Patients may not receive miscarriage care in a post-Roe America

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For those wondering how miscarriages would be handled in a post-deer America, Texas could be a scary harbinger.

In December 2021, Anna, a woman who lives 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 survival. But not only was Anna going to lose her child, she was also at high risk of becoming septic or bleeding, NPR reported. And because of strict abortion laws that went into effect in September in Texas – where the termination of a pregnancy is only permitted if there is “a danger of death or a serious risk of substantial impairment of a major bodily function” – her doctors told her they couldn’t terminate the pregnancy. This meant Anna had no choice but to fly to Colorado for treatment. She reserved front row seats to be close to the bathroom in case she went into labor during the flight.

Yes deer is cancelled, Anna’s case will probably not be the last. “It’s the kind of stuff we’re going to see more and more of,” warns Maya Manian, a professor at American University’s Washington College of Law who focuses on access to health care and justice and rights. reproductive.

Typically, when a person has a miscarriage – the spontaneous loss of a pregnancy before the 20th week – they are offered three options by their caregiver: medication to push the tissue out of the uterus; surgery (a procedure called dilation and curettage, or D&C) to remove tissue from the uterus; or choosing to sit still and watch for danger signs. Although the patient can decide, the standard of care is to terminate the pregnancy, usually with medication.

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

Thirteen US states have “trigger” laws that would immediately or very quickly ban abortion if deer falls. Theoretically, these laws would make an exception for terminating a pregnancy in circumstances where the life of the pregnant person is in danger, but what qualifies under this definition is up to the doctor to decide. “My concern is that some states want to interpret this very, very narrowly,” says Lisa Harris, an obstetrician and professor at the University of Michigan.

The vagueness of the laws means that medical professionals will have to decide whether or not to terminate a pregnancy – knowing that the penalties for calling a case too soon or not perfectly meeting the risk criteria could range from hefty fines to suspension from their medical license to life in prison. “When you have a law written in general terms, it can have a chilling effect,” says Manian. “That’s why we don’t usually have politicians regulating medicine.”

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