Two women filed federal complaints against Texas hospitals for failing to provide care for the troubled pregnancies endangering their lives.
This story was originally posted on Courier Texas.
It was several days after Kyleigh Thurman thought she was successfully treated for an ectopic pregnancy at the Ascension Seton Williamson Hospital in Round Rock, Texas.
She thought that the nightmare that she had been living through during January and February 2024, with over a month of suffering from bleeding, cramping, weakness and dizziness, was finally over.
But a week after receiving an injection of a drug that was supposed to stop the fertilized egg from growing inside her fallopian tube, Thurman was hit by a blinding pain in her right side.
She was all alone.
“I felt like I had been stabbed in my right side. It was terrible pain for one, but also just the rapid loss of blood, I nearly lost consciousness,” Thurman later told The Cut.
“I was in a location that I thought, man, if I pass out … I’m not sure anyone’s going to find me or get here. I was just like, don’t die, stay conscious,” she added.
Somehow, with her mom on the phone, she managed to stay alert and drive herself to a hospital in Burnet County. But the facility didn’t have the staff or resources to treat her now life-threatening condition. Her fallopian tube had ruptured.
Thurman was rushed to Ascension Seton Williamson Hospital an hour away, where she was told her fallopian tube needed to be removed. Even as she bled heavily and pooled blood filled her abdomen, she was reluctant to undergo the procedure. Thurman wanted to preserve her fertility.
“I want to have kids and I wanted to keep my fallopian tube,” she later recounted. That’s why she was glad to receive an injection of methotrexate, which was supposed to stop the ectopic pregnancy from growing a week before. It was supposed to be slowly re-absorbing into her body.
Unfortunately, that had come too late after days of delayed treatment at the hospital where she now faced surgery.
When Thurman balked at going under the knife, her OB-GYN, who was on call at the hospital when she arrived, laid out the urgency of her dire circumstances.
“You need a blood transfusion, you’re getting dangerously close to losing your life,” she told Thurman. “You’re going to have to have surgery, or you’re going to bleed out.”
Thurman later told the Associated Press in a tear-filled interview, “That’s when I just kind of was like, ‘Oh, my God, I’m dying.’”
The 35-year-old had already made multiple trips to hospital emergency rooms—twice to her hometown hospital and twice to the larger Ascension Seton Williamson Hospital in Round Rock.
But despite her own OB-GYN diagnosing an ectopic pregnancy based on blood tests and ultrasound results, the hospitals she visited kept discharging her without any treatment and told her to return a few days later.
Thurman’s experiences at the Ascension Hospital were documented and filed in a complaint against the facility on Aug. 6 with the U.S. Department of Health and Human Services.
Thurman wants the agency to investigate the Texas hospital for refusing to provide her with treatment to stabilize her emergency medical condition and with failing to provide her with timely medical treatment to terminate her ectopic pregnancy.
She is represented by lawyers from the Center For Reproductive Rights, who contend in the complaint that the hospital violated the Emergency Medical Treatment and Active Labor Act, a law passed in 1986 that requires all hospitals with emergency rooms that receive Medicare funding to provide health-stabilizing care even if it requires an abortion.
Delays Turn Dire
Thurman and Kelsie Norris-De La Cruz—a 25-year-old Arlington native whose fallopian tube nearly ruptured in an ectopic pregnancy—are the latest Texan women to file complaints or lawsuits after suffering harm to their reproductive health after the state enacted a near-total abortion ban.
Texas now has one of the strictest abortion bans to become law since the Supreme Court overturned Roe v. Wade after 50 years and ruled that women no longer had a federal right to abortion. State legislatures can now enact their own abortion bans and restrictions.
Texas has banned abortions for its 7 million women of reproductive age, from the moment of conception with no exceptions for rape, incest or health of the mother or if the mother is carrying a fetus with a fatal fetal anomaly.
Former President Donald Trump has repeatedly bragged that his three right-wing justices he appointed helped strip women of their reproductive rights and people in states could vote on the issue. That’s not the case in Texas.
