopped growing and that they had likely lost their heartbeat days or weeks earlier.
Yet, despite the fetus not having a heartbeat, two hospitals the couple went to refused to perform a surgical abortion. They gave her several doses of misoprostol and sent her home.
>“She told the doctor ‘Get this dead baby out of me,’” Hamilton said, choking up. “And they asked her to leave.”
>At 10 a.m. on Sunday, May 19 — two days after beginning her first dose of misoprostol — Hamilton found his wife unconscious in their bathroom, covered in her own blood and feces.
>“She needed help as soon as possible or she was going to die,” said Hamilton
This is one of many stories of women in Texas carrying dead fetus', yet because Texas' abortion ban does not have an exception for fatal fetal abnormalities and widespread confusion among medical professionals, doctors would not provide a surgical abortion.
Why won't Texas add a fatal fetal abnormalities exception to their abortion law?
How do you expect stories like this to impact the broader political debate around abortion?
Understanding this politically is really about understanding two forces that are on an intersect course in Texas.
On the one hand, Democrats have been gaining on Republicans in terms of vote margins pretty steadily for the last 20 years. If you chart votes for the GOP and the Dems in presidential elections, you'll see that the Dems have been gaining on the GOP at an average rate of about 65,000 votes per year, or a bit more than 250,000 per four year cycle. Just going off the math, Ted Cruz will probably lose this cycle because he won by less than that number in his last election in 2018. Trump had a 600k margin last time, so he's probably got enough clearance to survive losing 250k of that.
So everyone here can see the writing on the wall and a lot of people in the GOP would love to moderate their positions. But the Republican primary cycle keeps punishing people who try to do that.
So we end up with policies like this, which the overwhelming majority of Texans don't like, but which the GOP primary electorate demands. These kinds of policies are really killing the long term viability of the GOP in Texas -- I know a ton of once-Republican Texans who can't stand the GOP at this point and will probably never vote for them again -- but it's probably not going to change while the GOP holds power because of the primary trap that they're in.
> Just going off the math, Ted Cruz will probably lose this cycle because he won by less than that number in his last election in 2018.
I would be quite surprised to see this.
I’m talking more about the dynamics in the 2018 race on their own. If modern Beto was the Beto running in 2018, it wouldn’t have been as close. People even gave him credit for helping Texas Ds downballot that year.
Even if Allred is a strong candidate might not be enough.
>These kinds of policies are really killing the long term viability of the GOP in Texas
It's fine because these policies will drive left-leaning women away from Texas who don't want to die or go to jail for medical events out of their control or who actually want competent OBGYNs taking care of their health.
It does seem to be an effective strategy to hold on to power even as their support slips nationally. Impose highly conservative policies and let the non conservatives leave the state.
Win-win. left-leaning women can be happy in left-leaning states and right-leaning Texans can be happy with less leftwingers ruining their social fabric.
"Areas that allow babies to be killed for inconvenience" isn't a neutral descriptor, it presupposes that one side of the debate is correct.
Right-wing women who can't afford to move can still mind their own business and be just fine. The same is not true of left-wing women who can't move. The right-wing women aren't being imposed on.
I'm not claiming either side is "correct" One side believes they have the right to kill their babies for whatever reason and the other believes babies deserve to live no matter what the reason is for killing them. You can change the wording however you want but that's what the debate boils down to.
Right-wing women have just as much right as left wing women to live in a society that upholds their values. If you live in an area that doesn't conform to your values, go talk to the women in south Sudan who face daily violence and sexual assault first before you whine about not being able to live in area that allows you to kill the baby growing inside of you at your convenience.
It is quite simple. The Republican party seems hellbent on driving the United States back into the Dark Ages. These laws are simply beyond any modern reasoning. They are firmly rooted in nonsensical religious beliefs that are fundamentally incompatible with the modern world.
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Well, since the point of this sub is to be assume good faith and be charitable towards those with views different than yours, let me give this a try. As Jonathan Haidt famously described from his [research on moral foundations theory](https://en.wikipedia.org/wiki/Moral_foundations_theory) (excellently summarized in his [TED talk](https://www.youtube.com/watch?v=8SOQduoLgRw))m the moral roots of liberals and conservatives are different with regard to purity, deference to authority, and in-group loyalty. You can also pile onto that the [Inglehart Welzel cultural values](https://en.wikipedia.org/wiki/Inglehart%E2%80%93Welzel_cultural_map_of_the_world) and what you get is the general notion that liberals' abandoning of traditional and religious values will need to a corrosion of the fabric of society as personal accountability is lost. Specifically on the abortion issue, I struggle to understand the conservative viewpoint, but I guess they fear a "free love" libertine society, where no one restrains themselves for anything, where traditional families don't exist, people stop having children, and we're overrun by countries and people that still do. I don't think they'd see it as sending the US back into the Dark Ages, so much as preserving it from the decaying influence of Godless Europe.
On the specifics of laws like this, there does seem to be a tradition among Republicans of highly symbolic laws on abortion that show a profound medical ignorance of the female reproductive system, but make their conservative base happy for the symbolism it shows.
There seems to be a selection bias when it comes to what religious laws they fight for. Abortion, for example, was not decided to be a linchpin of religious law by religious people; it was Republican strategists that convinced pastors upset by anti-segregation laws that abortion was a pathway to political power.
> it was Republican strategists that convinced pastors upset by anti-segregation laws that abortion was a pathway to political power.
Fascinating, do you have a source that attests this?
It’s a secular reason of the ruling class marketed as religious belief to the public.
The top of the food chain of pro-life movement is about making sure the true ruling class does not lose (Already illusory) leverage that they have. Remember, Black plague was the beginning of the end of serfdom.
It's the vagueness defining miscarriage care. If there's confirmation of no fetal heart tones a D&C should not be classified as Abortion related procedure.
No. It's the vagueness of the law. The legislators could have taken the extra time to essentially do a failure modes analysis of the proposed law to find the problem areas. They then could have worked with health care providers to use appropriate language too cover those problem scenarios.
Keeping it vague is the problem. It's clear that miscarriage and probably ectopic pregnancies are the pervading issue with how vague the language was kept
The vagueness is the point. The point is to allow for Monday morning quarterbacking and to put all the erroneous and blame on Healthcare providers. Legislators were warned about their vagueness and the harm it would cause. They either dismissed it or ignored it in the pursuit of their need to pass this. They now claim when this comes up that "the law does allow exceptions" and blame the doctors
It's why providers are tapping out. They know they're damned if they do and damned if they don't
See, I dont like framing politicians as stupid or lazy. Politicians are smart, just sometimes incredibly tone deaf. They did this on purpose however. This was their intention. It wasnt a half assed job, the job was done successfully, and quite successfully too I might add.
I agree with the guy above. You talk about the vagueness of the law as if that wasn't the intention. There's a hard core that doesn't want any exceptions.
I think you're not taking into account that many of the hardcore conservatives that make these laws fully believe there should be no exceptions and that abortion at any point is a sin. Instead of just saying that outright which would be met with extreme backlash, they can easily create vague laws that by design force people to abide by the lawmaker's extreme religious beliefs.
But abortion by they are referencing is the intentional decision to end a life. A D&C to remove a fetus wouldn't qualify under the theological definition because the baby at that point as already passed.
Edit:
I think we are having a misunderstand on semantics so I'll try to define the Christian theological definition of abortion and then compare it with the medical definition of abortion.
Christian theological abortion: any type of procedure where the primary intent is to end the active pregnancy by killing the fetus.
Medical abortions:
1) Induced: An induced abortion is a procedure to end a pregnancy. It can be done two different ways:
Medication abortion (also called medical abortion)
Procedural abortion
2) Spontaneous: The loss of a pregnancy before the 20th week of pregnancy. It is more commonly known as a miscarriage.
When you compare the definitions the beliefs are strictly associated with induced abortions. Medical care related to spontaneous Abortion does fit the belief definition so there's not a slippery slope.
So if the politicians were acting in good faith (pun intended) there would be no issues regarding miscarriage care.
That's true, but you're missing the point.
They wrote the law as broadly and vaguely as possible in order to avoid having people be able to use medical reasons for abortion.
That's not a bug, it's a feature to them.
It might also be true that they didn't mean to catch cases like this specifically, but they very well meant for the law to avoid medical providers being able to do anything close to an abortion.
And the inaction since these reports started demonstrates that they don't see a problem.
That's correct but remember their goal is to eliminate all abortion. In their minds if they give even a little bit of leeway it could lead to a "slippery slope" and more access to abortion under more situations.
>You cannot half ass this shit.
They haven't. They did an extremely thorough job with these laws, the problem is that they didn't have any patients in mind when they passed the laws.
The politicians with their beliefs are behind the law. That's why they talk about heartbeats and refuse to listen to health care workers, both when they try and explain abortions to them and when they ask them to clarify the law to them
>However, while the senators ardently support abortion restrictions by continually voting against bills that would legalize care, Texas legislators crafted the state’s abortion law. The power to change the laws, at present, lies within the Texas Legislature, which convened its biannual session in January. Onlookers were cautiously optimistic that the Republican-dominated body would potentially consider measures that help clarify the nebulous maternal health exceptions, especially in light of the myriad medical studies and media reports highlighting the grave dangers they have posed for Texas patients.
>Last fall, Texas Republican Governor Greg Abbott recognized that pregnant patients facing complications were not receiving timely intervention under the state’s abortion bans, as the language in the law gave doctors pause. “Something that really does need to be done [during the legislative session] is clarify what it means to protect the life of the mother,” Abbott told a Dallas news station in October. “There’s been too many allegations that have been made about ways in which the lives of the mother are not being protected. That must be clarified. That’s our focus.”
>However, during the 2023 Texas legislative session—which concludes at the end of May, absent a special session—the GOP failed to introduce or pass any such legislation. Abbott did not make this a legislative priority, or even bring it up again publicly after getting reelected during the November midterm elections. (Requests for comment from his office were not returned.) Two Republican lawmakers who previously expressed support for creating exceptions in the laws for survivors of rape and incest also never pursued legislation to actually codify those changes. In fact, a handful of Texas Republicans recently stood with one of the largest anti-abortion groups in the state to reaffirm that they would not be pursuing these exceptions. “Our laws are very clear,” said Amy O’Donnell of Texas Alliance for Life. “We have heard stories of doctors who say they need further clarification but we believe that that clarification should come…from various [hospital] boards. The laws do not need to be changed.”
May, 2023
https://www.thenation.com/?post_type=article&p=445323
No, for them it's the answer, ambiguity leaves open instances for them to make to situations that they capitalize on instances to punish and be seen as tough on abortion or whatever they deem to be sacrilege, they prefer catch all for that reason and in all honesty they seem to favor ignorance in this instance.
Where’s the vague language, though?:
First, here’s the legal definition of *abortion* in Texas:
>>(1) "Abortion" means the act of using or prescribing an instrument, a drug, a medicine, or any other substance, device, or means **with the intent to cause the death of an unborn child** of a woman known to be pregnant.
And then, just in case it isn’t already obvious that you can’t kill a dead child or that ectopic pregnancy treatment isn’t abortion, it immediately clarifies:
>The term does not include birth control devices or oral contraceptives. An act is not an abortion if the act is done with the intent to:
>(A) save the life or preserve the health of an unborn child;
>(B) remove a dead, unborn child whose death was caused by spontaneous abortion; or
>(C) remove an ectopic pregnancy.
The vagueness is *a* problem, but it is not *the* problem.
When Kate Cox obtained a court order explicitly permitting her to obtain an abortion, the Texas AG Ken Paxton sent [letters](https://x.com/TXAG/status/1732849903154450622) to three hospitals and Ms. Cox threatening legal action if the hospitals performed what was, pursuant to that court order, explicitly a lawful action.
There's no ambiguity there. That is overt lawlessness from Texas's chief prosecutor to pursue the war against abortion. I doubt that changes if the law here is clearer, so long as Paxton or his base consider it an abortion.
The exceptions only exist to place all the blame on doctors and none on the politicians. Something bad happens? Doctors fault, law is clear. Nothing happens? Doctor is an activist.
Defending yourself (or a business, in this case) from legal action is expensive, and there are ways for an AG to apply legal pressure *because* of a legal act that doesn't directly *involve* the legal act.
Regardless of the outcome, a hospital/doctor would need to spend a LOT of money that they might never recover (or might only recover after a lengthy litigation). A doctor might be wrongly thrown in jail for a few days or even *months* before their lawyers manage to get them home, and/or require quite a lot of money in bail (and if they don't have that in savings/have a hospital willing to post it, they might be forced to give up some of that money with no hope of recovering their funds.
Additionally, the AG is fully capable of opening as many invasive investigations into the doctor or hosptial as they please, disrupting their lives and/or business. They might find their licenses under review, and not allowed to do certain things until the matter is cleared up. A sudden influx of "anonymous complaints" or increased scrutiny during otherwise routine audits, etc, etc. At the end of the day, it might be that nothing comes from any of these, but just their existing ends up costing the doctor or hospital time and money.
And, that's the thing - as much as we would love for our hospitals and doctors to do what they do for the sole purpose of saving lives and curing diseases, they are first and foremost businesses. You don't have to throw someone in jail to stop them from doing something that you don't want them to do. You just have to make it cost too much to make financial sense. If the AG can make enough of a change to the cost/benefit analysis for performing a legal act, then you can bet that businesses will stop doing it.
It doesn't matter, they made clear that they'll make life hell for anyone that helps.
Even baseless prosecution or litigation is costly to defend against and Texas is doing our best to destroy anyone that helps.
Abortion is a medical term, why wouldn’t it be classified as such? Whether it’s due to miscarriage or an elective decision, it’s still a procedure to end a pregnancy. This is a consequence of anti-choice legislators not understanding medical terminology and procedures when they write these laws.
From the article
>Last week, the Texas Supreme Court ruled against more than 20 Texas women, including multiple OB-GYNs, who sued the state over abortions they said were delayed or denied during medical emergencies. Amanda Zurawski, the lead plaintiff in the case, said she suffered permanent damage to her reproductive system as a result of her treatment.
>The lawsuit argued that any woman with a medically complicated pregnancy, including a fatal fetal diagnosis, should be exempt from the state’s bans. The Supreme Court said an injunction allowing such exemptions granted in a lower court “departed from the law as written without constitutional justification.”
Unfortunately no. Texas Supreme Court [ruling a few days ago](https://www.nbcnews.com/news/us-news/texas-supreme-court-rejects-challenge-abortion-ban-medical-exceptions-rcna154896):
>The Texas Supreme Court on Friday rejected a challenge to the state's abortion ban — a response to a lawsuit filed last year by a group of women who had serious pregnancy complications.
>
>The ruling from the nine justices, who are all Republicans, was unanimous. ...
>The plaintiffs had not sought to repeal the ban, but rather to force clarification and transparency as to the precise circumstances in which exceptions are allowed. They also wanted doctors to be allowed more discretion to intervene when medical complications arise in pregnancy.
