Pooja Salhotra
Sun, November 3, 2024
Thousands of people walk in a march in support of abortion rights near downtown San Antonio on June 24, 2022. Credit: Kaylee Greenlee Beal for The Texas Tribune
A group of 111 OB-GYNs in Texas released a letter to elected state leaders Sunday urging them to change abortion laws they say have prevented them from providing lifesaving care to pregnant women.
The doctors pointed to recent reporting by ProPublica on two Texas pregnant women who died after medical staff delayed emergency care.
Josseli Barnica, 28, died of an infection in 2021 three days after she began to miscarry. More than a dozen medical experts said Barnica’s death was preventable. However, the state’s abortion laws kept doctors from intervening until they couldn’t detect a fetal heartbeat, which didn’t happen until about 40 hours after the miscarriage started.
Nevaeh Crain, 18, died last year after developing a dangerous complication of sepsis that doctors refused to treat while her six-month-old fetus still had a heartbeat. Two emergency rooms didn’t treat her and a third delayed care, moving Crain to the intensive care unit only after she was experiencing organ failure. Medical experts said if the hospital staff had treated her early, they either could have helped Crain with an early delivery or saved her life by ending the pregnancy if the infection had gone too far.
“Josseli Barnica and Nevaeh Crain should be alive today,” the doctors wrote in their letter. “As OB-GYNs in Texas, we know firsthand how much these laws restrict our ability to provide our patients with quality, evidence-based care.”
In 2021, Texas lawmakers passed a law prohibiting doctors from performing an abortion after six weeks. The law allows members of the public to sue doctors or anyone who helps perform an abortion for $10,000.
After the Dobbs v. Jackson ruling overturned Roe v. Wade, Texas banned almost all abortions — including in cases of rape and incest. The law does create an exception for a doctor to perform an abortion when they believe it is necessary to save the life of the pregnant patient. Doctors who violate the state’s abortion law risk losing their medical license and potentially spending life in prison.
Doctors have said that confusion about what constitutes a life-threatening condition has changed the way they treat pregnant patients with complications. The Texas Medical Board has offered guidance on how to interpret the law’s medical exception, and the Texas Supreme Court has ruled that doctors don’t need to wait until there’s an imminent risk to the patient to intervene. But some physicians say the guidance is vague and that hospitals are navigating each situation on a case-by-case basis.
ProPublica’s reporting about Crain and Barnica comes as U.S. Sen. Ted Cruz and U.S. Rep. Colin Allred of Dallas face off in a heated bid for one of Texas' two seats in the U.S. Senate. Their divergent views on abortion have been a central issue in the race, and both candidates have weighed in on Crain and Barnica’s deaths.
“Texas doctors can’t do their jobs because of Ted Cruz’s cruel abortion ban,” Allred wrote on X, linking to the story about Crain. “Cruz even lobbied SCOTUS to allow states to ban life-saving emergency abortions.”
In 2021, Cruz sponsored a 20-week federal abortion ban. He also co-introduced a bill that would allow states to exclude medical providers that perform abortions from receiving Medicaid funding. After the U.S. Supreme Court overturned Roe v. Wade, Cruz celebrated the decision as a “massive victory.”
Cruz has previously said he thought Texas’ exception to save the life of the pregnant mother was working. This week he reiterated that stance. He called Crain and Barnica’s deaths “heartbreaking” in an interview with The Houston Chronicle and said procedures necessary to save the life of the pregnant mother are legal in Texas.
Dozens of women have come forward saying that, after the state’s abortion ban went into effect, they were unable to get the health care they needed for their medically complex pregnancies.
Last year, state lawmakers passed a law allowing abortions for people with ectopic pregnancies, a nonviable type of pregnancy in which the embryo implants outside the uterus, as well as when a patient’s water breaks before the fetus is viable.
The doctors who signed the letter said they want to see a change in state law.
“Texas needs a change. A change in laws. A change in how we legislate medical decisions that should be between a patient, their family, and their doctor.”
Texas woman died after waiting 40 hours for emergency care during miscarriage: report
Ryan Chandler
Sun, November 3, 2024
AUSTIN (NEXSTAR) — A new report published Wednesday details the story of a 28-year-old Texas woman who died from an infection after doctors allegedly delayed treating her miscarriage for about 40 hours, reigniting concerns about the state’s strict abortion laws.
Josseli Barnica arrived at a Houston hospital at 17 weeks pregnant in Sept. 2, 2021, experiencing severe cramping and bleeding, according to the nonprofit investigative newsroom ProPublica. The next day, an ultrasound confirmed she was experiencing a miscarriage.
