Off the Kuff Rotating Header Image

Quantifying the abortion ban harm

These stories will keep on coming.

Usually, articles in medical journals are about science; they bring data to their readers, who can use them to provide evidence-based care to their patients.

But sometimes, evidence is an expression of grief or even rage. A recent journal article, “Maternal Morbidity and Fetal Outcomes Among Pregnant Women at 22 Weeks’ Gestation or Less with Complications in 2 Texas Hospitals After Legislation on Abortion,” contains such evidence.

To understand this article, you need to know that any number of complications can threaten a pregnancy, such as rupture of the bag of water around the baby, preterm labor, or heavy bleeding. When those complications arise before 22 weeks of gestation— before the age of viability when a fetus can live outside of a uterus—the standard of medical care is to offer a patient termination of pregnancy as an option. Women who continue pregnancy in these situations take on significant risks to their own health, and because of the early gestation, the chance for a healthy baby is very, very low.

However, in September 2021, Texas adopted two measures, S.B. 4 and S.B. 8, which instituted punitive actions against anyone providing abortion. These laws took effect before the Supreme Court decision ended Roe v. Wade. And all of a sudden, termination of pregnancy became impossible in Texas unless and until there was an “immediate threat to maternal life.”

The journal article, published in the American Journal of Obstetrics and Gynecology, describes the experience of two large Texas hospitals over a period of eight months following that legislation. The authors, who care for patients at those hospitals, describe how their hospitals managed 28 women who presented at less than 22 weeks’ gestation with serious complications following the ban on abortion.

Without the ability to offer abortion to their patients, all 28 women were managed expectantly. This is a medical way of saying that they waited for something terrible to happen. That wait lasted, on average, nine days.

During that nine days of waiting, here is what was achieved for the babies: 27 of the patients had loss of the fetus in utero or the death of the infant shortly after delivery. Of the entire cohort, one baby remained alive, still in the NICU at time of the journal article’s publication, with a long list of complications from extreme prematurity, including bleeding in the brain, brain swelling, damage to intestines, chronic lung disease. and liver dysfunction. If a baby survives these complications, they often result in permanent, lifelong illnesses.

During those nine days of waiting for an immediate threat to maternal life, here is what happened to the women of that cohort: Most of them went into labor, or had a stillbirth, which meant the medical team could then legally intervene and empty the uterus. Fifty-seven percent of those pregnant women had some sort of complication, and for about a third of them, it was serious enough to require intensive-care admission, surgery, or a second admission to the hospital. One of the 28 patients ended up with a hysterectomy, which means she will never carry a pregnancy again. The authors of the article estimate, based on their pre-September practice, that about half of those maternal complications would have been avoided if immediate abortion had been offered as a choice. But of course, post-September in Texas, these women didn’t get a choice.

I’ll say again, it’s just a matter of time before some nice white suburban lady who already has kids dies as a result of not being able to get proper medical care following a similar instance. I’d love to tell the woman who was forced to have a hysterectomy to sue the state of Texas for that, but I don’t know that any deserving target of such a lawsuit would be allowed to be named as a defendant. You know what the refrain is for this song.

Related Posts:

One Comment

  1. David Fagan says:

    +3 and counting…….