It's been almost two weeks since the Supreme Court overturned the
five decade old landmark abortion rights decision Roe v. Wade. In
that short time, doctors and abortion providers have been left to
navigate different state by state laws. While still trying to provide
care for their patients. Stephanie Sai has more
In this post road world, physicians and states with near total abortion
bans are having to wade through medically and ethically murky waters.
In Texas, For example, a law set to go into effect makes all abortions
illegal, including in cases of rape and incest. The only exception
is to keep a woman from dying. But what does that mean in practice
to help us understand? I'm joined by Dr Ghazala Moya, T. O. B. G.
Y. N in Texas, who had offered abortion care as part of her practice
stuck.
Turmoil. Betty thank you so much for joining the news hour. I want
to jump right in here in Texas. The law says If a doctor sees quote,
substantial impairment of bodily function during a pregnancy, they
can legally provide an abortion. But couldn't that mean something
different to every doctor? And what are the ramifications of that?
Exactly Stephanie. There isn't one type of medical complication.
Where you say, Okay, This is life threatening and this isn't in practice.
What That means is that every single person will be faced with different
hospitals, different physicians, different nurses that will make
different decisions depending on the day and that is catastrophic
to the health and well being of pregnant people in our state.
Doctor Moretti and the recent article you co authored that was published
in The New England Journal of Medicine. You interviewed dozens of
clinicians in Texas and you wrote quote Patients with pregnancy complications
or pre existing medical conditions that may be exacerbated by pregnancy
are being forced to delay an abortion until their conditions become
life threatening. Do you think that some doctors are already waiting
until the woman's vital signs are in distress?
Where she is near dying before they feel they are legally covered
to provide an abortion.
Yes, that's exactly what we saw in the research that we conducted
and exactly what I've been hearing from my colleagues across the
state, but people will come in in the early second trimester with
their bag of water broken. This is a pregnancy complication that
let's say at 18 weeks cannot be saved.
But they're being told that they need to go home and wait until they
have a fever. Wait until they start hemorrhaging or wait until they
show signs of sepsis before they can return to have an abortion.
And that is we saw that through our study, and I'm hearing that from
colleagues all across the state in that setting.
Another complication that can happen in pregnancy. And one of the
most dangerous is an ectopic pregnancy when a fertilized egg implants
outside the uterus. This is in theory excluded from the abortion
ban in Texas. But what are you hearing in practice is happening in
that instance exactly. Even an ectopic pregnancy, which seemingly
is excluded falls into a gray area, which can be interpreted differently,
depending on where the person shows up.
Some most commonly an ectopic pregnancy might implants in the fallopian
tubes or in the ovaries, But an ectopic pregnancy can also implant
into a C section scar or into a uterine scar from a prior surgery.
That pregnancy will then grow through the uterine scar potentially
outside of the uterus and into the bladder. Even before this ban
went into effect, there were hospitals in Texas that would refuse
to care for someone with an ectopic in the C section scar because
they weren't sure if it was actually an ectopic or not.
And so what we are seeing now is that more and more people are being
denied care for these gray areas that are not as clear cut because
that decision making is very individualized. It can't be clearly
defined in a lot. This is a complication and this is not a complication.
This is near death.
And this is not in your death that is very individual.
In all the cases you've described so far. We're talking about the
life of the mother. What about those mothers that are carrying fetuses
with diagnosed fatal abnormalities, genetic abnormalities where they
know that once they have
the baby that that the baby's lifespan is limited.
Yes. Unfortunately, none of these laws and our state have any exceptions
for lethal fetal diagnosis. And so what we have seen over the past
10 months is that people that are diagnosed with lethal fetal conditions,
for example, like an encephalitis, where the brain doesn't grow.
Arenal, a genesis where there are no kidneys. There is not a potential
for life after birth, and yet pregnant people are forced to endure
a complete pregnancy and the risks that come with that.
And we have to remember Texas has one of the highest maternal mortality
rates in the country, even more so for black women in our state,
and so this disproportionately puts black people, people of color
at risk of maternal death without any benefit or potential chance
for a life birth. And we know that the United States as a whole has
a higher, more maternal mortality rate than other nations of equal
affluence. Um if a doctor or a hospital does make a decision to not
provide an abortion
And that leads to a woman's or girl's death. What accountability
do they have under the law?
You know that will remain to be seen. Um, I strongly believe that
our duty is to our community and to our patients, and we have to
act through that moral compass, the ethical duty We have to care
for people and to save their lives. But how this is going to turn
out from a medical legal standpoint is going to be determined by
the courts, and that is
Even more terrifying part for all of us, as, um, pregnant people
as pregnant, capable people as moms and as Americans, Dr Ghazala,
Marjorie and O b g Y n in Texas Thank you for joining the news hour.