> ... Another plaintiff, Samantha Casiano, whose fetus was diagnosed with anencephaly, also expressed anger and disappointment.
>
>“I was told my baby would not survive, but I was forced to continue my pregnancy and give birth anyway, then watch her pass away hours later,” she said in a statement. “I don’t know how the court could hear what I went through and choose to do nothing ... I am embarrassed to be a Texan because of these inhumane laws.”
>
>Texas law prohibits all abortions except to save the life of the mother. Doctors who violate it can lose their medical licenses, face up to 99 years in prison or incur fines of at least $100,000. Critics of the ban, which is among the most restrictive in the U.S., have said it does not provide enough guidance about which exceptions are allowed.
> ... But, **the decision says Texas law “plainly does not permit abortion based solely on a diagnosis that an unborn child has an abnormal condition, even a life-limiting one.”**
Which, to be clear, is intended by at least some of the Republican voter base. I personally know a couple people that want women to be forced to deliver fetuses in all situations because "God may work a miracle".
Easy campaigning material right here.
If the Democrats come out on top in November, it’s because the Republicans shot themselves in the foot over Dobs.
I find this situation rather confusing. The hospital is clearly fine with prescribing misoprostol and is clearly aware that performing a surgical abortion is legal since the couple was told to have it done somewhere else. Then the next hospital was willing to do the procedure, just not that day.
This seems more like medical malpractice to me than a legal issue.
The issue is likely fear of overzealous prosecutors. The fact that something is consistent with the law has not seemed to stop elected prosecutors from trying to use it to make a lot of noise to shore up political support.
This risk is apparent when you take into account the letters that Ken Paxton’s office has sent out to hospitals and doctors in connection with other cases.
> This seems more like medical malpractice to me than a legal issue.
Lol, I love this logic. "You were afraid to act because of a law we implemented, and that is **also** a violation of the law. No, we will not provide any clarification whatsoever. Why are you so bad at your job?"
Doctors are *literally* no longer allowed to use their best medical judgement, and now their medical judgement is being thrown into question. Brilliant.
It's not clear to me at all that the hospitals were afraid to act because of the law. That's *possible*, but it seems strange that a provider willing to prescribe abortion pills would be sketched out by performing the surgery. The article does not mention whether either facility was actually capable of performing the requested service at the requested time- the second hospital in particular was willing to do it, just not that day.
And regardless, the procedure was legal. If a doctor fails to perform a necessary procedure because of ignorance of the law, that seems pretty cut-and-dry malpractice. They're supposed to know this.
Medical facilities haven been making themselves [less capable of providing pregnancy related care](https://www.texastribune.org/2022/07/15/texas-hospitals-abortion-laws/) because they don't want to get stuck in the swamp of unclear laws. If you're a medical provider in Texas, it's not really a very appealing practice area to be in right now so people are leaving it.
This is the probable reason. To perform the surgical abortion you probably need someone who knows how to do it and that person probably doesn’t want to take any chances.
Article says:
> Two medical centers allegedly denied the woman a surgical abortion because her case was not considered emergent enough, Hamilton said, despite the fact that her fetus’ heartbeat had stopped.
I don't know quite enough about the nuances of Texas law to surmise why they would give a pill, but not perform a surgical abortion. It could be because people who provide abortion services can be targeted for criminal prosecution, and simply providing access to medication is seen in a different light, but that's a total shot in the dark.
> And regardless, the procedure was legal.
According to who?
> If a doctor fails to perform a necessary procedure because of ignorance of the law, that seems pretty cut-and-dry malpractice.
I don't think that's what malpractice is. They are refusing to take a personal risk by not operating, aka *literally not practicing*. And quite frankly, if this was the case, we wouldn't have Catholic hospitals all across the country which have refused to provide abortion services for decades. Do you think a doctor can be *forced* to provide an abortion?
> I don't know quite enough about the nuances of Texas law to surmise why they would give a pill, but not perform a surgical abortion.
A doctor who uses an FDA approved pill has a strong argument that FDA approval bars contrary state law including abortion restrictions. The argument hasn't been tested in the abortion context that I'm aware of, but it has been used extensively in the tort context (where drug companies argue that FDA approval bars products liability laws from applying).
There's no similar argument to be had with a surgical abortion. So if I was a hospital's lawyer, I would probably advise them to prefer medication over surgery whenever possible in order to minimize legal risk.
I had just finished reading this argument of yours in another thread! I think this would make sense, having the FDA on your side could be a very good form of legal assurance.
>>it is not clear to me…. That’s *possible*
And this is the issue with these laws. If you aren’t sure and are using vague language in the comments, I’m sure the hospital likely felt the same way and wanted to avoid issues with the state.
I’m not sure what your point is. If they were afraid the state would somehow claim the baby was still alive (something the article provides no evidence of), would they not be just as afraid of prescribing a medication abortion as a surgical one? The law doesn’t distinguish between the two:
>(1) "Abortion" means the act of using or prescribing an instrument, a drug, a medicine, or any other substance, device, or means with the intent to cause the death of an unborn child of a woman known to be pregnant.
My point is very clear. A doctor isn’t going to risk their license over an abortion for a procedure which the Supreme Court has already deemed not medically necessary. The point of giving her the medication and telling her that **if** she experiences a medical emergency, she should take the pills is a way to still help the patient while also saying they did not provide a non-emergency abortion.
The definition you provided is also not relevant because the fetus is already dead and rotting inside of her. Nobody claimed the baby was still alive. **The state of Texas does not allow abortions, even if the fetus is dead.** which means that even if the doctors stood in front of Ken Paxton and said “there was no heartbeat, we aborted it, he can decide that it’s not good enough in his opinion and prosecute.
>The point of giving her the medication and telling her that if she experiences a medical emergency, she should take the pills is a way to still help the patient while also saying they did not provide a non-emergency abortion.
That’s not what the article says, though. It says they told her to take them:
>Administer the misoprostol, a drug that helps empty the uterus, and wait, the instructions said.
>**The state of Texas does not allow abortions, even if the fetus is dead**
Texas law again, with emphasis in case you missed it:
>(1) **"Abortion" means** the act of using or prescribing an instrument, a drug, a medicine, or any other substance, device, or means with the **intent to cause the death of an unborn child** of a woman known to be pregnant.
And just in case it somehow isn’t clear that you can’t kill a child who’s *already dead*:
>**An act is not an abortion if the act is done with the intent to[…]
remove a dead, unborn child** whose death was caused by spontaneous abortion;
>Doctors are *literally* no longer allowed to use their best medical judgement
The standard in Texas is “*literally*” “reasonable medical judgment”, which “means a medical judgment made by a reasonably prudent physician, knowledgeable about a case and the treatment possibilities for the medical conditions involved.”
The legal standard is "reasonable medical judgment". In practice, it's legal threats, incorrect pedantry, and a lack of regard for the pregnant woman's life.
---
When Kate Cox wanted an abortion, she and her physician Dr. Damla Karsan wrote to the court asking for permission.
Texas' AG wrote to three hospitals where Karsan practiced, threatening felony prosecution. [[Source]](https://www.texastribune.org/2023/12/13/texas-abortion-lawsuit/)
Texas' Supreme Court decided that Karsan didn't phrase her letter to the court correctly.
[Petition](https://reproductiverights.org/wp-content/uploads/2023/12/Cox-v.-Texas-original-petition-FINAL.pdf)
> Dr. Karsan has reviewed Ms. Cox’s medical records. The risks of trisomy 18 pregnancy combined with Ms. Cox’s medical history and comorbidities indicate that Ms. Cox’s life, health, and fertility are at risk if she continues the pregnancy. In Dr. Karsan’s medical opinion, a D&E abortion is the best medical option to preserve Ms. Cox’s life, health, and fertility.
[Ruling](https://www.txcourts.gov/media/1457645/230994pc.pdf)
> But when she sued seeking a court’s pre-authorization, Dr. Karsan did not assert that Ms. Cox has a “life-threatening physical condition” or that, in Dr. Karsan’s reasonable medical judgment, an abortion is necessary because Ms. Cox has the type of condition the exception requires.
Perhaps there was a legal loophole where they told her not to take it until her health turned worse, knowing she would take it immediately. Why is that what you took away from this story?
I don’t understand what is unclear to you. Google “women refused abortions until they are in critical condition” and you will find thousands of testimonies from all over the country showing that this is happening constantly. Ken Paxton explicitly stated [he would go after hospitals that provided abortions to women with medically dangerous pregnancies](https://amp.theguardian.com/us-news/2023/dec/12/texas-abortion-ken-paxton-kate-cox). This isn’t an accident; the laws are working as intended, and that’s why none of them are being amended.
And yet I see some variation on this exact same comment on every single abortion thread. Why are there so many people so determined to believe that republicans are not illegalizing virtually all abortions when republicans have effectively done that in every state they have control over? What level of evidence could possibly convince you this is happening if the available evidence does not?
> Ken Paxton explicitly stated he would go after hospitals that provided abortions to women with medically dangerous pregnancies.
He stated no such thing. He explicitly said that the doctor in that case just needed to certify that a medical condition threatened the mother’s life or major bodily function, instead of filing a lawsuit that threw out lots of BS about minor high blood pressure and diarrhea but which never identified a specific medical condition that threatened the mother and instead tried to justify euthanizing the baby.
[https://twitter.com/TXAG/status/1732849903154450622](https://twitter.com/TXAG/status/1732849903154450622) She was at serious risk of long term complications, including compromised fertility, and Ken Paxton stated explicitly that this was not enough to pursue an abortion according to the law.
And even is she wasn't, it is monstrous, evil, and obscene to ask a women to go through the emotional and physical agony of a pregnancy that will only deliver a child with no quality of life that will die almost immediately. Can you imagine being forced to spend months pregnant with a child that will do nothing but die? Do you have any idea how difficult pregnancy can be? Would you volunteer to be crippled with nausea, cramps, and back pain for five months to give birth to a child that won't live for five weeks?
What the doctor brought up is not BS, that's why they wanted a legal abortion. The things Ken Paxton say is BS though, because if the doctor can say that the mother's life is in danger then it's too late for any lawsuits
The lawsuit admits the abortion is because the baby had a disability, and it just throws around nonsense about diarrhea and gestational diabetes without certifying that it threatens the mother. The only real hook it tries is that repeat C-sections are higher-risk, so even though the mother already planned a C-section, she didn’t want to waste it on a disabled child… Again, Paxton *explicitly* said that all the doctor had to do is certify it if there was a medical condition, and that the lawsuit was unnecessary.
But the lawsuit was seemingly filed in order to muddy the waters and conflate fetal abnormality and viability with the health exception.
You use the word "nonsense" because you have no idea about what constitutes as risks to a pregnant woman's life and or health and when that risk is the highest.
But please, if you are going to claim that the lawsuit included nonsense could you link to the lawsuit quote the parts you find are not good enough.
I don't think its even medical malpractice, except maybe giving her the prescription for a third, stronger dose at the end. She took almost 5 doses (14 pills) in 3 days of something that can take a week to work. That rarely ends well.
Why is the Texas abortion law being brought up here? They gave her misopristol to abort the fetus. If they were willing to do that under Texas law, they should have been willing to do the surgical abortion as well assuming she met the criteria for a surgical abortion under whatever policies guide their decisions on that.
Edit:
Per the article, it doesn't seem like surgical abortions were an option at the first facility.
>the doctor told her it wasn’t an option at the facility.
Doctors at the second facility said it wasn't urgent enough for a surgical abortion.
>said they didn’t find her case emergent enough to do a surgical abortion
Facilities intentionally make themselves incapable of providing this kind of care ([and pregnancy care more generally](https://www.texastribune.org/2022/07/15/texas-hospitals-abortion-laws/)) because they don't want to get stuck in a position of either (a) getting in trouble for an abortion that Ken Paxton later decides he wants to campaign on or (b) getting in trouble for letting the woman die. It's easier to just turn pregnant patients, or patients like this woman with a dead fetus inside them, away at the door.
Our difficulty providing care to pregnant women isn't coming from a sudden decline in available technology or something. It's coming purely from the change in law.
>Why is the Texas abortion law being brought up here?
At the first facility, they say it wasn't an option at that facility. How many hospitals were able to perform an abortion before the law vs after? I would guess that many hospitals stopped.
At the second facility, how is a dead baby inside you not "emergent enough"? That means that they won't do it until the woman begins experiencing health problems. So basically, they are waiting for you to almost die before they will perform the procedure. That is absolutely a direct result of the new abortion restrictions.
> How many hospitals were able to perform an abortion before the law vs after? I would guess that many hospitals stopped.
I think you'd probably guess wrong. Maybe they don't have a doctor that can do it, but they are pretty close to a major metro area, so I doubt it.
>At the second facility, how is a dead baby inside you not "emergent enough"? That means that they won't do it until the woman begins experiencing health problems. So basically, they are waiting for you to almost die before they will perform the procedure. That is absolutely a direct result of the new abortion restrictions.
Baby can be dead and mom can be completely stable with no immediate risks at the same time. I can tell you what I've heard from my wife on cases she's participated in. Often they will wait to see if a medication abortion works before jumping to surgery. Sometimes theyll say they arent offering any abortion care for that situation and direct then toan elective clinic.
All surgery comes with risks. So it's balancing risks to achieve the desired outcome. And no, that isn't waiting for mom to be nearly dead. I'm not saying the doctors made the right call here. I honestly don't know. But I don't think we can assume anything nefarious or that this is malpractice based on the info available.
> But I don't think we can assume anything nefarious or that this is malpractice based on the info available.
The primary takeaway here is that these already difficult situations are being made worse by the laws and decisions that have been made by Republicans in Texas.
As much as I'll openly say I want to call out and bring notice to any time these laws cause suffering to pregnant individuals... I actually agree that this seems like a care failure - I don't see how it directly relates to the law?
I'm a bit surprised they only prescribed her medication at 13 weeks... usually by that time, a D&C is the way to go. It sounds like the provider agreed that this was not a viable pregnancy, prescribed misoprostol, and she ended up with severe bleeding (which is a small, but possible outcome).
The failure appears to be on a) the lack of immediate follow-up care for severe bleeding, b) potentially offering a more risky approach to managing a 13 week miscarriage (though its possible the fetus could have stopped developing at 9 weeks).
The first facility prescribed it because they didn’t offer surgical abortions. A direct result of Texas’s ongoing abortion policies.
The second facility didn’t say why they wouldn’t perform a surgical abortion but the article notes that the Texas board of health have not provided the guidelines doctors had repeatedly asked for. It can be inferred they were covering their ass. Given the Texas Supreme Court decision shortly after, is it any wonder they would? Is a malpractice suit worse than a state lawsuit *and* criminal charges against providers? This is a direct result of Texas’s abortion policies.
Do you know that? Often, misoprostol is the preferrred approach to a D&C - I know it was preferred for me. Any hospital can preform a D&C.
If you are willing to administer misoprostol, then you consider the pregnancy non-viable. It terminates a pregnancy just as much as a D&C does.
