A 35-year-old woman in the Dallas-Fort Worth area lost a baby last year. A doctor performed a surgical procedure at a large hospital to remove tissue from a failed pregnant woman.
She woke up from anesthesia and found a card signed by the nurses and a bracelet with a butterfly charm. It was sweet because it was difficult to go through.
In January, the woman who asked to be identified by her first name lost a baby. She said she went to the same hospital and screamed as she passed a large blood clot.
She said the hospital told her not to request the same procedure.
The same procedure is used for some abortions. Texas implemented a law banning almost all abortions after six weeks into a pregnant woman's unborn child.
Several states have enacted bans or restrictions on abortion. Some patients have reported difficulties getting standard surgical procedures or medication for the loss of desired pregnancies because of the laws.
The hospital didn't mention the abortion law, but gave her instructions to return if she was bleeding so much that she had a diaper on. According to hospital records shared with The New York Times, the embryo had no cardiac activity during the visit and the one week later. She reported having a lot of pain and appeared distressed.
The records suggest waiting to confirm and advise a follow-up in seven days.
She sat on the toilet digging nail marks from the wall after returning from the hospital. Her husband held her hand as they both cried in the tub. The water in the tub is dark red. It was so bad for 48 hours that it was likened to a heavy bleed.
She said that it was different from her first experience where they were nice and comforting.
The hospital wouldn't say if Texas's abortion laws had any effect on its medical care. While we are not able to speak about an individual's case due to privacy laws, our multidisciplinary team of clinicians works together to determine the appropriate treatment plan on an individual case by case basis The health and safety of our patients is of paramount importance to us.
John Seago is the president of Texas Right to Life. He blamed the problem on a breakdown in communication of the law, not the law itself.
The uncertain climate has led some doctors and hospitals to worry about being accused of facilitating an abortion, a fear that has also caused some pharmacists to deny or delay filling prescriptions. The pharmacy may be discriminating on the basis of sex if they refuse to fill prescriptions for contraceptives because they can also be used to end a pregnant woman's baby's life.
Obstetricians say that delays in expelling tissue from a pregnant woman can lead to life threatening infections.
Dr. Monica Saxena is an emergency medicine physician at the hospital.
Miscarriage is a term used by medical experts to describe a pregnancy that ends naturally. The majority of stillbirths occur in the first 13 weeks of the baby's life. Miscarriage befalls about one in 10 known pregnancies, and may occur in as many as one in four when including miscarriages that occur before the patient knows they are pregnant.
Miscarriage is sometimes referred to as "spontaneous abortion," a designation that can increase patients' or providers' concerns about being targeted under abortion bans. The second miscarriage was labeled as a threat to abortion.
When cardiac activity stops, patients should be offered three options to expel tissue.
When patients are bleeding heavily, have blood-clotting issues, or are medically fragile, D&C is a good idea. Some patients prefer D&C's because they are easier to handle at home.
Mifepristone is a medication used to weaken the uterus and the cervix. They are used for abortion.
Waiting for tissue to pass on it's own can take weeks. It is unsuccessful for 20% of patients who need surgery or medication.
Doctors and patients agree that patients should be allowed to choose the method if possible.
In Wisconsin, where a 173-year-old abortion ban may soon be enforced again, a doctor treated a woman who showed up bleeding at the hospital after she had an abortion. She was advised by the hospital to find a doctor to help with her pregnancies. The woman had been bleeding for days when she found the doctor who gave her the drugs.
The laws leave providers questioning and afraid even in simple cases of OB/GYN practice. I think these laws are hurting my patients.
An assistant professor at the University of Pittsburgh Law School said that if the patient's water has broken too early for the pregnancy to be viable, a case of "inevitable miscarriage" may occur.
According to a study from two Dallas hospitals, there were 28 patients whose water broke or who had other serious complications before 22 weeks, who didn't receive medical intervention until there was an "immediate threat" to their lives. The patients waited an average of nine days, and 57 percent of them ended up with serious infections or other medical problems. According to an article in the New England Journal of Medicine, patients came back with signs of sepsis after doctors or hospitals decided Texas's abortion law prevented them from intervening earlier.
Delayed intervention might be required in such cases. He characterized it as a doctor saying "I want to cause the death of the child today because I believe that they're going to pass away someday." He admitted that delays could cause medical problems for women, but said that they could be treated immediately.
Mifepristone can't be prescribed by a typical pharmacy and can only be used by certified providers. Lauren Thaxton, an assistant professor in the department of women's health at the University of Texas at Austin's Dell Medical School, said some hospitals have expressed concern about this medication being used for abortion.
In some states, doctors only prescribe the drug for miscarriages, which can work on its own, but not well. It is also used for other medical conditions and should be easy to get at the pharmacy, but some have refused to fill prescriptions or required more documentation.
The Houston woman, who asked to be identified by her first name, said that her doctor found blood in her uterus and no heart activity when she miscarried.
She was prescribed a drug but had to wait a day for approval from the corporate office.
When I went to pick it up, I had to tell the pharmacy that it wasn't for an abortion, even though they knew my doctor had prescribed it.
A Walgreens spokesman said that some abortion laws require additional steps to be taken. Our pharmacy works closely with prescribers in these states to fill their prescriptions.
Some patients can't return for the medication another day if the pharmacy doesn't give it on time. She said that some people visit doctors a day or two later with bleeding that needs to be managed.
In March of this year, a woman who asked to be identified by her first name, said she had a blighted ovum, in which a fertilized egg implants in the uterus but doesn't develop. Her body wouldn't let it go.
She was prescribed a drug that didn't work well. According to a doctor's note shared with The Times, the doctor told her it was hard to get the drug there.
The doctor ordered a second round of the drug, but the pharmacy at Walgreens wouldn't give it to her if she was pregnant. She gave it to me because I stuttered out that I was having a baby. In front of all the people at Walgreens, I cried because I felt like I was being treated like a bad person.
According to Dr. Prager, some Texas patients were turned away by doctors because they thought the patients might have taken abortion pills that didn't kill the baby.
Patients are going to choose not to go to a hospital if there is no trust between doctors and patients.
Some women who have miscarried and are at risk of future losses are considering moving to a state that doesn't ban abortion.
We are not going to try and have a baby. We don't think it's safe to try after what we went through in Texas
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