While Thurman and Norris-De La Cruz, who filed her complaint on Aug. 6 against the hospital who treated her, were legally able to be treated for an ectopic pregnancy in Texas, both experienced the same delays at hospitals before their conditions became dire.
Ectopic pregnancies are the leading cause of death in the U.S. for pregnant women in their first trimester.
Texas Attorney General Ken Paxton issued an updated advisory in July 2022 that it was legal to remove an ectopic pregnancy in the state, despite the strict abortion ban. Then the Texas legislature passed House Bill 3058, providing doctors who terminate an ectopic pregnancy with an “affirmative defense” if they are prosecuted.
In other words, Texas doctors can still be charged for treating an ectopic pregnancy, but they have a legally recognized defense to the charge. But if a doctor loses, they face exceptionally harsh criminal penalties for performing an abortion, including up to 99 years in prison, the loss of their medical license, and a $100,000 fine.
Ectopic pregnancies aren’t viable. For Thurman and Norris-De la Cruz, the fertilized egg attached to their fallopian tubes where it was impossible for them to continue to grow.
In other cases of ectopic pregnancy, fertilized eggs can attach themselves to an ovary, on the cervix, in the abdomen or even in a scar from a previous C section instead of in the uterus.
Ectopic pregnancies can be deadly if not treated in time.They are the leading cause of death in the U.S. for pregnant women in their first trimester, with a mortality rate of 9-14 percent of all pregnancy-related deaths. Maternal mortality rates in Texas doubled between 1999 and 2019, even before the effect of the bans was felt in the state.
‘You Can Die From the Bleeding’
Ectopic pregnancies become dangerous when “they grow big enough to rupture the fallopian tube causing a significant amount of bleeding internally into the abdomen,” according to Austin Dennard, a Dallas OB-GYN.
“You can die from the bleeding,” Dennard told Courier Texas. “These are pregnancies that needed to be acted on immediately.”
But that wasn’t what happened to Thurman when she first arrived with her partner at the Ascension Hospital with instructions to ask for the methotrexate injection to treat her ectopic pregnancy.
She received an ultrasound that revealed a two-centimeter “rounded structure” on her right fallopian tube and no signs of a gestational sac in her uterus. In other words, there was no evidence of a pregnancy developing in her uterus.
Thurman’s OB-GYN also called the hospital and told doctors that her patient had an ectopic pregnancy and required the injection. Nevertheless, Thurman was sent home and told to come back for a check up in two days.
It was only on a return visit three days later when Thurman’s OB-GYN sent another doctor to the hospital to plead with the medical staff to provide the methotrexate injection, that it was finally administered.
Thurman said that before her own experience, she didn’t know about the state’s abortion ban and “it didn’t make sense to me why I couldn’t receive help. The experience was incredibly disempowering.”
Doctors ‘Walking on Eggshells’
But to Dennard, the experiences of Thurman and Norris-De La Cruz make sense given the abortion ban the legislature passed in 2021.
“When SB 8 and the other bans were created, it gave physicians cold feet about treating abortions. These women are examples of how scared, terrified and confused providers are even with the Texas law redefining that it’s legal that an ectopic pregnancy is a medical exception,” Dennard said.
“There has been irreparable damage done from these abortion bans and not every physician is keeping up with the law. They’ve been told that abortions are banned in the state. It’s not the provider’s fault,” she added.
Doctors “are walking on eggshells,” Dennard added, concerned about another medical provider disagreeing with the diagnosis and raising a red flag about providing treatment.
Nancy Binford, an Austin OB-GYN, agreed that doctors are afraid to treat patients with reproductive health care issues due to the Texas abortion bans. She cited instances of doctors being afraid of their treatment being misunderstood and then potentially being reported to the hospital or another authority.
Binford cited an example from her clinic in which a patient had a stillbirth and required a dilation and evacuation procedure to remove the fetus from the uterus. The correct medical terminology for a stillbirth is a “missed abortion,” and someone in the clinic misunderstood the diagnosis and reported the physician who treated the woman to the chief medical officer at the hospital, she said.
“But it’s never been against the law to care for a patient whose baby has already died,” Binford said. “They’ve criminalized obstetric care in the state.”