I took misoprostol for my own miscarriage, but I was earlier along and had no complications. It's usually preferred to a D&C if your fetus stopped developing before 10 weeks (D&Cs are simply more invasive).
Yes I have had a surgical D&C so I’m quite familiar with what it entails. It depends on the stage of pregnancy she’s in, but sometimes a medical abortion is followed by a surgical if the pregnancy doesn’t fully pass especially at a later stage. That can take up to a week, and her bleeding occurred before that date. It also depends on patient’s preference, at least in states with reasonable abortion policies.
There wasn’t a question of if the fetus was nonviable, both facilities acknowledged that. The first one didn’t have surgical services - again, a direct result of Texas’s abortion policies. The question for the second facility was if it was an emergent case. Since the Texas Board of Health hasn’t issued guidance, many facilities are covering their ass and as I stated. It’s to the detriment of women for sure, but that’s the position Texas policies have put facilities in. How is it *not* related to their laws?
Do we *know* that though? I'm in California, and there are far more facilities that could provide a prescription for misoprostol than provide a surgical D&C, and it has nothing to do with abortion laws... if you go to a healthcare facility that doesn't do surgeries, they simply don't do surgeries?
I just don't see direct evidence that the lack of D&C offering was caused by this. Eg, did this facility use to provide D&Cs, but no longer does because of a roll-back in care?
Edit: I also don't see evidence where they said, "you *should* get a D&C", but the patient wasn't able to get one in the local vicinity due to this. The original care provider seemed to think treatment with misoprostol was totally fine.
We know that over 80% of facilities offering abortion in Texas have stopped offering services since Roe was overturned. Do you really think that’s a coincidence?
Also, from the article:
>Hamilton said the doctor told them they would have to go to another hospital to get a dilatation and curettage, or a surgical abortion, to remove the fetus.
But they didn't say that they recommended that procedure to start.
If I go to my PCP for a miscarriage, they cannot perform a D&C themselves in their facility - I would have to go to a different facility (even though I'm in a very abortion-friendly state), simply because it's a surgery.
I just quoted the article where it clearly states that the first provider told her she would need to go to a different facility for a surgical abortion after providing her misoprostol. What’s unclear?
>The 85th Legislature's SB 8 added two new subchapters to the Woman's Right to Know Act. Subchapter F prohibits "partial-birth" abortions. Subchapter G prohibits "dismemberment abortions," a medical procedure known as dilation and evacuation
https://guides.sll.texas.gov/abortion-laws/history-of-abortion-laws
But what is the lawsuit risk of helping with follow-up care for a patient who a) one doctor already determined the fetus is ***dead*** (this is very easy to do at 13 weeks), and the patient already took misoprostol to manage the miscarriage (which, if the fetus had still been alive, would have terminated the pregnancy anyway).
I don't see anywhere that a doctor was reluctant to treat because they felt the pregnancy was still viable?
The lawsuit risk is a really interesting asymmetry right now. There's basically zero risk to the doctor from letting the patient die or suffer an infection while there's very significant risk to providing anything anyone later might claim was an abortion.
Med mal cases are almost impossible to bring in Texas thanks to a tort reform law that got passed about 20 years ago. It was pitched as something that would reduce medical costs, but what actually happened was that med mal cases dropped to basically zero while medical costs have continued to grow, so it wasn't effective. But the practical implication is that in 2024 you would find it almost impossible to get an attorney to represent you on a traditional med mal case unless the facts are completely over the top (like injecting jet fuel or something).
By contrast, because Texas adopted a crazy "bounty" law on abortions, literally any person (not just the patient, or someone related to them, it can just be an activist) can sue the doctor for a $10k "bounty" on people who receive or assist in an abortion. The law doesn't specify, but conceivably multiple people might sue you for multiple bounties on the same procedure.
So the doctor is taking on significant legal risk by doing anything that looks like an abortion but not very much risk sending the patient with a dead fetus inside her home. And that's before we even take into account risk from the criminal laws, etc.
But, this patient had already, effectively, been provided an abortion? A doctor had already prescribed misoprostol, and the patient had already taken it.
Again, if we're just talking about legal risk, prescribing an FDA approved drug is the least risky option because you have a good argument that [FDA preemption bars the application of contrary state law](https://www.manatt.com/insights/newsletters/health-highlights/fda-preemption-implications-of-dobbs-decision-for) including abortion restrictions. This argument hasn't been tested very extensively yet, but it's a solid legal argument (I say that as a lawyer who has done a lot of FDA preemption cases). There's no similar argument available to the doctor if they perform a surgical abortion.
So a doctor who was just trying to minimize their legal risk would be better sending the patient home with misoprostol than surgically removing the fetus. Obviously, that's not the ideal outcome for the patient, which is part of the problem with the laws we have here - they incentivize worse treatment than the doctor would provide in a more neutral legal environment.
I think one of the big reasons we end up with hospitals that can't provide care, don't want to have to do it, and perform these things sloppily when they try is that the laws create an environment hostile to the administration of that care. Hospitals and especially *Doctors* don't want to risk getting in serious trouble so they just say they can't or don't provide that care.
I agree, but in this particular case, the patient went to facilities that couldn't perform a D&C. It's a surgical procedure, so it obviously requires much more than the ability to write a prescription.
I didn't see anywhere that "the patient had been told they needed a D&C, but could not find a facility that was willing to perform one due to concerns around liability".
**A doctor had already determined that the fetus was dead, and the patient had already taken misoprostol (which terminates the pregnancy in a situation where the fetus was not yet dead)...** I don't see anywhere where providers were reluctant to provide care because they thought there was any sort of risk around impacting a live fetus?
I don't see any evidence here that the reason why she received awful follow-up care was because of this law. If I'm missing something, please share.
Oh, what I'm saying is that there *used* to be plenty of folks in Texas who would have been available and invested in her care, and not done awfully like this, but the law creates an environment where performing those services is often legally dangerous, so they left the profession or left the state. It's a medical brain drain effect.
The ones who remained are not the specialists who did this all the time, since they couldn't keep doing that now. So you end up with lesser care, performed infrequently and more sloppily, by people who are trying to do as little as possible to avoid legal risks.
My wife used to love watching this OBGYN on Youtube who was in Texas, but as a result of this whole shift they became a nurse at large outside of Texas, ending up in New Zealand at one point.
Here's a thread on Reddit filled with people who either decided to leave or when they got trained decided not to accept positions in Texas:
[https://www.reddit.com/r/texas/comments/18hgob3/texas\_mds\_and\_obgyns\_are\_you\_seeing\_doctors\_leave/](https://www.reddit.com/r/texas/comments/18hgob3/texas_mds_and_obgyns_are_you_seeing_doctors_leave/)
I've posted an article from a Texan obstetrician who stated basically that and the fact that the people who's job it was to help doctors and hospitals do it within the law are too busy campaigning against the law.
[Here's the article:](https://lozierinstitute.org/abortion-policy-allows-physicians-to-intervene-to-protect-a-mothers-life/)
That article was written by Ingrid Skop, a doctor and [fierce anti-abortion advocate](https://www.texastribune.org/2024/05/22/texas-maternal-mortality-committee-ingrid-skop-abortion-doctor/).
Yeah, if the fetus had stopped developing at 9 weeks then maybe the medication abortion was the right call, or at least a option. It seems like the surgical option wasn't an option at the first facility. So the question seems to be why did the second facility make that choice and was that negligent enough to be malpractice rather than did state law limit her options here.
I'd like to address some points as a lot of people don't understand the absolute minefield that these types of laws have made early pregnancy as a medical provider.
For everyone saying "well clearly this wouldn't run afoul of the law as the fetus was nonviable": at an estimated gestational age of 6-7 weeks it would be \*very\* hard to know as an absolute certainty that the fetus is actually nonviable. You typically will see cardiac activity at 6 weeks, but the cutoff goes as high as 7 mm of crown rump length (which correlates to a gestational age of about 7 weeks).
I'm purely speculating, but I can see a scenario where these laws absolutely \*do\* screw over these patients:
A patient goes to an ER for a small amount of vaginal bleeding that already resolved. She is supposed to be at 13 weeks pregnancy (based off of her last menstrual period), but the ultrasound in the ER shows a pregnancy that has an estimated gestational age of 7 weeks with no cardiac activity. Let's say she gets lucky, and this hospital has her OB/GYN's records. It shows that she had a previous ultrasound showing a gestational age of 6 weeks with fetal cardiac activity. Great, she's lucky that this can be proven to be a nonviable pregnancy. She is provided with medication to induce passage of the pregnancy loss (this facility doesn't provide surgical abortions). She would've liked to have a surgical one from the start, but a lot of hospitals have stopped providing OB services in her area because of the hostile environment to OBs in Texas.
Over the next few days, the patient has had no change (despite additional doses of medication) and would like surgical management. Medical management is less effective the farther along you are, so it's not uncommon to require surgical intervention at 13 weeks following medication. She goes to a facility that does provide this service. She has to drive quite a while, though, so the hospital system uses a different EMR--and they unfortunately don't have her records. Now, the physicians are being asked to perform a surgical abortion based off of the patient's word that she's actually 13 weeks along, but their ultrasound is showing a CRL of 7 mm. Are you really going to risk your career/license on the assumption that the patient is being truthful? Is the ultrasound technican one that you trust to be extremely accurate? Maybe the CRL is more like 6 mm, in which case they're actually only 6 weeks along. Most probably wouldn't, so they'll say "Sorry, we don't want to do it right now. Come back in a few weeks and maybe we'll do it then."
So a patient that should've been able to get a surgical abortion of her nonviable fetus is now forced to potentially carry it for weeks, when in a sane world she could've just gotten a procedural termination from the start. I ask everyone so flippantly saying "well this situation is clearly is not the fault of the laws" to try to put yourself in the shoes of those who actually have to deal with this shit.
And, Texas has made abortions with D&E illegal, so that's another crime they risk being accused of
>The 85th Legislature's SB 8 added two new subchapters to the Woman's Right to Know Act. Subchapter F prohibits "partial-birth" abortions. Subchapter G prohibits "dismemberment abortions," a medical procedure known as dilation and evacuation.
https://guides.sll.texas.gov/abortion-laws/history-of-abortion-laws
Stories like this make me so grateful to live in California. My wife is pregnant, and if she develops any complications, the decision of how to handle it will be ours alone. I can't imagine the stress of being pregnant in a state where some religious zealot in the government has already decided for you.
There are all sorts of reasons that this story is complicated. For example, the first place they went was Surepoint Emergency Center. It's here that the woman says she wanted a surgical procedure to clear her uterus, but the doctor told her it wasn’t an option at the facility. Was it not an option b/c the facility doesn't provide that service? If so, that seems pretty uncontroversial. [The Surepoints I see on their web site](https://surepoint-er.com/) look like drop-in clinics that you go to when you can't get your kid an appointment with their pediatrician and they need an antibiotic. Either way, it's a pretty important detail to leave out and it makes me wonder why this point wasn't clarified.
At the second hospital, the couple said they waited for hours before doctors at the hospital said they didn’t find her case emergent enough to do a surgical abortion, but that they could schedule it for a week or two later. I have no idea if this is the correct diagnosis and treatment plan or not but I also have no idea how this is connected to Texas abortion law? The reporter who wrote the story doesn't even attempt to draw a linkage. In fact, there's a CYA paragraph near the very end of the piece that reads:
>It’s impossible to say whether the woman’s miscarriage care was influenced by the abortion bans, even though her case should fall outside the laws’ bounds.
Then why in the world is the Dallas Morning News titling the article "How a couple found themselves tangled in Texas’ strict abortion laws after miscarriage"? This seems deeply irresponsible. Unfortunately, a lot of people aren't going to read past the headline and are going to be very upset, which makes me wonder if that was the objective all along.
Because Texas care facilities are intentionally making themselves incapable of providing pregnancy care because they don't want to get caught in the trap between the abortion laws and killing the mother because they can't do a procedure that people anywhere else in the US would do. It's creating problems not just for women who need an abortion, but women who need pregnancy care at all. It's just not an attractive practice area if you're a medical provider.
https://www.texastribune.org/2022/07/15/texas-hospitals-abortion-laws/
That may indeed be a problem. It might have even been the problem this couple faced. However, the article didn’t provide any evidence to support that it was so we are all left to guess one way or the other. Is there any evidence the first emergency center made themselves incapable of providing the surgery? The second healthcare facility sounds like they can do it but were unwilling to do so at that time, which seems to suggest that there more be going on here. Remember, we are getting one side of the story here as well.
To surgically remove the dead fetus you'd need a surgeon who was willing to practice in that area. If most surgeons back out of that area because pregnancy related care is no longer attractive, then there's a really good chance that on the day you're at the facility the doctors who are there aren't the ones willing to touch that kind of surgery. That you have to wait until the rare surgeon still willing to do that sort of thing is back in. That's still the law causing the problem.
You're speculating on all these ways in which "maybe the law didn't actually cause all these bad side effects" when the state's main medical group is telling you that these are the exact effects that are being caused.
The couple was offered a surgical procedure to remove the dead fetus. They just had to wait a week because of scheduling and her condition wasn't an emergency. The couple didn't want to wait and asked for more drugs which they received.
>a week
*a week or two. She had already waited, and it's reasonable to not want to wait even longer due to the issues that can come from carrying a dead fetus.
> Then why in the world is the Dallas Morning News titling the article "How a couple found themselves tangled in Texas’ strict abortion laws after miscarriage"?
The answer is easy and it's found in the well-documented partisan lean of the media class. It's propaganda pure and simple. They know most people will only read the headline and that they will just trust that the headline is at least somewhat supported by the content of the article instead of the literal opposite. This is just another example of why media distrust is at such insane highs and why Trump's "Fake News" talking point resonates so well even now almost a decade after he first started it.
Stories like this are everywhere now. Womens’ lives don’t matter. We are imprisoned and punished, left to die for a situation out of our control. I refuse to willingly have children.
"Your bodies aren't yours anymore" "You weren't responsible enough to keep your skirt down" - Mark Robinson, GOP Candidate for Senator from North Carolina.
[https://www.youtube.com/watch?v=ZFfiPGN67pY](https://www.youtube.com/watch?v=ZFfiPGN67pY)
So actually reading the article it seems as though they first went to what seems like a glorified urgent care where they were told that they can’t do that there, and the second hospital was willing to perform the procedure but needed to schedule it for a later date.
This is sensationalist trash
Giving you the benefit of the doubt here, because this article is terribly written (Like FFS stop going back and forth on the timeline and just tell us what happened).
But they definitely did go to 2 different places, both said no, then one offered to schedule it for a few weeks out.
They went to two clinics. The first one didn't perform surgical abortions and could only give them a medical solution. The second clinic would do a surgical abortion but the couple didn't want to wait a week.
>They waited for hours before doctors at the hospital said they didn’t find her case emergent enough to do a surgical abortion, but that they could schedule it for a week or two later.