However, Barnica reportedly told her husband that doctors could not intervene.
“They had to wait until there was no heartbeat,” the husband, whose name was not disclosed, told ProPublica in Spanish. “It would be a crime to give her an abortion.”
As she waited, Barnica’s cervix remained open, leaving her uterus exposed to bacteria, according to the outlet. After a fetal heartbeat was no longer detected, she delivered the fetus with medical assistance and was discharged later that day.
See where abortion will be on the ballot in the 2024 election
On Sept. 7, as her condition worsened, Barnica’s husband brought her back to the hospital, where she died from a sepsis infection.
Barnica’s story has reinvigorated the concern that Texas’ abortion ban does not give doctors enough autonomy to treat pregnancy complications.
Rep. Colin Allred, the Democratic candidate for U.S. Senate who has made abortion access a central tenant of his campaign, quickly used Barnica’s story as a critique of Sen. Ted Cruz’s anti-abortion stance.
“Josseli Barnica should be alive today but because of Ted Cruz’s cruel abortion ban, Texas women have been denied the life-saving health care they need,” Allred wrote on social media.
Sen. Ted Cruz, left, and Rep. Colin Allred are pictured in these side-by-side images. (Photos: Getty Images)
Cruz called the story “heartbreaking,” but he said Texas’ law is not to blame.
“I’ve read the story here, and the facts of the case seem heartbreaking. That this woman lost her life is truly a tragedy,” Cruz told reporters after a rally in Georgetown on Wednesday.
“The Texas law makes clear that any procedure that is necessary to save the life of a mother can be done and should be done,” Cruz added. “We don’t know all the details of what happened here, but it is critical that we do everything necessary to save the lives of moms and we grieve with the family at the tragedy that occurred here.”
Texas law prohibits abortion in nearly all cases, without exceptions for rape or incest. Physicians may be punished for performing abortions with six-figure fines, the loss of their medical license, and prison time.
An abortion is permitted under the law if, “in the exercise of reasonable medical judgment,” the pregnant person has a life-threatening condition caused or worsened by the pregnancy that poses a risk of death or serious impairment to a major bodily function, making the abortion necessary
Physicians have sued to argue that language is too vague, claiming the “reasonable medical judgment” standard is too subjective to allow them to act freely without concern for their own liability.
In May, the Texas Supreme Court rejected those concerns, ruling that the abortion ban’s exceptions are acceptable and permit abortions before imminent emergencies.
“The law does not require a woman to surrender her life or to first suffer serious bodily injury before an abortion may be performed,” the court wrote.
According to October polling from the Texas Politics Project, 7% of Texas likely voters say abortion/women’s rights is the most important issue to their vote, trailing the economy, immigration/border security, and inflation/cost of living.
Copyright 2024 Nexstar Media, Inc. All rights reserved.
How strict abortion bans impact women's health care
Brit McCandless Farmer
Sun, November 3, 2024
Yahoo is using AI to generate takeaways from this article. This means the info may not always match what's in the article. Reporting mistakes helps us improve the experience.Generate Key Takeaways
The Supreme Court's landmark 2022 overturning of Roe v. Wade has had an impact on women's health beyond abortion, accelerating a gap in obstetrics and gynecological care in some states across the country.
In Texas, the first state to implement more restrictive abortion laws, a fear of discussing abortion has impacted doctors practicing there and the medical students and OB-GYN residents looking to learn there.
"We asked for [abortion care] in our curriculum they're like, 'Oh, well, it's a state-funded school. And since the state doesn't support it, then we probably shouldn't teach it,'" said Dr. Dani Mathisen, who received her medical degree in Texas but relocated to Hawaii to complete her OB-GYN residency.
Doctors say strict abortion laws in Texas put pregnant women and their physicians at serious risk
Mathisen said she had discovered that education on anything to do with abortion was so limited, she and her fellow students had to teach themselves. They rented classrooms, where abortion providers came in to teach about abortion care and students practiced on papayas and dragon fruit.
"It's actually really common," Mathisen said. "[Fruit] is a really great model for a uterus."
OB-GYN resident Dr. Adrianne Smith began her residency in Texas but transferred to a hospital in New Mexico. Like Mathisen, Smith saw how abortion laws were impacting her education and said limits on education lead to restrictions on care — and not just in pregnancy.
"We're seeing now with these new restrictions, more OB-GYNs are leaving these states," Smith said. "You need OB-GYNs for pap smears, for birth control, for mammograms. And then not to mention routine pregnancy care. You need OB-GYNs staffing the hospitals and staffing those labor and deliveries, which in rural areas are already struggling to stay open. And so people are having to travel further for care — pregnancy or other care — and then waiting even longer to be able to be seen."
