Patients May Not Receive Miscarriage Care in a Post-Roe America

For those wondering how abortions will be managed in a post-Roe America, Texas could be a terrifying omen.

In December 2021, Anna, a woman living in central Texas, was 19 weeks pregnant when her waters broke on her wedding night. It was too early in the pregnancy for the baby to have a chance of surviving. But Anna was not only going to lose her child, she also had a high risk of being septic or bleeding, NPR reported. And because of the strict abortion laws that had come into force that September in Texas, where a pregnancy is only allowed to end if there is a “danger of death or a serious risk of substantial impairment of significant bodily function.” “, his doctors told him they couldn’t. Do not terminate the pregnancy. This meant that Anna was left with no choice but to fly to Colorado for care. He reserved front row seats to be near the bathroom in case he suffered during the flight.

Yes Roe she’s lying down, Anna’s case probably won’t be the last. “That’s the kind of thing we’re going to see more and more,” said Maya Manian, a professor at Washington College of Law at the American University who focuses on access to health care and justice and reproductive rights.

Usually, when someone has a miscarriage — the spontaneous loss of a pregnancy before the 20th week — their caregiver offers them three options: medication to get the tissue out of the uterus; surgery (a procedure called dilation and curettage, or D&C) to remove uterine tissue; or the option to sit well and watch for danger signs. Although the patient may decide, the standard of care is to terminate the pregnancy, usually with medication.

In addition to the emotional turmoil that miscarriages bring, they can be deadly. The wait-and-see approach is far more treacherous than the other two, not only for the future fertility of the pregnant person, but for their safety. If the tissue does not pass, it can become infected and cause sepsis, where the immune system reacts dangerously and begins to attack the tissues of the body. Failure to pass all of the tissue can also lead to a life-threatening complication of blood clots called disseminated intravascular coagulation, the risk of which increases as it is expected to remove the uterus from the tissue.

Thirteen U.S. states have “activating” laws that would ban abortion immediately or very quickly if Roe cau. Theoretically, these laws would be an exception to end a pregnancy in circumstances in which the life of the pregnant person is at risk, but what qualifies under this definition is what the doctor decides. “My fear is that there are some states that want to interpret this in a very, very narrow way,” says Lisa Harris, a gynecologist and professor at the University of Michigan.

The vagueness of the laws means that medical professionals will have to decide whether to terminate a pregnancy, knowing that the sanctions for summoning a case too soon or not fit perfectly with the risk criteria could range from heavy fines to the suspension of his medical leave for life. prison. “When you have a widely drafted law, it can have a creepy effect,” says Manian. “That’s why, in general, we don’t have politicians who regulate medicine.”

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