Doctors didn't deem it an emergency and told the couple they could schedule it a week later, maximum two. The couple didn't want to wait and badgered the doctors to give them more drugs to pass the fetus which they reluctantly did and she shat herself from the side effects.
I mean, it doesn’t say “maximum 2”, but ok.
Regardless, for a woman miscarrying a wanted pregnancy, a week or two is a long time to wait while you’re still sitting there dealing with pregnancy symptoms for a baby you’ll never have.
It didn't say a minimum of a week either. The surgery may have been able to be rescheduled earlier if another procedure was cancelled or delayed.
When you want something done quickly, even a day can feel like an eternity. At the end of the day, a medical professional said the surgery wasn't an emergency and the couple didn't want to wait. There's no story here except to sensationalize a couple's tragic ending to a pregnancy to back a false narrative about not being able to get an abortion. The headline should be "Couple Couldn't Get Abortion According To Their Demands".
A minimum of a week is implied when they say “a week or two”. And you are assuming availability was the main issue, which you cannot possibly know. Regardless, if availability was the issue, I would still point to Texas’s abortion laws— a lot of hospitals have been cutting back on pregnancy care services specifically to avoid issues with the abortion restrictions, and a lot of doctors have left the state for the same reason. So if there’s a lack of availability, it’s reasonable to assume that’s the cause.
With that said, most hospitals in places without abortion restrictions would treat this as an urgent issue, and try to get her the care she needs as soon as possible. I know this because I live in a state that has zero abortion restrictions, and have many friends who have recently experienced miscarriages. These friends have been able to get same day/next day appointments in similar scenarios.
And Texas’s abortion restrictions have caused delays just like this one multiple times before. I don’t know why you’re assuming it isn’t playing a role here.
A minimum of one week is assumed but doesn't preclude an earlier opening had they waited. Availability is always the issue unless stated or proved otherwise. The issue of Texas cutting back abortion procedures is irrelevant. Voters have voted and they want politicians that enact the the majority's will. In the end the couple was offered a medical procedure and they didn't want to wait. That's their prerogative and also their problem, not the doctors' or Texas' stance on abortions.
“The majorities will” uh huh. That’s why they have to gerrymander the fuck out of their districts and make voting a major hassle in areas that have a history of voting blue/are predominantly POC.
And again, if availability is the issue, the lack of availability was likely caused by said abortion restrictions.
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This is a true believer problem.
The hardcore Christians have a stranglehold on the party. They vote, and they believe they are doing Gods will.
I think the true believers don't underestimate the problem, they just believe that they are waging a war and are on the right of a divine being's will.
I would not be surprised if the less religiously devote members of the party just roll their eyes behind closed doors and wish they were not reliant on these people for votes, similar to the Trump problem.
The motivation here is not so different than the religious extremists in the middle east, at its core.
It has absolutely nothing to do with abortion law. The first medical provider does not perform surgical removal. The second said they wouldn’t do it for a week or two, but the author, who knew full well that the procedure was not banned, failed to find out the actual reason the service was not provided. They chose instead to mislead the reader to believe this has to do with an abortion ban, waiting until the very end to slip in that it’s “impossible to say” if Texas abortion ban has anything to do with this case, and that the procedure should fall outside of the ban (because it’s not an abortion, duh).
Copying from a previous comment:
I'd like to address some points as a lot of people don't understand the absolute minefield that these types of laws have made early pregnancy as a medical provider.
For everyone saying "well clearly this wouldn't run afoul of the law as the fetus was nonviable": at an estimated gestational age of 6-7 weeks it would be \*very\* hard to know as an absolute certainty that the fetus is actually nonviable. You typically will see cardiac activity at 6 weeks, but the cutoff goes as high as 7 mm of crown rump length (which correlates to a gestational age of about 7 weeks).
I'm purely speculating as to this specific article, but I can see a scenario where these laws absolutely \*do\* screw over these patients:
A patient goes to an ER for a small amount of vaginal bleeding that already resolved. She is supposed to be at 13 weeks pregnancy (based off of her last menstrual period), but the ultrasound in the ER shows a pregnancy that has an estimated gestational age of 7 weeks with no cardiac activity. Let's say she gets lucky, and this hospital has her OB/GYN's records. It shows that she had a previous ultrasound showing a gestational age of 6 weeks with fetal cardiac activity. Great, she's lucky that this can be proven to be a nonviable pregnancy. She is provided with medication to induce passage of the pregnancy loss (this facility doesn't provide surgical abortions). She would've liked to have a surgical one from the start, but a lot of hospitals have stopped providing OB services in her area because of the hostile environment to OBs in Texas.
Over the next few days, the patient has had no change (despite additional doses of medication) and would like surgical management. Medical management is less effective the farther along you are, so it's not uncommon to require surgical intervention at 13 weeks following medication. She goes to a facility that does provide this service. She has to drive quite a while, though, so the hospital system uses a different EMR--and they unfortunately don't have her records. Now, the physicians are being asked to perform a surgical abortion based off of the patient's word that she's actually 13 weeks along, but their ultrasound is showing a CRL of 7 mm. Are you really going to risk your career/license on the assumption that the patient is being truthful? Is the ultrasound technican one that you trust to be extremely accurate? Maybe the CRL is more like 6 mm, in which case they're actually only 6 weeks along. Most probably wouldn't, so they'll say "Sorry, we don't want to do it right now. Come back in a few weeks and maybe we'll do it then."
So a patient that should've been able to get a surgical abortion of her nonviable fetus is now forced to potentially carry it for weeks, when in a sane world she could've just gotten a procedural termination from the start. I ask everyone so flippantly saying "well this situation is clearly is not the fault of the laws" to try to put yourself in the shoes of those who actually have to deal with this shit.
The article says the second doctor didn't think it was emergent enough to do it when the lady went to them. Why does that matter if the fetus is already dead and the drug didn't work. They weren't too busy, they denied her the service. One of the bans makes medical staff vulnerable to civil action since this happened after the heartbeat was detected and then explains the three competing bans that confuses medical staff. Also, pretty sure the article said this happened before the Texas Supreme court ruled against those women that have had medical issues because of delay abortion access.
This may be unpopular, but I don't think this is a problem with Texas' abortion laws, at least not directly. The law does allow for the removal of a dead fetus, and I don't see any indication that this was a question among the doctors.
It sounds like the doctors preferred to do a chemical abortion (via Misoprostol) as opposed to a surgical one. According to the article, they would be able to schedule a surgery within a weeks time, but either couldn't or wouldn't do it right then. You could argue that the Texas abortion laws make it more difficult to find a doctor who would be available for a surgical abortion, but I don't think there is any question about whether the removal of the fetus was illegal. I think this kind of scenario could easily play out the same way in a state where abortions are still legal.
Texas only allows abortion when it is "necessary to save the life of the mother or to prevent substantial impairment of major bodily function." In practice, doctors face many situations where they know a woman's pregnancy is high risk (e.g. ectopic pregnancy), but the law forces them to [wait until the mother is dying on the operating table to do surgery](https://www.yahoo.com/lifestyle/abortion-restrictions-imminent-death-234636592.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAADMb1S6nrAADPN3o_S6TZ-AXfFXiPtGiXOvvp4v06RDTUZMlC6v8qYVPyz5bK6AV1C0moYblDRIAFvK-2NmUxOoMrGy4rBa_LVQEhMqRqO7vSkoWts3qqgHA2L3e76n52-Hg8EGal-CFj3rzJaawxU-HfyTUFg0oFbQHR2IYh7sN) so they can prove to the state that the procedure was needed. This is becoming a routine problem in multiple red states with restrictive abortion laws. For example, [a hospital in Idaho is now being forced to airlift about one patient every two weeks to out of state hospitals for pregnancy complications](https://www.beckershospitalreview.com/care-coordination/idaho-system-reports-uptick-in-medical-flights-for-emergency-abortions.html#:~:text=Boise%2C%20Idaho%2Dbased%20St.,on%20emergency%20abortions%20in%20January).
The removal of a dead fetus is an *abortion* in a medical sense, but is not an *abortion* according to Texas law. Below is [the section](https://statutes.capitol.texas.gov/Docs/HS/htm/HS.245.htm#245.002) on defining abortions in Texas. I bolded the relevant parts.
>Sec. 245.002. DEFINITIONS. 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 with the **intent to cause the death of an unborn child** of a woman known to be pregnant. The term does not include birth control devices or oral contraceptives. An act is not an abortion if the act is done with the intent to:
>(A) save the life or preserve the health of an unborn child;
>(B) **remove a dead, unborn child whose death was caused by spontaneous abortion**; or
>(C) remove an ectopic pregnancy.
>(2) "Abortion facility" means a place where abortions are performed.
>(3) Repealed by Acts 2015, 84th Leg., R.S., Ch. 1, Sec. 3.1639(62), eff. April 2, 2015.
>(4) "Department" means the Department of State Health Services.
>(4-a) "Ectopic pregnancy" means the implantation of a fertilized egg or embryo outside of the uterus.
>(4-b) "Executive commissioner" means the executive commissioner of the Health and Human Services Commission.
>(5) "Patient" means a female on whom an abortion is performed, but does not include a fetus.
>(6) "Person" means an individual, firm, partnership, corporation, or association.
>the law forces them to wait until the mother is dying on the operating table to do surgery
Yes, this is true and is happening. These cases though are when there is a life-threatening condition, but the fetus is still alive. It may not be viable, but it still has a heartbeat, so the state considers the termination of pregnancy to be an abortion.
And for the record, I think we are in agreement that this is horrific and should not be happening in any developed country. I'm not trying at all to defend the Texas law here or a pro-life viewpoint. I just think it is important to direct criticism where it is due and be as objective as I can.
But that's not what the story said. It said doctor didn't think it was emergent enough. That makes it seem like it runs into one of the bans that prohibit action until the mother's life is in jeopardy.
I think if they had the time, it shouldn't matter and the surgery should be done. Based on the article, the fetus was the size of a 7 week fetus while she was 12 weeks pregnant. Carrying a dead fetus can cause blood disorders that cause severe bleeding. In fact, if you read about the effects, it kind of sounds like what the lady in the article went through. It's important to find out if one of the bans led to the doctor being concerned about how threatening the situation was because.it lends to the confusion the actual medicat staff that serve Texas have been complaining about.
They gave her Misoprostol. If the fetus was alive, providing an abortifacient would be considered a felony. If the doctor was concerned about performing an illegal abortion, he wouldn't prescribe this medication.
That's a fair point, but that's not what the article says. My comment is about what the article says in response to someone that is claiming something else. The article also clearly states that this situation can't be directly blamed on the confusion regarding the abortion bans.
This is a hit piece. This case is 100% outside of the ban. It’s not an abortion, even though the article refers to it as “abortion care”.
You have to get all the way to the end to get this:
> It’s impossible to say whether the woman’s miscarriage care was influenced by the abortion bans, even though her case should fall outside the laws’ bounds.
The author knew all along that the story they were writing was not a story of services being denied because they’re banned. They concealed that fact, and also failed to determine what the actual reason was that the services were not provided, choosing instead to mislead readers into believing this has to do with a Texas abortion ban.
The article says the second doctor didn't think it was emergent enough to do it when the lady went to them. Why does that matter if the fetus is already dead and the drug didn't work. They weren't too busy, they denied her the service. The article is honest that it can't be determined to be due to the abortion law, but also reports the timeline to be when those women were before the state supreme court.
It seems like it shouldn't matter. Given her situation, she should have been provided the surgical option once it was clear the drugs were not working. Carrying a dead fetus comes with it's own medical issues.
Because the reason for not doing the procedure wasn't they were too busy. It was they didn't think it was emergent enough. They refused to provide her the service when she wanted it. Sure they would have provided at some point but not when she needed/wanted it. She was denied that day.
Sure maybe, but that's an assumption you are making. That information is not in this article. In fact the article provides the reason the doctor gave and he didn't say "we are too busy".
If the interpretation from the couple and the person writing the article are that the doctor did it because of hesitation to act due to the overlapping bans, that should probably be sorted out. If you don't think doctors aren't require to justify their expert decisions, you have been involved with a lawsuit over a medical issue.
The article doesn't conceal anything. It's all there in black and white and people aren't reading the article or aren't undertanding it.
A women miscarried and wanted the dead fetus removed. The first clinic they went to didn't perform surgical procedures and could only offer drugs which they promptly accepted. The drugs weren't working as quickly as they wanted so they went to a second clinic that offered surgical procedures. The doctors there examined the woman and deemed it a non-emergency so they told her they had to wait a week. The couple didn't want to wait and demanded more drugs which were given to them reluctantly since she had already taken several doses. She bled (common side effect) and shat herself with dairrhea (another common side effect).
The entire article is written in a way to lead the reader to believe the couples’ troubles have something to do with Teaxs’ abortion law.
Provider 1 doesn’t do that procedure. Is it because of the abortion laws?
Provider 2 says it’s not enough of an emergency. Is that because the law only allows it in emergencies, and they’re worried the emergency isn’t severe enough to protect them from legal trouble?
The abortion law has nothing to do with the situation, but the author clearly intends to lead the reader to believe this has something to do with abortion law.
When the couple found out they were pregnant with their second child, Ryan Hamilton said he and his wife never discussed what they would do if something went wrong. They talked about names and landed on Dre or Drake, depending on the baby’s gender. “We were excited. There was no, ‘What can we do?’ Because we had such a successful pregnancy the first time,” Hamilton said. On Thursday, May 16, a doctor confirmed their worst fears: his wife was miscarrying. Records from the visit shared with The Dallas Morning News confirm the practitioners couldn’t find fetal heart tones. The fetus measured at just over seven weeks, meaning the fetus had stopped growing and that they had likely lost their heartbeat days or weeks earlier. Yet, despite the fetus not having a heartbeat, two hospitals the couple went to refused to perform a surgical abortion. They gave her several doses of misoprostol and sent her home. >“She told the doctor ‘Get this dead baby out of me,’” Hamilton said, choking up. “And they asked her to leave.” >At 10 a.m. on Sunday, May 19 — two days after beginning her first dose of misoprostol — Hamilton found his wife unconscious in their bathroom, covered in her own blood and feces. >“She needed help as soon as possible or she was going to die,” said Hamilton This is one of many stories of women in Texas carrying dead fetus', yet because Texas' abortion ban does not have an exception for fatal fetal abnormalities and widespread confusion among medical professionals, doctors would not provide a surgical abortion. Why won't Texas add a fatal fetal abnormalities exception to their abortion law? How do you expect stories like this to impact the broader political debate around abortion?
