WASHINGTON – Bleeding and in pain, Kyleigh Thurman didn’t know her doomed pregnancy could kill her.
Emergency room doctors at Ascension Seton Williamson in Texas handed her a pamphlet about miscarriage and told her to “let nature take its course” before discharging her without treatment for her ectopic pregnancy.
When the 25-year-old returned three days later, still bleeding, doctors finally agreed to give her an injection designed to terminate the pregnancy. But it was already too late. The fertilized egg growing in Thurman’s fallopian tube would rupture it, destroying part of her reproductive system.
This is in accordance with a Thurman complaint and the Center for Reproductive Rights filed a request last week asking the government to investigate whether the hospital violated federal law when staff did not initially treat her in February 2023.
“I was left to flounder,” Thurman said. “It was nothing short of being tricked.”
Even though the Biden administration has publicly warned hospitals to treat pregnant patients in emergencies, the facilities continue to violate federal law.
More than 100 medically distressed pregnant women who sought help in emergency rooms have been turned away or negligently treated since 2022, an Associated Press analysis of investigations at federal hospitals found.
Two women – one in Florida and one in Texas – were left to abort in public bathrooms. In Arkansas, a woman went into septic shock and her fetus died after an emergency room sent her home. At least four other women with ectopic pregnancies have had difficulty getting any treatment, including a California woman who needed a blood transfusion after sitting in an emergency room waiting for nine hours.
The White House says hospitals must provide abortions when necessary to save a woman’s health, despite state bans. Texas is challenging that guidance, and earlier this summer the Supreme Court refused to solve the problem.
In Texas, where doctors face up to 99 years in prison if convicted of performing an illegal abortion, medical and legal experts say the law is complicating decision-making around emergency pregnancy care.
Although state law says that terminating an ectopic pregnancy is not considered an abortion, the draconian penalties scare Texas doctors and prevent them from treating these patients, the Center for Reproductive Rights argues.
“As much as hospitals and doctors are afraid of running afoul of these state abortion bans, they also need to be concerned about running afoul of federal law,” said Marc Hearron, an attorney for the center. Hospitals face a federal investigation, heavy penalties and threats to Medicare funding if they violate federal law.
The organization filed two complaints last week with the Centers for Medicare and Medicaid Service alleging that different Texas emergency rooms failed to treat two patients, including Thurman, with ectopic pregnancies.
Other 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 treating her ectopic pregnancy, even after a doctor said the high “was not in his interest”.
“Doctors knew I needed an abortion, but these bans are making it nearly impossible to get basic emergency health care,” she said in a statement. “I am filing this complaint because women like me deserve justice and accountability from those who hurt us.”
Conclusively diagnosing an ectopic pregnancy can be difficult. Doctors can’t always find the location of the pregnancy on an ultrasound, explained three doctors consulted for this article. Hormone levels, bleeding, a positive pregnancy test, and an empty uterus ultrasound indicate an ectopic pregnancy.
“You can’t be 100% — that’s the tricky part,” said Kate Arnold, an obstetrician and gynecologist in Washington. “They are literally ticking time bombs.
Texas Right to Life Director Dr. John Seago said state law clearly protects doctors from lawsuits if they terminate an ectopic pregnancy, even if the doctor “made a mistake” in diagnosing it.
“Sending a woman back home is completely unnecessary, completely dangerous,” Seago said.
But the state law has “absolutely” made doctors afraid to treat pregnant patients, said Hannah Gordon, an emergency room doctor who worked at a Dallas hospital until last year.
“This will force doctors to start creating questionable scenarios for patients, even if they are very dangerous,” Gordon said. She left Texas hoping to get pregnant and worried about the care she would receive there.
Gordon remembered a pregnant patient in the Dallas emergency room who showed signs of an ectopic pregnancy. Because the OB-GYNs said they could not definitively diagnose the problem, they waited to terminate the pregnancy until she returned the next day.
“It left a bad taste in my mouth,” Gordon said.
In Thurman’s case, when she returned to Ascension Seton Williamson for the third time, her gynecologist told her she would need surgery to remove her fallopian tube, which had ruptured. Thurman, still bleeding profusely, hesitated. Losing the tube would put her fertility at risk.
But her doctor told her she risked death if she waited any longer.
“She came in and said, you’re either going to have to have a blood transfusion, or you’re going to have to have surgery, or you’re going to bleed,” Thurman said, through tears. “That’s when I thought, ‘oh my God, I’m, I’m dying’.
Ascension Seton Williamson declined to comment on Thurman’s case but said in a statement that the hospital “is committed to providing high-quality care to everyone who seeks our services.”
In Florida, a 15-week pregnant woman leaked amniotic fluid for an hour in the emergency waiting room at Broward Health Coral Springs, according to federal documents. An ultrasound revealed that the patient had no amniotic fluid around the fetus, a dangerous situation that can cause serious infections.
The woman miscarried in a public bathroom that day, after the emergency room doctor listed her condition as “improved” and discharged her without consulting the hospital’s gynecologist and obstetrician.
Emergency crews rushed her to another hospital, where she was placed on a ventilator and released after six days.
Abortions after 15 weeks were banned in Florida at the time. The medical director of obstetrics at Broward Health Coral Springs told an investigator that inducing labor for anyone presenting with pre-viable premature rupture of membranes is “the standard of care for some time, regardless of heart rate, because of the risk for the mother. ”
The hospital declined to comment or share its policies with the AP.
In another Florida case, a doctor admitted that state law complicated emergency pregnancy care.
“Because of the new laws…staff cannot intervene unless there is a danger to the patient’s health,” a doctor at Memorial Regional Hospital in Hollywood, Florida, told an investigator looking into the hospital’s failure offering an abortion to a pregnant woman. woman whose water broke at 15 weeks, well before the fetus survived.
Serious violations that put the health of the mother or fetus at risk occurred in states with and without abortion bans, the AP analysis found.
In interviews with researchers, two understaffed hospitals – in Idaho and Washington – admitted to routinely directing pregnant patients to other hospitals.
A pregnant patient in the Bakersfield, California, emergency room was quickly triaged, but staff failed to realize the urgency of her condition, a ruptured uterus. The delay, an investigator concluded, may have contributed to the baby’s death.
Emergency room doctors in California, Nebraska, Arkansas and South Carolina were unable to check fetal heartbeats or patients discharged in active labor, leaving them to give birth at home or in ambulances, according to the documents.
The shortage of nurses and doctors that has plagued hospitals since the start of COVID-19, the difficulty in staffing 24-hour ultrasounds, and new abortion laws are making the emergency room a dangerous place for pregnant women, warned Dara Kass, an emergency medicine doctor and former U.S. Health and Human Services official.
“It is increasingly unsafe to be pregnant and seek emergency care in an emergency room,” she said.
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