WASHINGTON – Kyleigh Thurman was bleeding and in pain, but she didn't know her unlucky pregnancy could kill her.
Emergency room doctors at Ascension Seton Williamson Hospital in Texas gave her a pamphlet about miscarriages and advised her to “let nature take its course” before discharging her without treating her ectopic pregnancy.
When the 25-year-old returned three days later, still bleeding, doctors finally agreed to present her an injection to terminate the pregnancy. But it was too late. The fertilized egg growing in Thurman's fallopian tube would rupture it and destroy a part of her reproductive system.
According to a Complaint Thurman and the Center for Reproductive Rights last week, asking the federal government to analyze whether the hospital violated a federal law when staff initially refused to treat her in February 2023.
“I was just left helpless,” Thurman said. “I was just misled.”
Despite the Biden administration's public warning to hospitals to treat pregnant patients only in emergency situations, the facilities proceed to violate federal law. The issue got here under the administration's highlight after reports of improper treatment of ladies in emergency rooms emerged following the Supreme Court's ruling greater than two years ago striking down the constitutional right to abortion.
More than 100 pregnant women in medical distress looking for care in emergency rooms have been turned away or treated negligently since 2022, an Associated Press evaluation of investigations at federal hospitals found.
Two women – one in Florida and one in Texas – suffered miscarriages in public restrooms. In Arkansas, a girl went into septic shock and her fetus died after being sent home within the emergency room. At least 4 other women with ectopic pregnancies had trouble getting treatment, including a California woman who needed a blood transfusion after sitting in an emergency room waiting room for nine hours.
The White House says that despite state bans, hospitals must provide abortions when it’s essential to avoid wasting a girl's health. Texas challenged that policy, and earlier this summer the Supreme Court rejected to repair the issue.
Abortion bans make it difficult to take care of high-risk pregnancies
In Texas, doctors resist 99 years in prison if convicted of performing an illegal abortion. Medical and legal experts say the law makes it harder to make decisions about emergency pregnancy care.
Although terminating an ectopic pregnancy will not be considered an abortion under state law, the draconian penalties deter Texas doctors from treating these patients, argues the Center for Reproductive Rights.
“As much as hospitals and doctors are afraid of violating these state abortion bans, they also have to worry about violating federal law,” said Marc Hearron, a federal government attorney. Hospitals face federal investigation, heavy fines and the specter of having their Medicare funding cut off in the event that they violate federal law.
The organization filed two complaints with the Centers for Medicare and Medicaid Service last week alleging that various Texas emergency rooms didn’t treat two patients with ectopic pregnancies, including Thurman.
Another Complaint says Kelsie Norris-De La Cruz, 25, lost a fallopian tube and most of an ovary after an Arlington, Texas, hospital sent her home without treatment for her ectopic pregnancy, despite the fact that a physician said discharge was “not in her best interest.”
“Doctors knew I needed an abortion, but these bans make it nearly impossible to get basic emergency care,” she said in a press release. “I am filing this complaint because women like me deserve justice and accountability from those who have hurt us.”
Definitely diagnosing an ectopic pregnancy might be difficult. Doctors can't at all times determine the situation of the pregnancy through an ultrasound, explained three different doctors consulted for this text. Hormone levels, bleeding, a positive pregnancy test and an ultrasound of an empty uterus all indicate an ectopic pregnancy.
“You can't be 100 percent sure — that's the hard part,” said Kate Arnold, a Washington gynecologist. “They're literally time bombs. It's a pregnancy growing inside this thing that can only grow to a certain extent.”
John Seago, director of Texas Right to Life, said state law clearly protects doctors from prosecution in the event that they terminate an ectopic pregnancy, even when the doctor “makes an error” in diagnosis.
“Sending a woman home is totally unnecessary and totally dangerous,” Seago said.
But the state law has made doctors “absolutely” afraid to treat pregnant patients, says Hannah Gordon, an emergency physician who worked at a Dallas hospital until last yr.
“It will force doctors to create questionable scenarios for their patients, even if it is very dangerous,” Gordon said. She left Texas in hopes of becoming pregnant and was nervous concerning the care she would receive there.
Gordon recalled a pregnant patient in her emergency room in Dallas who had signs of an ectopic pregnancy. Because the gynecologists said they couldn't clearly diagnose the issue, they waited to terminate the pregnancy until the patient returned the subsequent day.
“It left a bad taste in my mouth,” Gordon said.
“Oh my God, I'm dying.”
When Thurman returned to Ascension Seton Williamson for a 3rd time, her gynecologist told her she would wish surgery to remove the ruptured fallopian tube. Thurman, who was still bleeding heavily, was reluctant to undergo the procedure. Losing the fallopian tube would put her fertility in danger.
However, her doctor told her that if she waited any longer, she would die.
“She came in and said, either you need a blood transfusion, or you need surgery, or you're going to bleed to death,” Thurman said through tears. “I just thought, 'Oh my God, I'm dying.'”
Ascension Seton Williamson declined to comment on Thurman's case, but said in a press release that the hospital is “committed to providing quality care to all who use our services.”
In Florida, a 15-week pregnant woman lost amniotic fluid for an hour within the emergency room at Broward Health Coral Springs, federal documents show. An ultrasound revealed that the patient's fetus was not surrounded by amniotic fluid, a dangerous situation that may result in serious infections.
The woman suffered a miscarriage in a public toilet that very same day after the emergency room doctor declared her condition “improved” and discharged her without consulting the hospital’s gynecologist.
Emergency personnel took her to a different hospital, where she was placed on a ventilator and discharged after six days.
Abortions after 15 weeks were illegal in Florida on the time. The medical director of obstetrics at Broward Health Coral Springs told an investigator that induction of labor in women with premature rupture of the membranes “has been the standard of care for some time, regardless of the heartbeat, because of the risk to the mother.”
The hospital declined to comment or share its policies with AP.
In one other case in Florida, a physician admitted that state law made emergency pregnancy care harder.
“Because of the new laws … staff can only intervene when the patient's health is in danger,” a physician at Memorial Regional Hospital in Hollywood, Florida, told an investigator looking into the hospital's refusal to supply an abortion to a pregnant woman whose water ruptured at 15 weeks, long before the fetus could survive.
Problems transcend states with abortion bans
In each states with and without abortion bans, serious violations occurred that endangered the health of the mother or her fetus, in line with the AP investigation.
In interviews with investigators, two hospitals in Idaho and Washington which are experiencing staff shortages admitted that they often sent pregnant patients to other hospitals.
A pregnant patient in an emergency room in Bakersfield, California, was examined quickly, but staff failed to acknowledge that she was affected by a uterine rupture. The delay, an investigator concluded, can have contributed to the infant's death.
According to the documents, doctors in emergency rooms in California, Nebraska, Arkansas and South Carolina failed to examine for a fetal heartbeat or discharged patients in mid-labor and left them to present birth at home or in an ambulance.
The shortage of nurses and doctors that hospitals have suffered because the Covid-19 outbreak, the issues in staffing ultrasound stations across the clock and latest abortion laws are making the emergency room a dangerous place for pregnant women, warned Dara Kass, an emergency physician and former official with the U.S. Department of Health and Human Services.
“It is increasingly unsafe to be pregnant and seek medical help in an emergency room,” she said.
Originally published:
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