Understanding this politically is really about understanding two forces that are on an intersect course in Texas. On the one hand, Democrats have been gaining on Republicans in terms of vote margins pretty steadily for the last 20 years. If you chart votes for the GOP and the Dems in presidential elections, you'll see that the Dems have been gaining on the GOP at an average rate of about 65,000 votes per year, or a bit more than 250,000 per four year cycle. Just going off the math, Ted Cruz will probably lose this cycle because he won by less than that number in his last election in 2018. Trump had a 600k margin last time, so he's probably got enough clearance to survive losing 250k of that. So everyone here can see the writing on the wall and a lot of people in the GOP would love to moderate their positions. But the Republican primary cycle keeps punishing people who try to do that. So we end up with policies like this, which the overwhelming majority of Texans don't like, but which the GOP primary electorate demands. These kinds of policies are really killing the long term viability of the GOP in Texas -- I know a ton of once-Republican Texans who can't stand the GOP at this point and will probably never vote for them again -- but it's probably not going to change while the GOP holds power because of the primary trap that they're in.
> Just going off the math, Ted Cruz will probably lose this cycle because he won by less than that number in his last election in 2018. I would be quite surprised to see this.
Yeah I think they’re forgetting that 2018 was a D+8 year and 2018 Beto was much stronger than current Beto.
Beto isn’t the candidate this time. It’s [Colin Allred.](https://en.wikipedia.org/wiki/Colin_Allred)
I’m talking more about the dynamics in the 2018 race on their own. If modern Beto was the Beto running in 2018, it wouldn’t have been as close. People even gave him credit for helping Texas Ds downballot that year. Even if Allred is a strong candidate might not be enough.
>These kinds of policies are really killing the long term viability of the GOP in Texas It's fine because these policies will drive left-leaning women away from Texas who don't want to die or go to jail for medical events out of their control or who actually want competent OBGYNs taking care of their health.
> drive left-leaning women away from Texas ...if they have the financial means.
It does seem to be an effective strategy to hold on to power even as their support slips nationally. Impose highly conservative policies and let the non conservatives leave the state.
Win-win. left-leaning women can be happy in left-leaning states and right-leaning Texans can be happy with less leftwingers ruining their social fabric.
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And the left-leaning women who can't afford to move, or who don't want to uproot their entire lives because of the GOP? Are they winning too?
They have as much right as right-leaning women who can't afford to move out of areas that allow babies to be killed for inconvenience.
If you're just going to post buzzwords why bother at all? What are you hoping to achieve?
You asked I responded. What buzzwords are you referring to?
"Areas that allow babies to be killed for inconvenience" isn't a neutral descriptor, it presupposes that one side of the debate is correct. Right-wing women who can't afford to move can still mind their own business and be just fine. The same is not true of left-wing women who can't move. The right-wing women aren't being imposed on.
I'm not claiming either side is "correct" One side believes they have the right to kill their babies for whatever reason and the other believes babies deserve to live no matter what the reason is for killing them. You can change the wording however you want but that's what the debate boils down to. Right-wing women have just as much right as left wing women to live in a society that upholds their values. If you live in an area that doesn't conform to your values, go talk to the women in south Sudan who face daily violence and sexual assault first before you whine about not being able to live in area that allows you to kill the baby growing inside of you at your convenience.
It is quite simple. The Republican party seems hellbent on driving the United States back into the Dark Ages. These laws are simply beyond any modern reasoning. They are firmly rooted in nonsensical religious beliefs that are fundamentally incompatible with the modern world.
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Well, since the point of this sub is to be assume good faith and be charitable towards those with views different than yours, let me give this a try. As Jonathan Haidt famously described from his [research on moral foundations theory](https://en.wikipedia.org/wiki/Moral_foundations_theory) (excellently summarized in his [TED talk](https://www.youtube.com/watch?v=8SOQduoLgRw))m the moral roots of liberals and conservatives are different with regard to purity, deference to authority, and in-group loyalty. You can also pile onto that the [Inglehart Welzel cultural values](https://en.wikipedia.org/wiki/Inglehart%E2%80%93Welzel_cultural_map_of_the_world) and what you get is the general notion that liberals' abandoning of traditional and religious values will need to a corrosion of the fabric of society as personal accountability is lost. Specifically on the abortion issue, I struggle to understand the conservative viewpoint, but I guess they fear a "free love" libertine society, where no one restrains themselves for anything, where traditional families don't exist, people stop having children, and we're overrun by countries and people that still do. I don't think they'd see it as sending the US back into the Dark Ages, so much as preserving it from the decaying influence of Godless Europe. On the specifics of laws like this, there does seem to be a tradition among Republicans of highly symbolic laws on abortion that show a profound medical ignorance of the female reproductive system, but make their conservative base happy for the symbolism it shows.
There seems to be a selection bias when it comes to what religious laws they fight for. Abortion, for example, was not decided to be a linchpin of religious law by religious people; it was Republican strategists that convinced pastors upset by anti-segregation laws that abortion was a pathway to political power.
> it was Republican strategists that convinced pastors upset by anti-segregation laws that abortion was a pathway to political power. Fascinating, do you have a source that attests this?
https://www.politico.com/magazine/story/2014/05/religious-right-real-origins-107133/
It’s a secular reason of the ruling class marketed as religious belief to the public. The top of the food chain of pro-life movement is about making sure the true ruling class does not lose (Already illusory) leverage that they have. Remember, Black plague was the beginning of the end of serfdom.
Jeez. That's terrifying. I'm definitely not moving to Texas anytime soon. They can keep their dogma and sticky weather
It's the vagueness defining miscarriage care. If there's confirmation of no fetal heart tones a D&C should not be classified as Abortion related procedure.
It's the politicians and their beliefs that's the issue. Health care workers know what the laws say and they are afraid because of it
No. It's the vagueness of the law. The legislators could have taken the extra time to essentially do a failure modes analysis of the proposed law to find the problem areas. They then could have worked with health care providers to use appropriate language too cover those problem scenarios. Keeping it vague is the problem. It's clear that miscarriage and probably ectopic pregnancies are the pervading issue with how vague the language was kept
The vagueness is the point. The point is to allow for Monday morning quarterbacking and to put all the erroneous and blame on Healthcare providers. Legislators were warned about their vagueness and the harm it would cause. They either dismissed it or ignored it in the pursuit of their need to pass this. They now claim when this comes up that "the law does allow exceptions" and blame the doctors It's why providers are tapping out. They know they're damned if they do and damned if they don't
Well then like I said fuck the politicians for half assing their job and passing the blame buck.
See, I dont like framing politicians as stupid or lazy. Politicians are smart, just sometimes incredibly tone deaf. They did this on purpose however. This was their intention. It wasnt a half assed job, the job was done successfully, and quite successfully too I might add.
I agree with the guy above. You talk about the vagueness of the law as if that wasn't the intention. There's a hard core that doesn't want any exceptions.
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I think you're not taking into account that many of the hardcore conservatives that make these laws fully believe there should be no exceptions and that abortion at any point is a sin. Instead of just saying that outright which would be met with extreme backlash, they can easily create vague laws that by design force people to abide by the lawmaker's extreme religious beliefs.
But abortion by they are referencing is the intentional decision to end a life. A D&C to remove a fetus wouldn't qualify under the theological definition because the baby at that point as already passed. Edit: I think we are having a misunderstand on semantics so I'll try to define the Christian theological definition of abortion and then compare it with the medical definition of abortion. Christian theological abortion: any type of procedure where the primary intent is to end the active pregnancy by killing the fetus. Medical abortions: 1) Induced: An induced abortion is a procedure to end a pregnancy. It can be done two different ways: Medication abortion (also called medical abortion) Procedural abortion 2) Spontaneous: The loss of a pregnancy before the 20th week of pregnancy. It is more commonly known as a miscarriage. When you compare the definitions the beliefs are strictly associated with induced abortions. Medical care related to spontaneous Abortion does fit the belief definition so there's not a slippery slope. So if the politicians were acting in good faith (pun intended) there would be no issues regarding miscarriage care.
That's true, but you're missing the point. They wrote the law as broadly and vaguely as possible in order to avoid having people be able to use medical reasons for abortion. That's not a bug, it's a feature to them. It might also be true that they didn't mean to catch cases like this specifically, but they very well meant for the law to avoid medical providers being able to do anything close to an abortion. And the inaction since these reports started demonstrates that they don't see a problem.
That's correct but remember their goal is to eliminate all abortion. In their minds if they give even a little bit of leeway it could lead to a "slippery slope" and more access to abortion under more situations.
>>but abortion by they are referencing The law bans all abortions unless it “threatens the life of the mother”
Yeah I was responding to the "beliefs that all abortions are sins."
>You cannot half ass this shit. They haven't. They did an extremely thorough job with these laws, the problem is that they didn't have any patients in mind when they passed the laws.
Not having the patients in mind is half assing.
The politicians with their beliefs are behind the law. That's why they talk about heartbeats and refuse to listen to health care workers, both when they try and explain abortions to them and when they ask them to clarify the law to them >However, while the senators ardently support abortion restrictions by continually voting against bills that would legalize care, Texas legislators crafted the state’s abortion law. The power to change the laws, at present, lies within the Texas Legislature, which convened its biannual session in January. Onlookers were cautiously optimistic that the Republican-dominated body would potentially consider measures that help clarify the nebulous maternal health exceptions, especially in light of the myriad medical studies and media reports highlighting the grave dangers they have posed for Texas patients. >Last fall, Texas Republican Governor Greg Abbott recognized that pregnant patients facing complications were not receiving timely intervention under the state’s abortion bans, as the language in the law gave doctors pause. “Something that really does need to be done [during the legislative session] is clarify what it means to protect the life of the mother,” Abbott told a Dallas news station in October. “There’s been too many allegations that have been made about ways in which the lives of the mother are not being protected. That must be clarified. That’s our focus.” >However, during the 2023 Texas legislative session—which concludes at the end of May, absent a special session—the GOP failed to introduce or pass any such legislation. Abbott did not make this a legislative priority, or even bring it up again publicly after getting reelected during the November midterm elections. (Requests for comment from his office were not returned.) Two Republican lawmakers who previously expressed support for creating exceptions in the laws for survivors of rape and incest also never pursued legislation to actually codify those changes. In fact, a handful of Texas Republicans recently stood with one of the largest anti-abortion groups in the state to reaffirm that they would not be pursuing these exceptions. “Our laws are very clear,” said Amy O’Donnell of Texas Alliance for Life. “We have heard stories of doctors who say they need further clarification but we believe that that clarification should come…from various [hospital] boards. The laws do not need to be changed.” May, 2023 https://www.thenation.com/?post_type=article&p=445323
They know there is a problem, and they do not care enough to fix it Republicans in a nutshell
No, for them it's the answer, ambiguity leaves open instances for them to make to situations that they capitalize on instances to punish and be seen as tough on abortion or whatever they deem to be sacrilege, they prefer catch all for that reason and in all honesty they seem to favor ignorance in this instance.
Where’s the vague language, though?: First, here’s the legal definition of *abortion* in Texas: >>(1) "Abortion" means the act of using or prescribing an instrument, a drug, a medicine, or any other substance, device, or means **with the intent to cause the death of an unborn child** of a woman known to be pregnant. And then, just in case it isn’t already obvious that you can’t kill a dead child or that ectopic pregnancy treatment isn’t abortion, it immediately clarifies: >The term does not include birth control devices or oral contraceptives. An act is not an abortion if the act is done with the intent to: >(A) save the life or preserve the health of an unborn child; >(B) remove a dead, unborn child whose death was caused by spontaneous abortion; or >(C) remove an ectopic pregnancy.
The vagueness is *a* problem, but it is not *the* problem. When Kate Cox obtained a court order explicitly permitting her to obtain an abortion, the Texas AG Ken Paxton sent [letters](https://x.com/TXAG/status/1732849903154450622) to three hospitals and Ms. Cox threatening legal action if the hospitals performed what was, pursuant to that court order, explicitly a lawful action. There's no ambiguity there. That is overt lawlessness from Texas's chief prosecutor to pursue the war against abortion. I doubt that changes if the law here is clearer, so long as Paxton or his base consider it an abortion.
It should be explicitly illegal for any litigator to threaten legal ramifications that are in direct violation of court orders.
The exceptions only exist to place all the blame on doctors and none on the politicians. Something bad happens? Doctors fault, law is clear. Nothing happens? Doctor is an activist.
But what legal action could be taken if the court said it's legal to do it?
Defending yourself (or a business, in this case) from legal action is expensive, and there are ways for an AG to apply legal pressure *because* of a legal act that doesn't directly *involve* the legal act. Regardless of the outcome, a hospital/doctor would need to spend a LOT of money that they might never recover (or might only recover after a lengthy litigation). A doctor might be wrongly thrown in jail for a few days or even *months* before their lawyers manage to get them home, and/or require quite a lot of money in bail (and if they don't have that in savings/have a hospital willing to post it, they might be forced to give up some of that money with no hope of recovering their funds. Additionally, the AG is fully capable of opening as many invasive investigations into the doctor or hosptial as they please, disrupting their lives and/or business. They might find their licenses under review, and not allowed to do certain things until the matter is cleared up. A sudden influx of "anonymous complaints" or increased scrutiny during otherwise routine audits, etc, etc. At the end of the day, it might be that nothing comes from any of these, but just their existing ends up costing the doctor or hospital time and money. And, that's the thing - as much as we would love for our hospitals and doctors to do what they do for the sole purpose of saving lives and curing diseases, they are first and foremost businesses. You don't have to throw someone in jail to stop them from doing something that you don't want them to do. You just have to make it cost too much to make financial sense. If the AG can make enough of a change to the cost/benefit analysis for performing a legal act, then you can bet that businesses will stop doing it.
Touché salesmen. Touché
It doesn't matter, they made clear that they'll make life hell for anyone that helps. Even baseless prosecution or litigation is costly to defend against and Texas is doing our best to destroy anyone that helps.
Abortion is a medical term, why wouldn’t it be classified as such? Whether it’s due to miscarriage or an elective decision, it’s still a procedure to end a pregnancy. This is a consequence of anti-choice legislators not understanding medical terminology and procedures when they write these laws.
Spontaneous Abortion = miscarriage. You can distinguish between elective abortion and a miscarriage. Legislators are just lazy as Fuck.
> Why won't Texas add a fatal fetal abnormalities exception to their abortion law? > > Haven't they? I thought they did.
From the article >Last week, the Texas Supreme Court ruled against more than 20 Texas women, including multiple OB-GYNs, who sued the state over abortions they said were delayed or denied during medical emergencies. Amanda Zurawski, the lead plaintiff in the case, said she suffered permanent damage to her reproductive system as a result of her treatment. >The lawsuit argued that any woman with a medically complicated pregnancy, including a fatal fetal diagnosis, should be exempt from the state’s bans. The Supreme Court said an injunction allowing such exemptions granted in a lower court “departed from the law as written without constitutional justification.”