Texas women facing pregnancy complications are forced to travel out of state for care
These vacancies are contributing to what a recent report by the March of Dimes calls a "maternity care access crisis." According to the report, more than one-third of counties in America are considered maternity care deserts. That means they don't have a single doctor, nurse, midwife, or medical center that specializes in maternity care, impacting more than 2.3 million women of reproductive age.
"We've seen people leave states," said Dr. Stella Dantas, the president of the American College of Obstetricians and Gynecologists. "We know we have maternal care deserts around the country that are being worsened by people leaving."
As an example, Dantas pointed to Idaho, where nearly one quarter of practicing obstetricians have left the state since its strict abortion laws took effect, according to a report by the Idaho Physician Well-Being Action Collaborative.
Dantas said that, in addition to practicing physicians leaving the state, restrictive abortion laws are also impacting training.
"When a medical student is applying to train for residency, they're now looking at residency programs and asking questions, 'What is the abortion training I'm going to get there? Am I going to get enough training to come out and feel competent and confident to practice the field that I desire?'" Dr. Dantas said.
How Texas's abortion laws are driving doctors out of the state
She went on to explain that OB-GYN residents are required to have training in abortion care to become licensed physicians.
"Abortion is reproductive health care, and OB-GYNs are the people that provide reproductive health care," Dantas said. "Abortion is the same procedure that's used in miscarriage management [and] ectopic pregnancy management. It is used in … situations where the pregnancy's highly desired and it cannot go on for the health of the mom. So, you do need that training."
In May, the Association of American Medical Colleges released a revealing set of data on the domino effect of the overturning of Roe and its potential impact on maternal health. In the two years since Dobbs, states with complete bans saw OB-GYN residency applications drop 6.7% in one year, compared to a small increase of applications in states without restrictions.
For Smith, the growing gap in women's health care has made her want to practice medicine in a state like Texas or Georgia after she completes her residency.
"Patients need us there," she said. "We need OB-GYNs in these areas that can provide these procedures, and the education and counseling in the cases where we can still do them. And we need the OB-GYNs to advocate for changes. If no one is there advocating on behalf of these patients, then we may not ever see some of these laws get overturned."
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Jasmine Crockett Hits Ted Cruz With Brutal Reality Check On Texas Abortion Bans
Ben Blanchet
Updated Sat, November 2, 2024
Rep. Jasmine Crockett (D-Texas) on Friday reminded Sen. Ted Cruz (R-Texas) that he’s a politician and not her doctor as she went after GOP officials for their defense of the state’s strictabortionbans.
“I don’t want my governor, I don’t want AG Paxton, I definitely don’t want Ted Cruz telling me what to do with my body if my doctor has a recommendation because the last time I checked, I don’t need any of them to be my doctor,” she told MSNBC’s Chris Hayes, referring to Texas Attorney General Ken Paxton.
“I don’t want them to be my elected officials,” she added.
Crockett appeared on MSNBC as Hayes highlighted the death of Nevaeh Crain, a Texas teenager and one of at least two pregnant women in the state who died after doctors delayed treating miscarriages, ProPublica reported.
“When people talk about women’s lives being on the line in this election, it’s not a slogan, it’s not hyperbole,” said Hayes. He added that women are seeing “preventable deaths right now” due to GOP-backed abortion bans in multiple states following the Supreme Court’s 2022 decision to overturn Roe v. Wade, the 1973 ruling that had legalized abortion nationwide.
Hayes later turned to Republicans getting “slippery” on the abortion issue, including Cruz, who he noted has been “anti-abortion his entire career” and is currently in a tight race to defend his Senate seat in Texas.
The MSNBC host played a clip of Cruz giving a nonanswer on abortion during a debate last month with his Democratic opponent, Rep. Colin Allred (D-Texas).
“Why is this an issue you won’t address, about saying whether you support or oppose exceptions like rape and incest?” asked moderator Jason Whitely after Cruz repeatedly dodged the question.
“Jason, I’m curious, why do you keep asking me that?” said Cruz, before pivoting to talk of Allred’s opposition to state law requiring parental notification for minors wanting abortions.
Hayes asked Crockett if she has “any doubt in her mind” over where Cruz is on abortion.
“I have zero doubts,” Crockett said.
She later continued, “When you can’t answer a question, that is the answer, right? And the idea that we should just trust you, we shouldn’t trust you. Not when people are dying. You guys are not going to save us. You are going to, again, inflict more pain.”
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