Astrid Ackerman, an attorney for the Center For Reproductive Rights, said doctors face severe penalties for abortions so they are going beyond what’s been normally required to diagnose ectopic pregnancies. That slows down treatment.
“Even when there are exceptions to the law, doctors feel they have to over-document what care they are providing to prove they are ectopic pregnancies. The risk of prosecution is preventing doctors from doing their jobs to protect their patients,” Ackerman said.
It’s never been against the law to care for a patient whose baby has already died. … They’ve criminalized obstetric care in the state.
Nancy Binford, Austin OB-GYN
Dennard and Binford said their pregnant patients are terrified of encountering a complication—whether it’s a miscarriage, a fatal fetal anomaly or a risk to their health—that may be difficult or not treatable in the state now.
“One hundred percent of my pregnant patients are afraid,” Dennard said. “It’s an extra stress to every stage of pregnancy. You don’t want it to, but these laws are stealing the joy out of pregnancy.”
“Women are afraid to get pregnant in Texas. There is a pervasive unease with pregnancy. Women in their 40s with high-risk pregnancies are very afraid. Those pregnancies are fraught with difficulties.”
Binford is also seeing women in their 20s asking for tubal ligations. “They don’t want to get pregnant in this world,” she said.
Cramping, Bleeding and Waiting
When Norris-De La Cruz had a positive pregnancy test in January, she and her boyfriend were excited. But once cramping and bleeding began, she went to an emergency room and learned she was either miscarrying or experiencing an ectopic pregnancy.
At Texas Health Arlington Memorial Hospital, she said she was denied care by two OB-GYNS for an ectopic pregnancy despite an ultrasound showing a six-centimeter mass, as well as complex fluid in her pelvis, and no gestational pregnancy sac in her uterus. Her fallopian tube was at risk of rupturing.
Norris-De La Cruz was told to return in 48 hours. But she and her mom, Stephanie Lloyd, were so desperate for treatment that they waited several hours until a new OB-GYN came on call. The emergency room physician recommended treatment for an ectopic pregnancy.
“I do not feel comfortable discharging her home and do not think that is in her best interest,” the doctor noted in her file.
Yet a third OB-GYN told her to go home and return in 48 hours. Lloyd told The Washington Post that she panicked, fearing that her daughter was going to die.
It was only through a stroke of luck that a friend’s OB-GYN agreed to examine Norris-De La Cruz and review her test results that afternoon. He immediately scheduled surgery at a different hospital.
The mass had grown so large that he was forced to remove most of her right fallopian tube and most of her right ovary. The fallopian tube had already started to rupture. If Norris-De La Cruz had waited much longer, she would have been “in extreme danger of losing her life,” Jeffery Morgan, the OB-GYN that treated her, told the Post.
“I was scared I was going to … lose my entire reproductive system if they waited too long,” Norris-De La Cruz said later. “I knew it could happen at any moment.”
Texas Health Arlington Memorial Hospital told the Post that the hospital’s top priority is “providing our patients with safe, high-quality care.”
“Treatment decisions are individualized based on a patient’s clinical condition and we believe the care provided to the patient in this case was appropriate,” the hospital said.
I was scared I was going to … lose my entire reproductive system if they waited too long. … I knew it could happen at any moment.
Kelsie Norris-De La Cruz
Ascension Hospital told The Cut that it declined to discuss the specifics of Thurman’s case but that it denied the allegations.
Ackerman said that the Health and Human Services department opened an investigation into the complaints that could last months. If the hospitals violated federal law, the facilities could lose their Medicare funding.
“We are hoping that with these complaints this won’t happen to other pregnant women in Texas,” she said.
Norris-De La Cruz said the state’s abortion ban is also to blame.
“The doctors knew I needed an abortion, but these bans are making it nearly impossible to get basic emergency healthcare. I’m filing this complaint because women like me deserve justice and accountability from those that hurt us,” she told the Associated Press.
Thurman, in a TikTok video, said she “lost a piece of my womanhood.”
“I had to fight like hell to get my care and even with all the fight I had, I still didn’t get it fast enough,” she added.
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