Pregnant Women in Crisis: ERs Denying Care Despite Federal Law

The latest cases emerge from two women who report not receiving treatment for ectopic pregnancies at different emergency rooms in Texas.

WASHINGTON — Kyleigh Thurman, bleeding and in pain, was unaware her pregnancy could be fatal.

At Ascension Seton Williamson in Texas, doctors gave her a miscarriage pamphlet and advised her to let nature take its course, discharging her without treating her ectopic pregnancy.

Three days later, she returned still bleeding. Doctors then administered an injection to end the pregnancy, but it was too late. The ectopic pregnancy ruptured her fallopian tube, severely impacting her reproductive system.

Thurman filed a complaint with the Center for Reproductive Rights, alleging the hospital violated federal law by initially failing to treat her in February 2023.

“I was left to flail,” said Thurman. “It was nothing short of being misled.”

Despite warnings from the Biden administration for hospitals to treat pregnant patients in emergencies, many facilities continue to violate federal law. This issue gained prominence after the Supreme Court overturned the constitutional right to an abortion over two years ago.

An Associated Press analysis reveals more than 100 pregnant women in medical distress were inadequately treated or turned away from emergency rooms since 2022.

Instances include two women, one in Florida and another in Texas, who miscarried in public restrooms. In Arkansas, a woman went into septic shock and lost her fetus after being sent home from an emergency room. Four other women with ectopic pregnancies encountered delays in treatment, including a California woman who required a blood transfusion after waiting nine hours in an emergency room.

The White House insists hospitals must offer abortions when necessary to save a woman’s health, regardless of state bans. Texas is challenging this guidance, and the Supreme Court declined to resolve the issue earlier this summer.

In Texas, performing an illegal abortion can result in up to 99 years in prison. Legal experts argue this law complicates decision-making in emergency pregnancy care.

Although Texas law states that terminating ectopic pregnancies is not considered an abortion, doctors fear the severe penalties, according to the Center for Reproductive Rights.

“Hospitals need to be equally concerned about violating federal law,” said Marc Hearron, an attorney with the center. Hospitals risk federal investigation, fines, and Medicare funding loss for breaking federal law.

The Center for Reproductive Rights recently filed two complaints with the Centers for Medicare and Medicaid Services, claiming Texas emergency rooms failed to treat ectopic pregnancies, including Thurman’s case.

Another complaint involves Kelsie Norris-De La Cruz, 25, who lost a fallopian tube and most of an ovary after an Arlington, Texas hospital sent her home without treating her ectopic pregnancy, despite a doctor’s advice against it.

“The bans are making it nearly impossible to get basic emergency healthcare,” Norris-De La Cruz said. “I’m filing this complaint because women like me deserve justice and accountability.”

Diagnosing an ectopic pregnancy can be challenging. Doctors cannot always locate the pregnancy via ultrasound. Hormone levels, bleeding, positive pregnancy tests, and an empty uterus on ultrasound are indicators.

“You can’t be 100% sure—that’s the tricky part,” said Kate Arnold, an OB-GYN in Washington. “They’re literally time bombs.”

John Seago, Director of Texas Right to Life, said the state law protects doctors if they terminate ectopic pregnancies, even in cases of misdiagnosis.

“Sending a woman back home is completely unnecessary, completely dangerous,” Seago emphasized.

Hannah Gordon, an emergency medicine physician who left Texas last year, said the law has “absolutely” made doctors afraid to treat pregnant patients.

“It’s going to force doctors to start creating questionable scenarios, even if it’s very dangerous,” Gordon warned. She left Texas in hopes of becoming pregnant elsewhere due to concerns about the care she’d receive.

Gordon recalled an incident at her Dallas emergency room involving a patient showing signs of an ectopic pregnancy. Because OB-GYNs couldn’t definitively diagnose it, they waited until the next day to end the pregnancy.

“It left a bad taste in my mouth,” Gordon said.

When Thurman returned to Ascension Seton Williamson a third time, her OB-GYN recommended surgery to remove the ruptured fallopian tube. Thurman was still heavily bleeding and feared losing her fertility.

The doctor warned her death was possible if she waited any longer.

“I realized I was dying,” Thurman said tearfully. “That’s when I broke down.”

Ascension Seton Williamson declined to comment on Thurman’s case but reiterated its commitment to high-quality care in a statement.

In Florida, a 15-week pregnant woman experiencing amniotic fluid leakage waited for an hour in Broward Health Coral Springs’ emergency room. An ultrasound showed no amniotic fluid around the fetus, creating a high infection risk.

She miscarried in a public bathroom after being discharged by an emergency room doctor who didn’t consult an OB-GYN.

Emergency responders transported her to another hospital, where she was placed on a ventilator and discharged after six days.

At the time, Florida banned abortions after 15 weeks. An investigator revealed that inducing labor for those with pre-viable membrane rupture is standard care, regardless of fetal heartbeat, due to maternal risk.

Broward Health Coral Springs declined to comment or share its policies with the AP.

Another doctor acknowledged that state laws were complicating emergency pregnancy care.

“Staff cannot intervene unless there is a danger to the patient’s health,” said a doctor at Memorial Regional Hospital in Hollywood, Florida. This was during an investigation into why the hospital failed to offer an abortion to a woman whose water broke at 15 weeks.

Violations occurred both in states with and without abortion bans, the AP review found.

Two short-staffed hospitals in Idaho and Washington admitted routinely directing pregnant patients to other hospitals.

A pregnant woman in a Bakersfield, California emergency room experienced a uterine rupture, but a staff delay in recognizing the urgency may have contributed to her baby’s death.

Doctors in California, Nebraska, Arkansas, and South Carolina failed to check for fetal heartbeats or discharged patients in active labor, resulting in deliveries at home or in ambulances.

Nursing and doctor shortages since COVID-19, understaffed ultrasound units, and new abortion laws are turning emergency rooms into dangerous places for pregnant women, warned Dara Kass, an emergency medicine doctor and former U.S. Health and Human Services official.

“It is increasingly less safe to be pregnant and seeking emergency care,” Kass said.