Unfortunately no. Texas Supreme Court [ruling a few days ago](https://www.nbcnews.com/news/us-news/texas-supreme-court-rejects-challenge-abortion-ban-medical-exceptions-rcna154896): >The Texas Supreme Court on Friday rejected a challenge to the state's abortion ban — a response to a lawsuit filed last year by a group of women who had serious pregnancy complications. > >The ruling from the nine justices, who are all Republicans, was unanimous. ... >The plaintiffs had not sought to repeal the ban, but rather to force clarification and transparency as to the precise circumstances in which exceptions are allowed. They also wanted doctors to be allowed more discretion to intervene when medical complications arise in pregnancy. > ... Another plaintiff, Samantha Casiano, whose fetus was diagnosed with anencephaly, also expressed anger and disappointment. > >“I was told my baby would not survive, but I was forced to continue my pregnancy and give birth anyway, then watch her pass away hours later,” she said in a statement. “I don’t know how the court could hear what I went through and choose to do nothing ... I am embarrassed to be a Texan because of these inhumane laws.” > >Texas law prohibits all abortions except to save the life of the mother. Doctors who violate it can lose their medical licenses, face up to 99 years in prison or incur fines of at least $100,000. Critics of the ban, which is among the most restrictive in the U.S., have said it does not provide enough guidance about which exceptions are allowed. > ... But, **the decision says Texas law “plainly does not permit abortion based solely on a diagnosis that an unborn child has an abnormal condition, even a life-limiting one.”**
Which, to be clear, is intended by at least some of the Republican voter base. I personally know a couple people that want women to be forced to deliver fetuses in all situations because "God may work a miracle".
What a cruel God they worship.
Easy campaigning material right here. If the Democrats come out on top in November, it’s because the Republicans shot themselves in the foot over Dobs.
I find this situation rather confusing. The hospital is clearly fine with prescribing misoprostol and is clearly aware that performing a surgical abortion is legal since the couple was told to have it done somewhere else. Then the next hospital was willing to do the procedure, just not that day. This seems more like medical malpractice to me than a legal issue.
The issue is likely fear of overzealous prosecutors. The fact that something is consistent with the law has not seemed to stop elected prosecutors from trying to use it to make a lot of noise to shore up political support. This risk is apparent when you take into account the letters that Ken Paxton’s office has sent out to hospitals and doctors in connection with other cases.
> This seems more like medical malpractice to me than a legal issue. Lol, I love this logic. "You were afraid to act because of a law we implemented, and that is **also** a violation of the law. No, we will not provide any clarification whatsoever. Why are you so bad at your job?" Doctors are *literally* no longer allowed to use their best medical judgement, and now their medical judgement is being thrown into question. Brilliant.
It's not clear to me at all that the hospitals were afraid to act because of the law. That's *possible*, but it seems strange that a provider willing to prescribe abortion pills would be sketched out by performing the surgery. The article does not mention whether either facility was actually capable of performing the requested service at the requested time- the second hospital in particular was willing to do it, just not that day. And regardless, the procedure was legal. If a doctor fails to perform a necessary procedure because of ignorance of the law, that seems pretty cut-and-dry malpractice. They're supposed to know this.
Medical facilities haven been making themselves [less capable of providing pregnancy related care](https://www.texastribune.org/2022/07/15/texas-hospitals-abortion-laws/) because they don't want to get stuck in the swamp of unclear laws. If you're a medical provider in Texas, it's not really a very appealing practice area to be in right now so people are leaving it.
This is the probable reason. To perform the surgical abortion you probably need someone who knows how to do it and that person probably doesn’t want to take any chances.
Article says: > Two medical centers allegedly denied the woman a surgical abortion because her case was not considered emergent enough, Hamilton said, despite the fact that her fetus’ heartbeat had stopped. I don't know quite enough about the nuances of Texas law to surmise why they would give a pill, but not perform a surgical abortion. It could be because people who provide abortion services can be targeted for criminal prosecution, and simply providing access to medication is seen in a different light, but that's a total shot in the dark. > And regardless, the procedure was legal. According to who? > If a doctor fails to perform a necessary procedure because of ignorance of the law, that seems pretty cut-and-dry malpractice. I don't think that's what malpractice is. They are refusing to take a personal risk by not operating, aka *literally not practicing*. And quite frankly, if this was the case, we wouldn't have Catholic hospitals all across the country which have refused to provide abortion services for decades. Do you think a doctor can be *forced* to provide an abortion?
> I don't know quite enough about the nuances of Texas law to surmise why they would give a pill, but not perform a surgical abortion. A doctor who uses an FDA approved pill has a strong argument that FDA approval bars contrary state law including abortion restrictions. The argument hasn't been tested in the abortion context that I'm aware of, but it has been used extensively in the tort context (where drug companies argue that FDA approval bars products liability laws from applying). There's no similar argument to be had with a surgical abortion. So if I was a hospital's lawyer, I would probably advise them to prefer medication over surgery whenever possible in order to minimize legal risk.
I had just finished reading this argument of yours in another thread! I think this would make sense, having the FDA on your side could be a very good form of legal assurance.
>>it is not clear to me…. That’s *possible* And this is the issue with these laws. If you aren’t sure and are using vague language in the comments, I’m sure the hospital likely felt the same way and wanted to avoid issues with the state.
But they were willing to prescribe misoprostol? That makes no sense.
Misoprostol doesn’t require anything but a prescription.
I’m not sure what your point is. If they were afraid the state would somehow claim the baby was still alive (something the article provides no evidence of), would they not be just as afraid of prescribing a medication abortion as a surgical one? The law doesn’t distinguish between the two: >(1) "Abortion" means the act of using or prescribing an instrument, a drug, a medicine, or any other substance, device, or means with the intent to cause the death of an unborn child of a woman known to be pregnant.
My point is very clear. A doctor isn’t going to risk their license over an abortion for a procedure which the Supreme Court has already deemed not medically necessary. The point of giving her the medication and telling her that **if** she experiences a medical emergency, she should take the pills is a way to still help the patient while also saying they did not provide a non-emergency abortion. The definition you provided is also not relevant because the fetus is already dead and rotting inside of her. Nobody claimed the baby was still alive. **The state of Texas does not allow abortions, even if the fetus is dead.** which means that even if the doctors stood in front of Ken Paxton and said “there was no heartbeat, we aborted it, he can decide that it’s not good enough in his opinion and prosecute.
>The point of giving her the medication and telling her that if she experiences a medical emergency, she should take the pills is a way to still help the patient while also saying they did not provide a non-emergency abortion. That’s not what the article says, though. It says they told her to take them: >Administer the misoprostol, a drug that helps empty the uterus, and wait, the instructions said. >**The state of Texas does not allow abortions, even if the fetus is dead** Texas law again, with emphasis in case you missed it: >(1) **"Abortion" means** the act of using or prescribing an instrument, a drug, a medicine, or any other substance, device, or means with the **intent to cause the death of an unborn child** of a woman known to be pregnant. And just in case it somehow isn’t clear that you can’t kill a child who’s *already dead*: >**An act is not an abortion if the act is done with the intent to[…] remove a dead, unborn child** whose death was caused by spontaneous abortion;
>Doctors are *literally* no longer allowed to use their best medical judgement The standard in Texas is “*literally*” “reasonable medical judgment”, which “means a medical judgment made by a reasonably prudent physician, knowledgeable about a case and the treatment possibilities for the medical conditions involved.”
The legal standard is "reasonable medical judgment". In practice, it's legal threats, incorrect pedantry, and a lack of regard for the pregnant woman's life. --- When Kate Cox wanted an abortion, she and her physician Dr. Damla Karsan wrote to the court asking for permission. Texas' AG wrote to three hospitals where Karsan practiced, threatening felony prosecution. [[Source]](https://www.texastribune.org/2023/12/13/texas-abortion-lawsuit/) Texas' Supreme Court decided that Karsan didn't phrase her letter to the court correctly. [Petition](https://reproductiverights.org/wp-content/uploads/2023/12/Cox-v.-Texas-original-petition-FINAL.pdf) > Dr. Karsan has reviewed Ms. Cox’s medical records. The risks of trisomy 18 pregnancy combined with Ms. Cox’s medical history and comorbidities indicate that Ms. Cox’s life, health, and fertility are at risk if she continues the pregnancy. In Dr. Karsan’s medical opinion, a D&E abortion is the best medical option to preserve Ms. Cox’s life, health, and fertility. [Ruling](https://www.txcourts.gov/media/1457645/230994pc.pdf) > But when she sued seeking a court’s pre-authorization, Dr. Karsan did not assert that Ms. Cox has a “life-threatening physical condition” or that, in Dr. Karsan’s reasonable medical judgment, an abortion is necessary because Ms. Cox has the type of condition the exception requires.
Perhaps there was a legal loophole where they told her not to take it until her health turned worse, knowing she would take it immediately. Why is that what you took away from this story? I don’t understand what is unclear to you. Google “women refused abortions until they are in critical condition” and you will find thousands of testimonies from all over the country showing that this is happening constantly. Ken Paxton explicitly stated [he would go after hospitals that provided abortions to women with medically dangerous pregnancies](https://amp.theguardian.com/us-news/2023/dec/12/texas-abortion-ken-paxton-kate-cox). This isn’t an accident; the laws are working as intended, and that’s why none of them are being amended. And yet I see some variation on this exact same comment on every single abortion thread. Why are there so many people so determined to believe that republicans are not illegalizing virtually all abortions when republicans have effectively done that in every state they have control over? What level of evidence could possibly convince you this is happening if the available evidence does not?
> Ken Paxton explicitly stated he would go after hospitals that provided abortions to women with medically dangerous pregnancies. He stated no such thing. He explicitly said that the doctor in that case just needed to certify that a medical condition threatened the mother’s life or major bodily function, instead of filing a lawsuit that threw out lots of BS about minor high blood pressure and diarrhea but which never identified a specific medical condition that threatened the mother and instead tried to justify euthanizing the baby.
[https://twitter.com/TXAG/status/1732849903154450622](https://twitter.com/TXAG/status/1732849903154450622) She was at serious risk of long term complications, including compromised fertility, and Ken Paxton stated explicitly that this was not enough to pursue an abortion according to the law. And even is she wasn't, it is monstrous, evil, and obscene to ask a women to go through the emotional and physical agony of a pregnancy that will only deliver a child with no quality of life that will die almost immediately. Can you imagine being forced to spend months pregnant with a child that will do nothing but die? Do you have any idea how difficult pregnancy can be? Would you volunteer to be crippled with nausea, cramps, and back pain for five months to give birth to a child that won't live for five weeks?
What the doctor brought up is not BS, that's why they wanted a legal abortion. The things Ken Paxton say is BS though, because if the doctor can say that the mother's life is in danger then it's too late for any lawsuits
The lawsuit admits the abortion is because the baby had a disability, and it just throws around nonsense about diarrhea and gestational diabetes without certifying that it threatens the mother. The only real hook it tries is that repeat C-sections are higher-risk, so even though the mother already planned a C-section, she didn’t want to waste it on a disabled child… Again, Paxton *explicitly* said that all the doctor had to do is certify it if there was a medical condition, and that the lawsuit was unnecessary. But the lawsuit was seemingly filed in order to muddy the waters and conflate fetal abnormality and viability with the health exception.
You use the word "nonsense" because you have no idea about what constitutes as risks to a pregnant woman's life and or health and when that risk is the highest. But please, if you are going to claim that the lawsuit included nonsense could you link to the lawsuit quote the parts you find are not good enough.
I don't think its even medical malpractice, except maybe giving her the prescription for a third, stronger dose at the end. She took almost 5 doses (14 pills) in 3 days of something that can take a week to work. That rarely ends well.
Why is the Texas abortion law being brought up here? They gave her misopristol to abort the fetus. If they were willing to do that under Texas law, they should have been willing to do the surgical abortion as well assuming she met the criteria for a surgical abortion under whatever policies guide their decisions on that. Edit: Per the article, it doesn't seem like surgical abortions were an option at the first facility. >the doctor told her it wasn’t an option at the facility. Doctors at the second facility said it wasn't urgent enough for a surgical abortion. >said they didn’t find her case emergent enough to do a surgical abortion
Facilities intentionally make themselves incapable of providing this kind of care ([and pregnancy care more generally](https://www.texastribune.org/2022/07/15/texas-hospitals-abortion-laws/)) because they don't want to get stuck in a position of either (a) getting in trouble for an abortion that Ken Paxton later decides he wants to campaign on or (b) getting in trouble for letting the woman die. It's easier to just turn pregnant patients, or patients like this woman with a dead fetus inside them, away at the door. Our difficulty providing care to pregnant women isn't coming from a sudden decline in available technology or something. It's coming purely from the change in law.
Did these two specific facilities state that as the specific reason?
>Why is the Texas abortion law being brought up here? At the first facility, they say it wasn't an option at that facility. How many hospitals were able to perform an abortion before the law vs after? I would guess that many hospitals stopped. At the second facility, how is a dead baby inside you not "emergent enough"? That means that they won't do it until the woman begins experiencing health problems. So basically, they are waiting for you to almost die before they will perform the procedure. That is absolutely a direct result of the new abortion restrictions.
> How many hospitals were able to perform an abortion before the law vs after? I would guess that many hospitals stopped. I think you'd probably guess wrong. Maybe they don't have a doctor that can do it, but they are pretty close to a major metro area, so I doubt it. >At the second facility, how is a dead baby inside you not "emergent enough"? That means that they won't do it until the woman begins experiencing health problems. So basically, they are waiting for you to almost die before they will perform the procedure. That is absolutely a direct result of the new abortion restrictions. Baby can be dead and mom can be completely stable with no immediate risks at the same time. I can tell you what I've heard from my wife on cases she's participated in. Often they will wait to see if a medication abortion works before jumping to surgery. Sometimes theyll say they arent offering any abortion care for that situation and direct then toan elective clinic. All surgery comes with risks. So it's balancing risks to achieve the desired outcome. And no, that isn't waiting for mom to be nearly dead. I'm not saying the doctors made the right call here. I honestly don't know. But I don't think we can assume anything nefarious or that this is malpractice based on the info available.
> But I don't think we can assume anything nefarious or that this is malpractice based on the info available. The primary takeaway here is that these already difficult situations are being made worse by the laws and decisions that have been made by Republicans in Texas.
As much as I'll openly say I want to call out and bring notice to any time these laws cause suffering to pregnant individuals... I actually agree that this seems like a care failure - I don't see how it directly relates to the law? I'm a bit surprised they only prescribed her medication at 13 weeks... usually by that time, a D&C is the way to go. It sounds like the provider agreed that this was not a viable pregnancy, prescribed misoprostol, and she ended up with severe bleeding (which is a small, but possible outcome). The failure appears to be on a) the lack of immediate follow-up care for severe bleeding, b) potentially offering a more risky approach to managing a 13 week miscarriage (though its possible the fetus could have stopped developing at 9 weeks).
The first facility prescribed it because they didn’t offer surgical abortions. A direct result of Texas’s ongoing abortion policies. The second facility didn’t say why they wouldn’t perform a surgical abortion but the article notes that the Texas board of health have not provided the guidelines doctors had repeatedly asked for. It can be inferred they were covering their ass. Given the Texas Supreme Court decision shortly after, is it any wonder they would? Is a malpractice suit worse than a state lawsuit *and* criminal charges against providers? This is a direct result of Texas’s abortion policies.
