While no national data has yet been released to show the extent of these complications, the report, It was released on Tuesday by researchers at the University of California, San Francisco And shared with The Washington Post, it provides a first-of-its-kind summary of anonymous examples from medical providers across the country.
The two research groups that conducted the report — UCSF’s New Standards in Reproductive Health and the Texas Policy Review Project at the University of Texas at Austin — support abortion rights.
Individual cases of health problems associated with abortion restrictions Since the June decision, they have emerged. Including stories of women returning from hospitals with life-threatening complications because doctors and hospital administrators fear the legal risks of even terminating a pregnancy that puts the mother’s safety at risk. But the new report, which lists 50 examples shared by providers who chose to participate in a national survey, represents an effort to capture a broader picture of how health care has been affected by abortion restrictions.
“Patients are being significantly harmed because care is being denied or delayed,” said Daniel Grossman, a UCSF professor and lead author of the report. “These laws are having a far-reaching impact beyond people seeking abortions because they have unwanted pregnancies.”
The findings include examples of one patient who developed a serious infection after being sent home from the hospital, leaving her in critical condition — and another, who failed to abort an ectopic pregnancy due to a caesarean scar, a life-threatening pregnancy. Implantation in the scar of a previous caesarean section.
Medical special conditions to preserve the life of the mother involved in abortion They’re often couched in vague language, Grossman said, creating uncertainty among medical providers who say the law doesn’t allow them to terminate pregnancies for patients with serious medical conditions.
Anti-abortion lawmakers, who pushed the abortion bill, say the language in the bill allows doctors to intervene in a variety of emergencies, which some say doctors intentionally misinterpret medical conditions to score political points.
“I believe that in situations where a doctor is acting in good faith, they can act in that moment,” said former Florida state Sen. Kelly Stargell, who supported Florida’s 15-week abortion ban. “It’s not in anyone’s interest to have things go to court.”
Grossman said responses to the report show that many doctors do not feel they can safely perform abortions in high-risk situations. Hospitals often do not provide doctors with any additional guidance beyond the language in the law, leaving doctors unsure of how to act in any given situation.
“Medicine is not black and white,” Grossman said. “It’s not like you suddenly know that a patient is more likely to die in a certain situation. There is a lot of gray and this danger will gradually change over time.
To gather submissions for the report, Grossman and his team set up an online portal that allows medical providers to submit their experiences anonymously if they choose, Grossman said, which is important because many hospitals prohibit medical providers from speaking to the media through policies. to abortion restrictions. The research team shared the portal with various medical and nursing associations, including a variety of medical providers, including doctors, nurse practitioners, midwives and nurses.
The most common type of complication among respondents was premature rupture of membranes, or PPROM, a condition in which a woman’s water breaks before the fetus can survive on its own, leaving the patient at high risk of infection and bleeding.
Abortion is legal across the country and doctors in all states routinely offer to induce Or perform a surgical procedure to terminate the pregnancy when faced with a case of beta PPROM – according to the American College of Obstetricians and Gynecologists (ACOG) and the standard of care that many women choose. Especially before the 20-week mark, a fetus is more likely to remain without amniotic fluid.
Since then, many doctors have been returning patients with PPROM. Ro According to the report, it did not offer the option of inducing pregnancy or abortion.
In one case cited in the report, a patient was sent home after her water broke between 16 and 18 weeks pregnant in a state where abortion is prohibited — only to return to the intensive care unit two days later with a severe infection, he said. The doctor involved in the case.
“The anesthesiologist cried over the phone as he discussed it with me,” the doctor wrote. “If the patient has to put it in, no one thinks she’s going to put it in. [operating room.]”
After the doctor finally decided to terminate the pregnancy, the doctor wrote, the patient asked if she or the doctor would face criminal charges.
“She asked me: Can she or I go to jail for this?” The doctor explained in his comments. “Or is this considered life-threatening?”
Republican lawmakers have repeatedly said they would cover patients with ectopic pregnancies under medical exceptions that prohibit abortions.
But several clinics said in the report that patients with cesarean scar ectopic pregnancies experienced delays in care when abortions were denied, put patients at greater risk for bleeding, placental abruption, and uterine rupture.
A doctor has described how after green-lighting an abortion for a patient with a caesarean scar ectopic pregnancy, other colleagues who were essential to completing the procedure safely refused to help because they did not feel they were “legally protected”. The doctor suggested that the patient go to another place, but the patient did not have the means to leave the state.
The doctor said his team continued to monitor the patient, who was pregnant at the time of referral and developed a life-threatening complication of pregnancy (percreta) that could lead to severe bleeding or rupture of the uterus at any time.
The study highlighted several other pregnancy complications that medical providers said were affected by the Supreme Court decision. Patients have been unable to terminate pregnancies because of miscarriages, medical providers said, while others have experienced delays in getting the medication needed to treat early miscarriages.
Concerns over the abortion ban have led doctors to delay or deny many non-abortion-related treatments, the report said. In one case, a clinic refused to remove an intrauterine device (IUD) from a patient who was 10 to 12 weeks pregnant, even though partially removing the IUD would increase the patient’s risk of conception or miscarriage.
A doctor consulted on the matter said, “The doctor was not comfortable removing the IUD because it could cause a miscarriage.” “The proposed context was concerned with the legal changes it would create. [the] Abortion providers in our state face criminal charges.
One limitation of the report, Grossman said, is that he and his team were unable to collect enough samples to meaningfully observe changes over time. As time passes, doctors may become more familiar with the types of care they can provide under the new rules — something Grossman and his team plan to measure.
To help with these situations, Grossman said, hospitals in states where abortion is prohibited can provide a list of conditions that doctors can legally treat — specifying, for example, that providers can legally offer PPROM to induce a pregnancy. Alternatively, he said, Republican lawmakers could introduce additional laws or amendments to clarify medical exceptions.
“It could be the first step,” Grossman said. “But I don’t think any list can ever be comprehensive. There are always dangers that are not on the list.
Last month in Florida, during a debate over six-week abortions, Democratic lawmaker Rep. Robin Bartleman introduced an amendment that would have allowed doctors to openly perform an abortion if a woman was in a hospital. PPROM.
Rep. Jenna Persons-Mulica (R) supported the six-week ban. The Republican-led Legislature said a medical exception included in the bill would cover that type of condition, despite stories on the House floor that doctors don’t feel comfortable working in PPROM situations.
The amendment was defeated on a party-line vote of 33-80.