Author: Kavitha Surana, ProPublica

Kavitha Surana is a reporter at ProPublica.

If You’re Pregnant, Here’s What You Should Know About the Medical Procedures That Could Save Your Life

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Abortion laws are affecting how physicians treat pregnancy loss and other complications because the procedures used in these cases are also used for abortions. We spoke to women who survived terrifying experiences, and we interviewed family members of those who died without care. They all felt unprepared as they entered emergency rooms, unaware of how abortion laws were reaching into pregnancy care.

They wished they had known what to expect and how to advocate for themselves and their loved ones.

We created this guide for them and anyone who finds themselves in the same position.

Texas Banned Abortion. Then Sepsis Rates Soared.

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ProPublica’s investigation reveals that Texas’ abortion ban has led to a sharp rise in life-threatening complications, particularly sepsis, for women experiencing pregnancy loss.

Since the ban’s enactment, the rate of sepsis during second-trimester pregnancy loss has surged by over 50 percent, and maternal deaths in Texas hospitals have increased significantly, even as the national maternal mortality rate declined. Doctors cite the law’s vague emergency exception and the threat of legal consequences as key reasons for dangerous delays in care.

While some Texas lawmakers now acknowledge the need for legal clarifications, the Republican-controlled legislature remains divided, with some pushing for even stricter abortion penalties.

A Third Woman Died Under Texas’ Abortion Ban. Doctors Are Avoiding D&Cs and Reaching for Riskier Miscarriage Treatments.

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Wrapping his wife in a blanket as she mourned the loss of her pregnancy at 11 weeks, Hope Ngumezi wondered why no obstetrician was coming to see his wife. Over the course of six hours on June 11, 2023, Porsha Ngumezi had bled so much in the emergency department at Houston Methodist Sugar Land that she’d needed two transfusions. Three hours later, her heart stopped.

The 35-year-old’s death was preventable, according to more than a dozen doctors who reviewed a detailed summary of her case for ProPublica. Some said it raises serious questions about how abortion bans are pressuring doctors to diverge from the standard of care and reach for less-effective options that could expose their patients to more risks. Doctors and patients described similar decisions they’ve witnessed across the state.

Porsha’s is the fifth case ProPublica has reported in which women died after they did not receive a D&C or its second-trimester equivalent, a dilation and evacuation; three of those deaths were in Texas.

A Texas Woman Died After the Hospital Said It Would Be a ‘Crime’ to Intervene in Her Miscarriage

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Josseli Barnica grieved the news as she lay in a Houston hospital bed on Sept. 3, 2021: The sibling she’d dreamt of giving her daughter would not survive this pregnancy. The fetus was on the verge of coming out, its head pressed against her dilated cervix; she was 17 weeks pregnant and a miscarriage was “in progress,” doctors noted in hospital records. At that point, they should have offered to speed up the delivery or empty her uterus to stave off a deadly infection.

But when Barnica’s husband rushed to her side from his job on a construction site, she relayed what she said the medical team had told her: “They had to wait until there was no heartbeat,” he told ProPublica in Spanish. “It would be a crime to give her an abortion.”

For 40 hours, the anguished 28-year-old mother prayed for doctors to help her get home to her daughter; all the while, her uterus remained exposed to bacteria. Three days after she delivered, Barnica died of an infection.

Abortion Bans Have Delayed Emergency Care. In Georgia, Experts Say This Mother’s Death Was Preventable.

Tasked with examining pregnancy-related deaths to improve maternal health, a panel of experts, including 10 doctors, deemed Amber Nicole Thurman’s death “preventable” and said the hospital’s delay in performing the critical procedure had a “large” impact on her fatal outcome.

Thurman’s case marks the first time an abortion-related death, officially deemed “preventable,” is coming to public light.

Their reviews of individual patient cases are not made public. But ProPublica obtained reports that confirm that at least two women have already died after they couldn’t access legal abortions and timely medical care in their state. There are almost certainly others. Though Republican lawmakers who voted for state bans on abortion say the laws have exceptions to protect the “life of the mother,” medical experts cautioned that the language is not rooted in science and ignores the fast-moving realities of medicine.

Some Republicans Were Willing to Compromise on Abortion Ban Exceptions. Anti-Abortion Activists Made Sure They Didn’t.

On the floors of state legislatures over the past year, doctors detailed the risks their pregnant patients have faced when forced to wait to terminate until their health deteriorated. Women shared their trauma. Some Republican lawmakers even promised to support clarifications.

But so far, few efforts to add exceptions to the laws have succeeded.