Nearly four years ago in Texas, the state’s new abortion law started getting in the way of basic miscarriage care: As women waited in hospitals cramping, fluid running down their legs, doctors told them they couldn’t empty their uterus to guard against deadly complications.
The state banned most abortions, even in pregnancies that were no longer viable; then, it added criminal penalties, threatening to imprison doctors for life and punish hospitals. The law had one exception, for a life-threatening emergency.
Heeding the advice of hospital lawyers, many doctors withheld treatment until they could document patients were in peril. They sent tests to labs, praying for signs of infection, and watched as women lost so much blood that they needed transfusions.“You would see the pain in peoples’ eyes,” one doctor said of her patients.
Not every hospital tolerated this new normal, ProPublica found. A seismic split emerged in how medical institutions in the state’s two largest metro areas treated miscarrying patients — and in how these women fared.
Leaders of influential hospitals in Dallas empowered doctors to intervene before patients’ conditions worsened, allowing them to induce deliveries or perform procedures to empty the uterus.
In Houston, most did not.
The result, according to a first-of-its-kind ProPublica analysis of state hospital discharge data, is that while the rates of dangerous infections spiked across Texas after it banned abortion in 2021, women in Houston were far more likely to get gravely ill than those in Dallas.
As ProPublica reported earlier this year, the statewide rate of sepsis — a life-threatening reaction to infection — shot up more than 50% for women hospitalized when they lost a second-trimester pregnancy.
A new analysis zooms in: In the region surrounding Dallas-Fort Worth, it rose 29%. In the Houston area, it surged 63%.
[…]
One second-trimester pregnancy complication that threatens patients’ lives is previable premature rupture of membranes, called PPROM, when a woman’s water breaks before the fetus can live on its own. Without amniotic fluid, the likelihood of the fetus surviving is low. But with every passing hour that a patient waits for treatment or for labor to start, the risk of sepsis increases.
The Texas Supreme Court has said that doctors can legally provide abortions in PPROM cases, even when an emergency is not imminent.
Yet legal departments at many major Houston hospitals still advise physicians not to perform abortions in these cases, doctors there told ProPublica, until they can document serious infection.
Dr. John Thoppil, the immediate past president of the Texas Association of Obstetricians and Gynecologists, said he was “blown away” by this finding. He said it’s time for hospitals to stop worrying about hypothetical legal consequences of the ban and start worrying more about the real threats to patients’ lives.
“I think you’re risking legal harm the opposite way for not intervening,” he said, “and putting somebody at risk.”
See here for a bit of background. There’s more, so read the rest. It’s appalling that black-box hospital policies can have such an impact on these women’s health, and appalling that the only way this even came to light is because of dogged investigative journalism. This is exactly the sort of thing that patients should have a right to know about. And while I agree that the hospitals should take action and be more responsible, let’s be clear about who’s really at fault here. This is entirely on the Legislature, Greg Abbott, Dan Patrick, Ken Paxton, the Supreme Court, and every Republican who had any role in passing our abomination of anti-abortion laws. All that blood is on their hands, first and foremost.