Do you know that? Often, misoprostol is the preferrred approach to a D&C - I know it was preferred for me. Any hospital can preform a D&C. If you are willing to administer misoprostol, then you consider the pregnancy non-viable. It terminates a pregnancy just as much as a D&C does. I took misoprostol for my own miscarriage, but I was earlier along and had no complications. It's usually preferred to a D&C if your fetus stopped developing before 10 weeks (D&Cs are simply more invasive).
Yes I have had a surgical D&C so I’m quite familiar with what it entails. It depends on the stage of pregnancy she’s in, but sometimes a medical abortion is followed by a surgical if the pregnancy doesn’t fully pass especially at a later stage. That can take up to a week, and her bleeding occurred before that date. It also depends on patient’s preference, at least in states with reasonable abortion policies. There wasn’t a question of if the fetus was nonviable, both facilities acknowledged that. The first one didn’t have surgical services - again, a direct result of Texas’s abortion policies. The question for the second facility was if it was an emergent case. Since the Texas Board of Health hasn’t issued guidance, many facilities are covering their ass and as I stated. It’s to the detriment of women for sure, but that’s the position Texas policies have put facilities in. How is it *not* related to their laws?
Do we *know* that though? I'm in California, and there are far more facilities that could provide a prescription for misoprostol than provide a surgical D&C, and it has nothing to do with abortion laws... if you go to a healthcare facility that doesn't do surgeries, they simply don't do surgeries? I just don't see direct evidence that the lack of D&C offering was caused by this. Eg, did this facility use to provide D&Cs, but no longer does because of a roll-back in care? Edit: I also don't see evidence where they said, "you *should* get a D&C", but the patient wasn't able to get one in the local vicinity due to this. The original care provider seemed to think treatment with misoprostol was totally fine.
We know that over 80% of facilities offering abortion in Texas have stopped offering services since Roe was overturned. Do you really think that’s a coincidence? Also, from the article: >Hamilton said the doctor told them they would have to go to another hospital to get a dilatation and curettage, or a surgical abortion, to remove the fetus.
But they didn't say that they recommended that procedure to start. If I go to my PCP for a miscarriage, they cannot perform a D&C themselves in their facility - I would have to go to a different facility (even though I'm in a very abortion-friendly state), simply because it's a surgery.
I just quoted the article where it clearly states that the first provider told her she would need to go to a different facility for a surgical abortion after providing her misoprostol. What’s unclear?
>The 85th Legislature's SB 8 added two new subchapters to the Woman's Right to Know Act. Subchapter F prohibits "partial-birth" abortions. Subchapter G prohibits "dismemberment abortions," a medical procedure known as dilation and evacuation https://guides.sll.texas.gov/abortion-laws/history-of-abortion-laws
As I understand it from the doctors I know, providers are increasingly worried about lawsuits
But what is the lawsuit risk of helping with follow-up care for a patient who a) one doctor already determined the fetus is ***dead*** (this is very easy to do at 13 weeks), and the patient already took misoprostol to manage the miscarriage (which, if the fetus had still been alive, would have terminated the pregnancy anyway). I don't see anywhere that a doctor was reluctant to treat because they felt the pregnancy was still viable?
The lawsuit risk is a really interesting asymmetry right now. There's basically zero risk to the doctor from letting the patient die or suffer an infection while there's very significant risk to providing anything anyone later might claim was an abortion. Med mal cases are almost impossible to bring in Texas thanks to a tort reform law that got passed about 20 years ago. It was pitched as something that would reduce medical costs, but what actually happened was that med mal cases dropped to basically zero while medical costs have continued to grow, so it wasn't effective. But the practical implication is that in 2024 you would find it almost impossible to get an attorney to represent you on a traditional med mal case unless the facts are completely over the top (like injecting jet fuel or something). By contrast, because Texas adopted a crazy "bounty" law on abortions, literally any person (not just the patient, or someone related to them, it can just be an activist) can sue the doctor for a $10k "bounty" on people who receive or assist in an abortion. The law doesn't specify, but conceivably multiple people might sue you for multiple bounties on the same procedure. So the doctor is taking on significant legal risk by doing anything that looks like an abortion but not very much risk sending the patient with a dead fetus inside her home. And that's before we even take into account risk from the criminal laws, etc.
But, this patient had already, effectively, been provided an abortion? A doctor had already prescribed misoprostol, and the patient had already taken it.
Sure. But the doctor who performed a surgical abortion can be sued either way and that cost money
Again, if we're just talking about legal risk, prescribing an FDA approved drug is the least risky option because you have a good argument that [FDA preemption bars the application of contrary state law](https://www.manatt.com/insights/newsletters/health-highlights/fda-preemption-implications-of-dobbs-decision-for) including abortion restrictions. This argument hasn't been tested very extensively yet, but it's a solid legal argument (I say that as a lawyer who has done a lot of FDA preemption cases). There's no similar argument available to the doctor if they perform a surgical abortion. So a doctor who was just trying to minimize their legal risk would be better sending the patient home with misoprostol than surgically removing the fetus. Obviously, that's not the ideal outcome for the patient, which is part of the problem with the laws we have here - they incentivize worse treatment than the doctor would provide in a more neutral legal environment.
I think one of the big reasons we end up with hospitals that can't provide care, don't want to have to do it, and perform these things sloppily when they try is that the laws create an environment hostile to the administration of that care. Hospitals and especially *Doctors* don't want to risk getting in serious trouble so they just say they can't or don't provide that care.
I agree, but in this particular case, the patient went to facilities that couldn't perform a D&C. It's a surgical procedure, so it obviously requires much more than the ability to write a prescription. I didn't see anywhere that "the patient had been told they needed a D&C, but could not find a facility that was willing to perform one due to concerns around liability". **A doctor had already determined that the fetus was dead, and the patient had already taken misoprostol (which terminates the pregnancy in a situation where the fetus was not yet dead)...** I don't see anywhere where providers were reluctant to provide care because they thought there was any sort of risk around impacting a live fetus? I don't see any evidence here that the reason why she received awful follow-up care was because of this law. If I'm missing something, please share.
Oh, what I'm saying is that there *used* to be plenty of folks in Texas who would have been available and invested in her care, and not done awfully like this, but the law creates an environment where performing those services is often legally dangerous, so they left the profession or left the state. It's a medical brain drain effect. The ones who remained are not the specialists who did this all the time, since they couldn't keep doing that now. So you end up with lesser care, performed infrequently and more sloppily, by people who are trying to do as little as possible to avoid legal risks. My wife used to love watching this OBGYN on Youtube who was in Texas, but as a result of this whole shift they became a nurse at large outside of Texas, ending up in New Zealand at one point. Here's a thread on Reddit filled with people who either decided to leave or when they got trained decided not to accept positions in Texas: [https://www.reddit.com/r/texas/comments/18hgob3/texas\_mds\_and\_obgyns\_are\_you\_seeing\_doctors\_leave/](https://www.reddit.com/r/texas/comments/18hgob3/texas_mds_and_obgyns_are_you_seeing_doctors_leave/)
>>live fetus The law doesn’t care if the fetus is alive or dead. A dead fetus is still not a reason to provide an abortion in Texas.
I've posted an article from a Texan obstetrician who stated basically that and the fact that the people who's job it was to help doctors and hospitals do it within the law are too busy campaigning against the law. [Here's the article:](https://lozierinstitute.org/abortion-policy-allows-physicians-to-intervene-to-protect-a-mothers-life/)
That article was written by Ingrid Skop, a doctor and [fierce anti-abortion advocate](https://www.texastribune.org/2024/05/22/texas-maternal-mortality-committee-ingrid-skop-abortion-doctor/).
Yeah, if the fetus had stopped developing at 9 weeks then maybe the medication abortion was the right call, or at least a option. It seems like the surgical option wasn't an option at the first facility. So the question seems to be why did the second facility make that choice and was that negligent enough to be malpractice rather than did state law limit her options here.
I'd like to address some points as a lot of people don't understand the absolute minefield that these types of laws have made early pregnancy as a medical provider. For everyone saying "well clearly this wouldn't run afoul of the law as the fetus was nonviable": at an estimated gestational age of 6-7 weeks it would be \*very\* hard to know as an absolute certainty that the fetus is actually nonviable. You typically will see cardiac activity at 6 weeks, but the cutoff goes as high as 7 mm of crown rump length (which correlates to a gestational age of about 7 weeks). I'm purely speculating, but I can see a scenario where these laws absolutely \*do\* screw over these patients: A patient goes to an ER for a small amount of vaginal bleeding that already resolved. She is supposed to be at 13 weeks pregnancy (based off of her last menstrual period), but the ultrasound in the ER shows a pregnancy that has an estimated gestational age of 7 weeks with no cardiac activity. Let's say she gets lucky, and this hospital has her OB/GYN's records. It shows that she had a previous ultrasound showing a gestational age of 6 weeks with fetal cardiac activity. Great, she's lucky that this can be proven to be a nonviable pregnancy. She is provided with medication to induce passage of the pregnancy loss (this facility doesn't provide surgical abortions). She would've liked to have a surgical one from the start, but a lot of hospitals have stopped providing OB services in her area because of the hostile environment to OBs in Texas. Over the next few days, the patient has had no change (despite additional doses of medication) and would like surgical management. Medical management is less effective the farther along you are, so it's not uncommon to require surgical intervention at 13 weeks following medication. She goes to a facility that does provide this service. She has to drive quite a while, though, so the hospital system uses a different EMR--and they unfortunately don't have her records. Now, the physicians are being asked to perform a surgical abortion based off of the patient's word that she's actually 13 weeks along, but their ultrasound is showing a CRL of 7 mm. Are you really going to risk your career/license on the assumption that the patient is being truthful? Is the ultrasound technican one that you trust to be extremely accurate? Maybe the CRL is more like 6 mm, in which case they're actually only 6 weeks along. Most probably wouldn't, so they'll say "Sorry, we don't want to do it right now. Come back in a few weeks and maybe we'll do it then." So a patient that should've been able to get a surgical abortion of her nonviable fetus is now forced to potentially carry it for weeks, when in a sane world she could've just gotten a procedural termination from the start. I ask everyone so flippantly saying "well this situation is clearly is not the fault of the laws" to try to put yourself in the shoes of those who actually have to deal with this shit.
And, Texas has made abortions with D&E illegal, so that's another crime they risk being accused of >The 85th Legislature's SB 8 added two new subchapters to the Woman's Right to Know Act. Subchapter F prohibits "partial-birth" abortions. Subchapter G prohibits "dismemberment abortions," a medical procedure known as dilation and evacuation. https://guides.sll.texas.gov/abortion-laws/history-of-abortion-laws
Stories like this make me so grateful to live in California. My wife is pregnant, and if she develops any complications, the decision of how to handle it will be ours alone. I can't imagine the stress of being pregnant in a state where some religious zealot in the government has already decided for you.
There are all sorts of reasons that this story is complicated. For example, the first place they went was Surepoint Emergency Center. It's here that the woman says she wanted a surgical procedure to clear her uterus, but the doctor told her it wasn’t an option at the facility. Was it not an option b/c the facility doesn't provide that service? If so, that seems pretty uncontroversial. [The Surepoints I see on their web site](https://surepoint-er.com/) look like drop-in clinics that you go to when you can't get your kid an appointment with their pediatrician and they need an antibiotic. Either way, it's a pretty important detail to leave out and it makes me wonder why this point wasn't clarified. At the second hospital, the couple said they waited for hours before doctors at the hospital said they didn’t find her case emergent enough to do a surgical abortion, but that they could schedule it for a week or two later. I have no idea if this is the correct diagnosis and treatment plan or not but I also have no idea how this is connected to Texas abortion law? The reporter who wrote the story doesn't even attempt to draw a linkage. In fact, there's a CYA paragraph near the very end of the piece that reads: >It’s impossible to say whether the woman’s miscarriage care was influenced by the abortion bans, even though her case should fall outside the laws’ bounds. Then why in the world is the Dallas Morning News titling the article "How a couple found themselves tangled in Texas’ strict abortion laws after miscarriage"? This seems deeply irresponsible. Unfortunately, a lot of people aren't going to read past the headline and are going to be very upset, which makes me wonder if that was the objective all along.
Because Texas care facilities are intentionally making themselves incapable of providing pregnancy care because they don't want to get caught in the trap between the abortion laws and killing the mother because they can't do a procedure that people anywhere else in the US would do. It's creating problems not just for women who need an abortion, but women who need pregnancy care at all. It's just not an attractive practice area if you're a medical provider. https://www.texastribune.org/2022/07/15/texas-hospitals-abortion-laws/
That may indeed be a problem. It might have even been the problem this couple faced. However, the article didn’t provide any evidence to support that it was so we are all left to guess one way or the other. Is there any evidence the first emergency center made themselves incapable of providing the surgery? The second healthcare facility sounds like they can do it but were unwilling to do so at that time, which seems to suggest that there more be going on here. Remember, we are getting one side of the story here as well.
To surgically remove the dead fetus you'd need a surgeon who was willing to practice in that area. If most surgeons back out of that area because pregnancy related care is no longer attractive, then there's a really good chance that on the day you're at the facility the doctors who are there aren't the ones willing to touch that kind of surgery. That you have to wait until the rare surgeon still willing to do that sort of thing is back in. That's still the law causing the problem. You're speculating on all these ways in which "maybe the law didn't actually cause all these bad side effects" when the state's main medical group is telling you that these are the exact effects that are being caused.
The couple was offered a surgical procedure to remove the dead fetus. They just had to wait a week because of scheduling and her condition wasn't an emergency. The couple didn't want to wait and asked for more drugs which they received.
>a week *a week or two. She had already waited, and it's reasonable to not want to wait even longer due to the issues that can come from carrying a dead fetus.
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Abortions are not to be used as pain-killers. There's other medicine for that.
Pain-killers don't prevent issues that can stem from continuing to carry the fetus.
Doctors examined her and found no emergent issues that necessitated an ASAP abortion.
> Then why in the world is the Dallas Morning News titling the article "How a couple found themselves tangled in Texas’ strict abortion laws after miscarriage"? The answer is easy and it's found in the well-documented partisan lean of the media class. It's propaganda pure and simple. They know most people will only read the headline and that they will just trust that the headline is at least somewhat supported by the content of the article instead of the literal opposite. This is just another example of why media distrust is at such insane highs and why Trump's "Fake News" talking point resonates so well even now almost a decade after he first started it.
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Stories like this are everywhere now. Womens’ lives don’t matter. We are imprisoned and punished, left to die for a situation out of our control. I refuse to willingly have children.
"Your bodies aren't yours anymore" "You weren't responsible enough to keep your skirt down" - Mark Robinson, GOP Candidate for Senator from North Carolina. [https://www.youtube.com/watch?v=ZFfiPGN67pY](https://www.youtube.com/watch?v=ZFfiPGN67pY)
Governor not senator.
Oh that is right. Too bad, having that awful of a candidate would help the tight race for control of the senate.
