Many pregnant women denied access to ERs despite federal law

WASHINGTON — Experiencing blood loss and discomfort, Kyleigh Thurman was unaware that her failing pregnancy could be life-threatening.

In Texas, healthcare providers at Ascension Seton Williamson gave her a brochure on spontaneous abortion and instructed her to “allow nature to run its course” before releasing her without any treatment for her ectopic pregnancy.

Upon her return three days later, still experiencing bleeding, medical professionals finally consented to administering an injection to terminate the pregnancy. Unfortunately, it was too late. The fertilized egg developing in Thurman’s fallopian tube ruptured it, causing damage to her reproductive system.

This information comes from a complaint filed by Thurman and the Center for Reproductive Rights last week, urging the government to investigate whether the hospital violated federal law by neglecting to provide treatment initially in February 2023.

“I was left to flounder,” Thurman expressed. “It was essentially a case of being deceived.”

The Biden administration asserts that medical facilities must provide pregnancy termination services when necessary to safeguard a woman’s life, despite state restrictions imposed following the Supreme Court’s reversal of the constitutional right to an abortion over two years ago. Texas is contesting this guidance, and the Supreme Court refused to address the issue earlier this summer.

More than 100 expectant women experiencing medical emergencies who sought assistance from emergency rooms were turned away or negligently handled since 2022, as per an analysis of federal hospital investigations conducted by the Associated Press.

Two women — one in Florida and one in Texas — were left to miscarry in public restrooms. In Arkansas, a woman entered septic shock, and her fetus expired after an emergency room discharged her. At least four other women with ectopic pregnancies encountered challenges in receiving treatment, including one in California who necessitated a blood transfusion after sitting in an emergency waiting room for nine hours.

In Texas, where healthcare providers could face up to 99 years in prison if found guilty of performing an unlawful abortion, medical and legal experts suggest that the law is complicating the decision-making process concerning emergency pregnancy care.

Despite the state law stating that ending ectopic pregnancies is not categorized as abortion, the severe consequences deter Texas healthcare providers from treating such patients, as argued by the Center for Reproductive Rights.

“Hospitals and physicians are not only concerned about violating state abortion prohibitions but also must consider the implications of violating federal regulations,” stated Marc Hearron, an attorney at the center. Hospitals risk federal scrutiny, substantial penalties, and potential loss of Medicare funding if they breach federal laws.

The organization lodged complaints last week with the Centers for Medicare and Medicaid Services, alleging that various Texas emergency rooms neglected to treat two patients, including Thurman, with ectopic pregnancies.

One complaint states that Kelsie Norris-De La Cruz, 25, lost a fallopian tube and most of an ovary after an Arlington, Texas, hospital discharged her without addressing her ectopic pregnancy, even though a physician advised against it.

“The physicians knew that I required a termination, but these bans are making it exceedingly challenging to access basic emergency healthcare,” she remarked in a statement. “I am submitting this complaint because women like me deserve justice and accountability for the harm inflicted upon us.”

Accurately diagnosing an ectopic pregnancy can be complex. Three medical practitioners consulted for this article explained that doctors may not always be able to pinpoint the location of the pregnancy on an ultrasound. Hormone levels, bleeding, a positive pregnancy test, and an ultrasound of an empty uterus are all indicators of an ectopic pregnancy.

“It’s not always possible to be completely certain — that’s the challenging aspect,” stated Kate Arnold, an OB-GYN based in Washington. “Ectopic pregnancies are essentially time bombs. It’s a pregnancy developing in an area with limited space to accommodate its growth.”

Director of Texas Right to Life, John Seago, mentioned that state laws shield physicians from legal repercussions for terminating ectopic pregnancies, even in cases of misdiagnosis.

“Sending a woman home unnecessarily is entirely avoidable and extremely perilous,” Seago emphasized.

However, according to Hannah Gordon, an emergency medicine specialist who worked at a Dallas hospital until last year, the state law has undeniably instilled fear in doctors when it comes to treating pregnant patients.

She recounted an incident at her Dallas emergency room involving a patient displaying symptoms of an ectopic pregnancy. Due to inconclusive diagnoses from OB-GYNs, they postponed terminating the pregnancy until the patient’s return the following day.

“It left me with a feeling of discontent,” expressed Gordon, who relocated from Texas, hoping to conceive, and anxious about the quality of care she might receive.

Upon her third return to Ascension Seton Williamson, Thurman’s OB-GYN informed her that she required surgery to remove the ruptured fallopian tube. Thurman, still experiencing severe bleeding, hesitated. The loss of the tube would endanger her fertility.

Her doctor cautioned her that further delay could result in death.

“She came in and said, you’re either going to need a blood transfusion, or you will require surgery, or you’re going to bleed out,” Thurman recounted tearfully. “That’s when I realized, ‘Oh my goodness, I’m, I’m dying.’”

The hospital opted not to comment on Thurman’s case but stated in a release that it “is dedicated to delivering high-quality care to all individuals seeking our services.”

In Florida, a pregnant woman at 15 weeks leaked amniotic fluid for an hour in the emergency waiting area at Broward Health Coral Springs, according to federal records. An ultrasound revealed that there was no amniotic fluid surrounding the fetus, a critical condition that can lead to severe infection.

The woman miscarried in a public restroom that day, after the emergency room physician reported her condition as “improved” and discharged her without consulting the hospital’s OB-GYN.

She was rushed by emergency services to another hospital, where she was placed on a ventilator and discharged after six days.

Abortions after 15 weeks were prohibited in Florida at the time. The obstetrics medical director