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Ahead of this year’s state legislative session, lawmakers have introduced more than a dozen bills to expand access to abortion in at least seven states, and another bill filed in Texas would extend the state’s abortion ban to pregnant women. The purpose of this study is to investigate the impact on outcomes.
Some were filed in direct response to ProPublica reporting on the deadly consequences of such laws. Other works have been submitted for two or three years in a row, but this time I have a newfound optimism that it will get noticed.
Current differences are an unavoidable reality. In states where abortion is prohibited, women have died without access to life-saving treatment.
They all required a procedure to empty the uterus (dilation and curettage, or the equivalent of the second trimester). Although both are used for abortions, they are also standard medical care for miscarriages and help patients avoid complications such as hemorrhage and sepsis. But ProPublica found that doctors are hesitant to perform abortions because violating state abortion regulations could result in jail time.
Three women in Texas who suffered miscarriages died without treatment while grieving the loss of their pregnancies. One was a teenager. Two women in Georgia suffered complications after having abortions at home. One was afraid to seek treatment and the other died of sepsis after doctors did not provide a D&C for 20 hours.
Florida Sen. Tina Polsky said the bill she introduced Thursday was “100 percent” inspired by ProPublica’s reporting. Expanding exceptions to the state’s abortion ban to make it easier for doctors and hospitals to treat patients with complications. “Lives have been lost in Texas and Georgia. We don’t need to follow suit,” Democrats said. “It’s only a matter of time before that happens in Florida.”
Texas Rep. Donna Howard, who is pushing to expand the list of medical conditions that qualify for her state’s exemption, said she has had encouraging conversations with her Republican colleagues about the state’s bill. The revelation that a woman died after failing to receive life-saving treatment “made a huge difference here in Texas,” Howard said, adding there was widespread bipartisan support for the change.
Republican lawmakers in other states told ProPublica they have similar motivations.
They include Kentucky Rep. Jim Gooch Jr., a great-grandfather of Baptists, who for the second time sought to expand the circumstances under which doctors can perform abortions, including incomplete miscarriages and fatal fetal abnormalities. I am making an effort. He thinks the bill might be more well-received now that his colleagues know a woman’s life was lost. “We don’t want that in Kentucky,” he said. “I hope my colleagues agree.”
He said more clearly defined exceptions are needed so doctors can do their jobs without fear. “They need to have some clarity and not worry about being accused of some kind of crime or illegal activity.”
After a judge in North Dakota overturned the state’s blanket abortion ban, Republican state Rep. Eric James Murphy acted quickly to block a similar ban, restricting abortion for any reason. We have drafted a bill that would allow up to 16 weeks and then up to about 26 weeks. For several weeks if your doctor deems it medically necessary.
“We need other states to understand that there are approaches that don’t have to be so controversial,” said Murphy, who is also an associate professor of pharmacology at the University of North Dakota School of Medicine and Health. “What if we moved the discussion forward and let people know that there are rational Republicans out there? Maybe others will come along.”
He said state regulations require North Dakota lawmakers to give his bill a full hearing, and he plans to introduce the ProPublica article as evidence. “Does that make it any easier? I certainly hope so,” he said. “If the Lord wills, I hope the stream never rises.”
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So far, efforts to expand access to abortion in more than a dozen states with bans in place have faced fierce opposition, and lawmakers introducing the bills say they don’t expect that to change. Ta. And some lawmakers, advocates and medical experts argue that even with exceptions, doctors and hospitals will remain cautious about intervening.
As ProPublica reported, a woman also died in a state where abortion is banned in order to save “the mother’s life.” Doctors told ProPublica that the law’s language is often vague and not rooted in real-world medical scenarios, making colleagues hesitant to act until patients are on the brink of death.
Experts also say it’s essential to examine maternal deaths in states with bans to understand exactly how the law is impacting life-saving medical care. But Texas law prohibits the state Maternal Mortality Investigation Board from investigating deaths of patients who received abortions or medication, even in cases of miscarriage. Under these restrictions, the circumstances surrounding two of the Texas deaths ProPublica documented will never be considered.
“I think it’s going to be a problem for us if we don’t know what the hell is going on,” said Sen. Jose Menendez of Texas.
In response to ProPublica’s reporting, Democrats introduced a bill that would lift the restrictions and direct a state commission to investigate deaths related to abortion access, including miscarriages. “Some of my colleagues say that the only reason these women died was because of improper medical treatment or malpractice,” he says. “So what’s the harm in investigating what actually happened?”
U.S. Rep. Jasmine Crockett agreed. Texas Democrats and three other members of the House Oversight and Accountability Committee sent a letter to Texas officials on Dec. 19 demanding an explanation for their decision not to investigate fatal crashes in 2022 and 2023. I asked for it.
Crockett said the state has not responded to a letter he sent to Texas Surgeon General Jennifer Shuford.
“If you think your policies are worth the money, show us the money, show us the product,” she said. “This should be a wake-up call to Texans, and Texans should demand more. If you believe these policies are good, you should look at the numbers.”
Doctors are starting to hear growing concerns in hospital conversations.
Dr. Austin Dennard, an obstetrician-gynecologist in Dallas, said her hospital recently held a meeting with attorneys, administrators, and various experts to discuss “how to ensure the safety of pregnant patients within the hospital system.” The focus was on “how to keep doctors safe and how to keep doctors safe.” They discussed developing additional guidance for physicians.
CDC does not require countries to track deaths related to abortion bans
Dennard said she is speaking on her own behalf and has received further questions from patients. “We often talked about whether we should stop taking vitamins or certain medications or get vaccines,” she said. “Now that we’ve done all that, there’s even more conversations in Texas about pregnancy and just, ‘What’s the safest way for us to do this?'”
In addition to being a doctor, Dennard was one of 20 women who joined the lawsuit against the state after being denied abortions due to miscarriages or high-risk complications in their pregnancies. When she learned her fetus had anencephaly (a condition in which the brain and skull are not fully developed), she had to travel out of state for an abortion. (The lawsuit asked state courts to clarify the exception to the law, but the state Supreme Court refused.)
Dennard said articles like the one in ProPublica crystallized a new level of consciousness among local patients: “If you have the ability to get pregnant, you can easily become one of these women.”
Mariam Elba contributed research and Kavithurana contributed the report.