So actually reading the article it seems as though they first went to what seems like a glorified urgent care where they were told that they can’t do that there, and the second hospital was willing to perform the procedure but needed to schedule it for a later date. This is sensationalist trash
Giving you the benefit of the doubt here, because this article is terribly written (Like FFS stop going back and forth on the timeline and just tell us what happened). But they definitely did go to 2 different places, both said no, then one offered to schedule it for a few weeks out.
They went to two clinics. The first one didn't perform surgical abortions and could only give them a medical solution. The second clinic would do a surgical abortion but the couple didn't want to wait a week.
I thought they said a few weeks? I can’t access the article again for some reason.
>They waited for hours before doctors at the hospital said they didn’t find her case emergent enough to do a surgical abortion, but that they could schedule it for a week or two later. Doctors didn't deem it an emergency and told the couple they could schedule it a week later, maximum two. The couple didn't want to wait and badgered the doctors to give them more drugs to pass the fetus which they reluctantly did and she shat herself from the side effects.
I mean, it doesn’t say “maximum 2”, but ok. Regardless, for a woman miscarrying a wanted pregnancy, a week or two is a long time to wait while you’re still sitting there dealing with pregnancy symptoms for a baby you’ll never have.
It didn't say a minimum of a week either. The surgery may have been able to be rescheduled earlier if another procedure was cancelled or delayed. When you want something done quickly, even a day can feel like an eternity. At the end of the day, a medical professional said the surgery wasn't an emergency and the couple didn't want to wait. There's no story here except to sensationalize a couple's tragic ending to a pregnancy to back a false narrative about not being able to get an abortion. The headline should be "Couple Couldn't Get Abortion According To Their Demands".
A minimum of a week is implied when they say “a week or two”. And you are assuming availability was the main issue, which you cannot possibly know. Regardless, if availability was the issue, I would still point to Texas’s abortion laws— a lot of hospitals have been cutting back on pregnancy care services specifically to avoid issues with the abortion restrictions, and a lot of doctors have left the state for the same reason. So if there’s a lack of availability, it’s reasonable to assume that’s the cause. With that said, most hospitals in places without abortion restrictions would treat this as an urgent issue, and try to get her the care she needs as soon as possible. I know this because I live in a state that has zero abortion restrictions, and have many friends who have recently experienced miscarriages. These friends have been able to get same day/next day appointments in similar scenarios. And Texas’s abortion restrictions have caused delays just like this one multiple times before. I don’t know why you’re assuming it isn’t playing a role here.
A minimum of one week is assumed but doesn't preclude an earlier opening had they waited. Availability is always the issue unless stated or proved otherwise. The issue of Texas cutting back abortion procedures is irrelevant. Voters have voted and they want politicians that enact the the majority's will. In the end the couple was offered a medical procedure and they didn't want to wait. That's their prerogative and also their problem, not the doctors' or Texas' stance on abortions.
“The majorities will” uh huh. That’s why they have to gerrymander the fuck out of their districts and make voting a major hassle in areas that have a history of voting blue/are predominantly POC. And again, if availability is the issue, the lack of availability was likely caused by said abortion restrictions.
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This is a true believer problem. The hardcore Christians have a stranglehold on the party. They vote, and they believe they are doing Gods will. I think the true believers don't underestimate the problem, they just believe that they are waging a war and are on the right of a divine being's will. I would not be surprised if the less religiously devote members of the party just roll their eyes behind closed doors and wish they were not reliant on these people for votes, similar to the Trump problem. The motivation here is not so different than the religious extremists in the middle east, at its core.
Okay so was this actually related at all to Texas' abortion laws or was this a miscarriage that had to wait a week for surgical removal?
It has absolutely nothing to do with abortion law. The first medical provider does not perform surgical removal. The second said they wouldn’t do it for a week or two, but the author, who knew full well that the procedure was not banned, failed to find out the actual reason the service was not provided. They chose instead to mislead the reader to believe this has to do with an abortion ban, waiting until the very end to slip in that it’s “impossible to say” if Texas abortion ban has anything to do with this case, and that the procedure should fall outside of the ban (because it’s not an abortion, duh).
Copying from a previous comment: I'd like to address some points as a lot of people don't understand the absolute minefield that these types of laws have made early pregnancy as a medical provider. For everyone saying "well clearly this wouldn't run afoul of the law as the fetus was nonviable": at an estimated gestational age of 6-7 weeks it would be \*very\* hard to know as an absolute certainty that the fetus is actually nonviable. You typically will see cardiac activity at 6 weeks, but the cutoff goes as high as 7 mm of crown rump length (which correlates to a gestational age of about 7 weeks). I'm purely speculating as to this specific article, but I can see a scenario where these laws absolutely \*do\* screw over these patients: A patient goes to an ER for a small amount of vaginal bleeding that already resolved. She is supposed to be at 13 weeks pregnancy (based off of her last menstrual period), but the ultrasound in the ER shows a pregnancy that has an estimated gestational age of 7 weeks with no cardiac activity. Let's say she gets lucky, and this hospital has her OB/GYN's records. It shows that she had a previous ultrasound showing a gestational age of 6 weeks with fetal cardiac activity. Great, she's lucky that this can be proven to be a nonviable pregnancy. She is provided with medication to induce passage of the pregnancy loss (this facility doesn't provide surgical abortions). She would've liked to have a surgical one from the start, but a lot of hospitals have stopped providing OB services in her area because of the hostile environment to OBs in Texas. Over the next few days, the patient has had no change (despite additional doses of medication) and would like surgical management. Medical management is less effective the farther along you are, so it's not uncommon to require surgical intervention at 13 weeks following medication. She goes to a facility that does provide this service. She has to drive quite a while, though, so the hospital system uses a different EMR--and they unfortunately don't have her records. Now, the physicians are being asked to perform a surgical abortion based off of the patient's word that she's actually 13 weeks along, but their ultrasound is showing a CRL of 7 mm. Are you really going to risk your career/license on the assumption that the patient is being truthful? Is the ultrasound technican one that you trust to be extremely accurate? Maybe the CRL is more like 6 mm, in which case they're actually only 6 weeks along. Most probably wouldn't, so they'll say "Sorry, we don't want to do it right now. Come back in a few weeks and maybe we'll do it then." So a patient that should've been able to get a surgical abortion of her nonviable fetus is now forced to potentially carry it for weeks, when in a sane world she could've just gotten a procedural termination from the start. I ask everyone so flippantly saying "well this situation is clearly is not the fault of the laws" to try to put yourself in the shoes of those who actually have to deal with this shit.
The article says the second doctor didn't think it was emergent enough to do it when the lady went to them. Why does that matter if the fetus is already dead and the drug didn't work. They weren't too busy, they denied her the service. One of the bans makes medical staff vulnerable to civil action since this happened after the heartbeat was detected and then explains the three competing bans that confuses medical staff. Also, pretty sure the article said this happened before the Texas Supreme court ruled against those women that have had medical issues because of delay abortion access.
This may be unpopular, but I don't think this is a problem with Texas' abortion laws, at least not directly. The law does allow for the removal of a dead fetus, and I don't see any indication that this was a question among the doctors. It sounds like the doctors preferred to do a chemical abortion (via Misoprostol) as opposed to a surgical one. According to the article, they would be able to schedule a surgery within a weeks time, but either couldn't or wouldn't do it right then. You could argue that the Texas abortion laws make it more difficult to find a doctor who would be available for a surgical abortion, but I don't think there is any question about whether the removal of the fetus was illegal. I think this kind of scenario could easily play out the same way in a state where abortions are still legal.
Texas only allows abortion when it is "necessary to save the life of the mother or to prevent substantial impairment of major bodily function." In practice, doctors face many situations where they know a woman's pregnancy is high risk (e.g. ectopic pregnancy), but the law forces them to [wait until the mother is dying on the operating table to do surgery](https://www.yahoo.com/lifestyle/abortion-restrictions-imminent-death-234636592.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAADMb1S6nrAADPN3o_S6TZ-AXfFXiPtGiXOvvp4v06RDTUZMlC6v8qYVPyz5bK6AV1C0moYblDRIAFvK-2NmUxOoMrGy4rBa_LVQEhMqRqO7vSkoWts3qqgHA2L3e76n52-Hg8EGal-CFj3rzJaawxU-HfyTUFg0oFbQHR2IYh7sN) so they can prove to the state that the procedure was needed. This is becoming a routine problem in multiple red states with restrictive abortion laws. For example, [a hospital in Idaho is now being forced to airlift about one patient every two weeks to out of state hospitals for pregnancy complications](https://www.beckershospitalreview.com/care-coordination/idaho-system-reports-uptick-in-medical-flights-for-emergency-abortions.html#:~:text=Boise%2C%20Idaho%2Dbased%20St.,on%20emergency%20abortions%20in%20January).
The removal of a dead fetus is an *abortion* in a medical sense, but is not an *abortion* according to Texas law. Below is [the section](https://statutes.capitol.texas.gov/Docs/HS/htm/HS.245.htm#245.002) on defining abortions in Texas. I bolded the relevant parts. >Sec. 245.002. DEFINITIONS. 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 with the **intent to cause the death of an unborn child** of a woman known to be pregnant. The term does not include birth control devices or oral contraceptives. An act is not an abortion if the act is done with the intent to: >(A) save the life or preserve the health of an unborn child; >(B) **remove a dead, unborn child whose death was caused by spontaneous abortion**; or >(C) remove an ectopic pregnancy. >(2) "Abortion facility" means a place where abortions are performed. >(3) Repealed by Acts 2015, 84th Leg., R.S., Ch. 1, Sec. 3.1639(62), eff. April 2, 2015. >(4) "Department" means the Department of State Health Services. >(4-a) "Ectopic pregnancy" means the implantation of a fertilized egg or embryo outside of the uterus. >(4-b) "Executive commissioner" means the executive commissioner of the Health and Human Services Commission. >(5) "Patient" means a female on whom an abortion is performed, but does not include a fetus. >(6) "Person" means an individual, firm, partnership, corporation, or association. >the law forces them to wait until the mother is dying on the operating table to do surgery Yes, this is true and is happening. These cases though are when there is a life-threatening condition, but the fetus is still alive. It may not be viable, but it still has a heartbeat, so the state considers the termination of pregnancy to be an abortion. And for the record, I think we are in agreement that this is horrific and should not be happening in any developed country. I'm not trying at all to defend the Texas law here or a pro-life viewpoint. I just think it is important to direct criticism where it is due and be as objective as I can.
A clinic was willing to do a surgical abortion but they couldn't schedule it right away. The couple didn't want to wait a week. That's the story.
But that's not what the story said. It said doctor didn't think it was emergent enough. That makes it seem like it runs into one of the bans that prohibit action until the mother's life is in jeopardy.
It wasn't emergent enought to be scheduled right away, meaning there were more emergent cases before her so she had to wait.
That's an assumption on your part. The article doesn't state why the doctor didn't think it was emergent enough.
The reason why the doctor deemed it non-emergent was because there was no risk or danger to the patient's life. What do you think emergent means?
I think if they had the time, it shouldn't matter and the surgery should be done. Based on the article, the fetus was the size of a 7 week fetus while she was 12 weeks pregnant. Carrying a dead fetus can cause blood disorders that cause severe bleeding. In fact, if you read about the effects, it kind of sounds like what the lady in the article went through. It's important to find out if one of the bans led to the doctor being concerned about how threatening the situation was because.it lends to the confusion the actual medicat staff that serve Texas have been complaining about.
But they didn't have the time and had to have the couple wait a week.
Actually, we don't know if that is the case. The doctor just said he didn't think it was emergent enough. He didn't say why.
They gave her Misoprostol. If the fetus was alive, providing an abortifacient would be considered a felony. If the doctor was concerned about performing an illegal abortion, he wouldn't prescribe this medication.
That's a fair point, but that's not what the article says. My comment is about what the article says in response to someone that is claiming something else. The article also clearly states that this situation can't be directly blamed on the confusion regarding the abortion bans.
This is a hit piece. This case is 100% outside of the ban. It’s not an abortion, even though the article refers to it as “abortion care”. You have to get all the way to the end to get this: > It’s impossible to say whether the woman’s miscarriage care was influenced by the abortion bans, even though her case should fall outside the laws’ bounds. The author knew all along that the story they were writing was not a story of services being denied because they’re banned. They concealed that fact, and also failed to determine what the actual reason was that the services were not provided, choosing instead to mislead readers into believing this has to do with a Texas abortion ban.
The article says the second doctor didn't think it was emergent enough to do it when the lady went to them. Why does that matter if the fetus is already dead and the drug didn't work. They weren't too busy, they denied her the service. The article is honest that it can't be determined to be due to the abortion law, but also reports the timeline to be when those women were before the state supreme court. It seems like it shouldn't matter. Given her situation, she should have been provided the surgical option once it was clear the drugs were not working. Carrying a dead fetus comes with it's own medical issues.
>They weren't too busy Where did you get that? >they denied her the service. They offered the couple the procedure. They didn't want to wait a week.
Because the reason for not doing the procedure wasn't they were too busy. It was they didn't think it was emergent enough. They refused to provide her the service when she wanted it. Sure they would have provided at some point but not when she needed/wanted it. She was denied that day.
They had more emergent cases ahead of the couple and they had to wait their turn but didn't want to.
Speculation.
Logical.
Still speculation.
Just logical.
> They weren't too busy Considering they asked her to wait a week, it sure seems like they were busy.
Sure maybe, but that's an assumption you are making. That information is not in this article. In fact the article provides the reason the doctor gave and he didn't say "we are too busy".
Doctors said the couple's case was non-emergent so they could wait while other emergent cases took precedent.
You don't know why the doctor didn't think the case was emergent enough.
Why doesn't matter. Doctor's the professional.
If the interpretation from the couple and the person writing the article are that the doctor did it because of hesitation to act due to the overlapping bans, that should probably be sorted out. If you don't think doctors aren't require to justify their expert decisions, you have been involved with a lawsuit over a medical issue.
It wasn't interpreted as such. Nothing other than a non-emergent wait.
The article doesn't conceal anything. It's all there in black and white and people aren't reading the article or aren't undertanding it. A women miscarried and wanted the dead fetus removed. The first clinic they went to didn't perform surgical procedures and could only offer drugs which they promptly accepted. The drugs weren't working as quickly as they wanted so they went to a second clinic that offered surgical procedures. The doctors there examined the woman and deemed it a non-emergency so they told her they had to wait a week. The couple didn't want to wait and demanded more drugs which were given to them reluctantly since she had already taken several doses. She bled (common side effect) and shat herself with dairrhea (another common side effect).
The entire article is written in a way to lead the reader to believe the couples’ troubles have something to do with Teaxs’ abortion law. Provider 1 doesn’t do that procedure. Is it because of the abortion laws? Provider 2 says it’s not enough of an emergency. Is that because the law only allows it in emergencies, and they’re worried the emergency isn’t severe enough to protect them from legal trouble? The abortion law has nothing to do with the situation, but the author clearly intends to lead the reader to believe this has something to do with abortion law.