'Republican Abortion Bans Kill Women': Maternal Sepsis Rates Soar in Texas

"This is exactly what we predicted would happen and exactly what we were afraid would happen."

That's what Dr. Lorie Harper, a maternal-fetal medicine specialist in Austin, said after reviewing the data behind a ProPublica analysis published Thursday revealing that, since Texas banned abortion in 2021, the rate of sepsis soared by more than 50% for women hospitalized in the state when they lost their pregnancies in the second trimester.

In the years immediately preceding Texas' abortion ban, the rate of sepsis—a life-threatening condition caused by infection—for women hospitalized in the second trimester of pregnancy held relatively steady around 3%. Since the ban, the sepsis rate for such women has shot up to nearly 5%.

"After the state banned abortion, dozens more pregnant and postpartum women died in Texas hospitals than had in pre-pandemic years, which ProPublica used as a baseline to avoid Covid-19-related distortions," states the report by Lizzie Presser, Andrea Suozzo, Sophie Chou, and Kavitha Surana.

The analysis notes that "the standard of care for miscarrying patients in the second trimester is to offer to empty the uterus," which can lower the risk of infection and, by extension, sepsis. However, some hospitals don't allow doctors to perform the potentially lifesaving procedure until after a fetal heartbeat stops, or until they find a life-threatening complication.

That's because under Texas' misnomered "Heartbeat Law," pregnant people who have abortions cannot be penalized, but anyone who performs or aids in the procurement of the procedure faces as many as 99 years in prison, up to a $100,00 fine, and the possible loss of their professional license.

Texas empowers private individuals to sue anyone who "knowingly engages in conduct that aids or abets the performance or inducement of an abortion" after the sixth week of pregnancy, a period before which many people even know they are pregnant. Plaintiffs who win in court are entitled to a reward of $10,000 plus costs and attorneys' fees.

Although the law contains an exception for "a life-threatening physical condition aggravated by, caused by, or arising from a pregnancy," the authors of the ProPublica analysis noted that "the definition of what constitutes an emergency has been subject to confusion and debate."

In short, healthcare providers fear running afoul of the ambiguous law. This has resulted in deadly and life-threatening delays in care.

As the report highlights:

Forced to wait 40 hours as her dying fetus pressed against her cervix, Josseli Barnica risked a dangerous infection. Doctors didn't induce labor until her fetus no longer had a heartbeat.

Physicians waited, too, as Nevaeh Crain's organs failed. Before rushing the pregnant teenager to the operating room, they ran an extra test to confirm her fetus had expired.

Both women had hoped to carry their pregnancies to term, both suffered miscarriages, and both died.

"It's black and white in the law, but it's very vague when you're in the moment," Dr. Tony Ogburn, an OB-GYN in San Antonio, told ProPublica.

Republican lawmakers who helped write Texas' law have recently said they're open to revisions aimed at protecting pregnant peoples' lives in light of the harms reported by ProPublica and others. Last month, Republican Texas Lt. Gov. Dan Patrick said that "I do think we need to clarify any language so that doctors are not in fear of being penalized if they think the life of the mother is at risk."

However, it is uncertain how or when the law might be amended. Meanwhile, deaths attributed to abortion bans have also been reported—and reportedly covered up—in other states.

"It is kind of mind-blowing," perinatal epidemiologist Alison Gemmill told ProPublica, "that even before the bans researchers barely looked into complications of pregnancy loss in hospitals."