Grace Ferguson, a doctor who treated a woman whose water broke halfway through her pregnancy, was able to save her life weeks after Roe V. Wade was overturned. The baby would never survive, and the patient’s chance of developing a potentially life-threatening infection grew with every hour.
Before she could make it to Pittsburgh, Ferguson had already spent two days in West Virginia, where she couldn’t have an abortion because of a ban. While medical emergencies are an exception to the law, the patient was not in immediate danger.
“She was just kind of standing on the edge of the cliff,” Ferguson said, “waiting for an emergency to happen or for the baby to pass away.”
Ferguson was able induce labor in Pennsylvania at a hospital four hours away.
As a post-Roe fear grows, a growing number of doctors and their families are sharing similar stories. Pregnant mothers with serious medical conditions are being seen in hospitals and doctors’ offices to be denied abortions that could treat them. Certain doctors who practice in restrictive abortion laws states claim they have referred more patients or recommended that they go elsewhere. Some women face dangerous, potentially fatal delays.
Doctors say they’re forced to balance medical judgment with potential punishments, including prison time. Although even the strictest laws allow abortion to save a mother’s life, a weighty question lingers: How close to death must the patient be?
On Tuesday, November 15, 2022, Dr. Kristina Tcce poses for a portrait at the Planned Parenthood offices of east Denver. Tocce claimed she was able to treat a Texas woman who had been in remission from her cancer but returned to aggressive treatment after becoming pregnant with her second baby. To continue her treatment for cancer, she requested an abortion.
David Zalubowski / AP
“You don’t automatically go from living to dead,” Ferguson said. “You slowly get sicker and sicker.”
It’s impossible to say when that line is crossed, said Dr. Alison Haddock, who’s on the board of the American College of Emergency Physicians. “There’s just no moment where I’m standing in front of a critically ill patient where I know: OK, before their health was just in danger. But now, their life is in danger,” she said.
Experts say it’s hard to pinpoint data on abortion denials when serious complications arise. Although employers often try to discourage workers in health care from talking about it, The Associated Press reached out to more than a dozen doctors who shared their stories.
Doctors and researchers are unanimous in their belief that the problem is widespread, even if it’s largely anecdotal. Texas was one example. A Texas doctors’ association wrote to the state’s medical boards stating that some hospitals refused to care for patients with serious complications due to the state’s ban on abortion.
Researchers from the University of California, San Francisco asked health care workers to anonymously share examples of poor-quality care due to abortion restrictions. They were surprised at the response rate. In the first six weeks, there were 25 submissions. There were many stories of patients who returned to hospital with severe infections after their water broke during the second trimester. One told of an ectopic pregnancy that was allowed to grow on a scar left by a previous cesarean section – which can cause uterine rupture, hemorrhage and death.
“The legislators are playing with fire,” said Dr. Dan Grossman, the project’s leader.
Dr. Cara Heuser is a Utah maternal-fetal specialist. She recalls that one patient refused an abortion in Idaho, even though she had a serious heart condition during pregnancy. The procedure required the woman to be flown to Utah.
Dr. Lauren Miller, a maternal-fetal specialist in Boise, said she regularly sees patients whose water breaks at 15 through 19 weeks’ gestation, and all doctors can do is help them make the tough decision: “Do they stay here for their care and just wait until something bad happens, or do we facilitate them finding care out of state?”
Dr. David Eisenberg, an associate professor at Washington University in St. Louis, said Missouri doctors and hospitals are regularly “punting that responsibility for care” when people show up with serious complications. They wind up at the university-affiliated medical center where he works — one of the few in Missouri that performs abortions in such cases.
He said patients in crisis are told: “I’ve got to call the lawyer for the hospital before I can figure out what I can do.
“That’s just totally insane and totally inappropriate and really unfortunate.”
The stories are similar when pregnancy is complicated by cancer — diagnosed in about 1 in 1,000 pregnant women each year.
Dr. Karen Knudsen (CEO of the American Cancer Society) stated that many oncologists are confused about how to treat patients with pregnancies, especially when there is the possibility of miscarriage. Dr. Kristina Tocce, medical director for Planned Parenthood of the Rocky Mountains, said she’s seen patients with life-threatening diagnoses forced to drive 10 hours or more, or fly out of state, to get abortions so they can begin chemotherapy or radiation treatment.
Tocce claimed that she had recently treated a Texas lady whose cancer had returned after she gave birth to her second child. To continue her treatment for cancer, she requested an abortion. She thanked Tocce numerous times during the visit.
“I finally told the patient: ‘You can’t thank us anymore. We are doing our jobs,’” Tocce said. “I said, ‘I am so disturbed that you had to travel so far with your family and the hurdles you have had to overcome.’”
Some abortion opponents claim doctors may refuse to perform abortions in life-threatening situations because they fear for their lives. Dr. Patti Giebink, a former abortion doctor who described changing her views in her book “Unexpected Choice: An Abortion Doctor’s Journey to Pro-Life,” said it comes down to intent. If you intend to save the mother and not end the life of the fetus, she said, “you’re doing good medicine.”
“We’re sort of in a period of time where all these questions come up,” she said. “The legislatures are going to be working to solve some of these problems.”
Paul LaRose (a member of American Association of Pro-Life Obstetricians and Gynologists) said that he believes the issue is exaggerated and that people raising concerns about it are exaggerating.
“Or they may be they misinformed,” he said. “Most pro-life physicians would take care of the mother and do what’s necessary without purposely taking the life of the unborn baby.”
However, some women believe that restrictive abortion laws are putting them at risk.
Kristina Cruickshank of Rosenberg, Texas, thought her life was in jeopardy after a diagnosis of a nonviable “partial molar pregnancy,” in which the fetus has too many chromosomes and develops incompletely. Cruickshank was 35 and had massive cysts surrounding both her ovaries. She was experiencing vomiting, bleeding, and pain.
In June of 1973, Texas had banned almost all abortions within six weeks of a woman’s pregnancy. This was just before Roe was repealed. Before her doctor could agree to terminate her pregnancy, she endured three days in pain in one hospital. She thought: “What am I supposed to do, just lay here and die?’”
Similar delays occurred in August for Mylissa Farmers of Joplin, Missouri. Her water broke at 17 1/2 weeks’ gestation, sending her to the emergency room. All her amniotic liquid had been removed by tests. The fetus she and her boyfriend had named Maeve wasn’t expected to survive.
Despite risks of infection and blood loss, she couldn’t get an abortion. The baby still had a beating heart. Medical records prove that doctors told the mother that Missouri law had overruled their judgment.
She tried for days to get an out-of-state abortion, but many hospitals said they couldn’t take her. Farmer was finally connected to a Granite City, Illinois clinic by an abortion helpline. She drove 4 ½ hours from home — while in labor — and had the procedure.
After Farmer’s story was covered by news media and Farmer appeared in a political advertisement, the Missouri department of health began an investigation into whether Joplin hospital had violated federal law. The Missouri health department declined to comment. The state shared its preliminary findings with federal authorities.
Farmer described the experience as so frightening that she made a permanent change to ensure it never happens again.
She tied her tubes.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. All content is the sole responsibility of the Associated Press.
