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"I ended up losing half of my fertility and if I was made to wait any longer, it's very likely I would have died," said one Texas patient.
Monday reporting from The Associated Press and newly filed federal complaints highlight how abortion restrictions enacted in U.S. states since the 2022 reversal of Roe v. Wade endanger the health and lives of pregnant people nationwide.
Building on a report published earlier this year ahead of oral arguments in a relevant U.S. Supreme Court case, the AP's Amanda Seitz revealed that "more than 100 pregnant women in medical distress who sought help from emergency rooms were turned away or negligently treated since 2022," according to an analysis of federal hospital investigations.
Legal experts and medical providers argue that "nursing and doctor shortages that have plagued hospitals since the onset of Covid-19, trouble staffing ultrasounds around-the-clock, and new abortion laws are making the emergency room a dangerous place for pregnant women," Seitz reported. Even when laws make exceptions intended for cases of rape, incest, and emergencies, some doctors and facilities decline to provide care out of fear of state restrictions.
As the AP detailed:
A pregnant patient at a Bakersfield, California, emergency room was quickly triaged, but staff failed to realize the urgency of her condition, a uterine rupture. The delay, an investigator concluded, may have contributed to the baby’s death.
Doctors at emergency rooms in California, Nebraska, Arkansas, and South Carolina failed to check for fetal heartbeats or discharged patients who were in active labor, leaving them to deliver at home or in ambulances, according to the documents.
Seitz also shared stories from Florida, Idaho, Texas, and Washington. Two women from Texas—Kelsie Norris-De La Cruz and Kyleigh Thurman—had the Center for Reproductive Rights (CRR) file complaints on their behalf with the U.S. Department of Health and Human Services last week. They both had ectopic pregnancies and lost a fallopian tube.
"Despite the fact that my life was clearly in danger, the hospital told me that they could not help me. I ended up losing half of my fertility and if I was made to wait any longer, it's very likely I would have died," Norris-De La Cruz said Monday in a CRR statement.
"The doctors knew I needed an abortion, but these bans are making it nearly impossible to get basic emergency healthcare," she continued. "So, I'm filing this complaint because women like me deserve justice and accountability from those that hurt us. Texas state officials can't keep ignoring us. We can't let them."
Thurman said that "I never imagined I would find myself in the crosshairs of my home state's extreme abortion bans. For weeks, I was in and out of emergency rooms trying to get the abortion that I needed to save my future fertility and life. This should have been an open-and-shut case. Yet, I was left completely in the dark without any information or options for the care I deserved."
"Pregnancy is not straightforward, and I now have to live with the consequences of these extreme laws every day," she added. "None of this should have happened to me, and I want to make sure this doesn't happen to anyone else."
Beth Brinkmann, CRR's senior director of U.S. litigation, asked: "How many more people will nearly die before we see change? These women are proof that exceptions do not make abortion bans less dangerous, even when they are exceedingly clear."
"Texas law clearly allows for abortions to treat ectopic pregnancies, and federal law requires it," Brinkmann explained. "Yet, Kelsie and Kyleigh were denied absolutely urgent care. As long as these bans are in place, doctors will be terrified to provide abortions of any kind."
"It's impossible to have the best interest of your patient in mind when you're staring down a life sentence," she asserted. "Texas officials have put doctors in an impossible situation. It is clear that these exceptions are a farce, and that these laws are putting countless lives in jeopardy."
The relevant Supreme Court case focuses on Idaho's strict abortion ban and the Emergency Medical Treatment and Labor Act (EMTALA), a federal law requiring emergency departments that accept Medicare to provide patients with "necessary stabilizing treatment," which the Biden administration argues includes abortion care.
Two years after reversing Roe with the Dobbs v. Jackson Women's Health Organization ruling, the high court in June dismissed the Idaho case without ruling on its merits and sent it back to the lower courts. The decision temporarily restored emergency abortions in Idaho but, as CRR said at the time, "still leaves millions of people in states with abortion bans vulnerable."
In response to the "horrifying" AP reporting and CRR complaints, reproductive rights advocates, including some doctors, called out the Supreme Court's right-wing supermajority—led by Chief Justice John Roberts—and politicians who installed them and are trying to outlaw abortion care.
"In addition to these individual incidents is the horrifying recognition that they are not one-off consequences of some short-term disaster. They represent a reality created by the Supreme Court that will take a generation at minimum to undo. This is now our status quo," said Gillian Branstetter, a communications strategist at the ACLU, on her personal social media.
Denver Post opinion editor Megan Schrader declared that "pregnant women are suffering because of the twisted and corrupted jurisprudence of Justices Neil Gorsuch, Samuel Alito, Amy Coney Barrett, Brett Kavanaugh, and Clarence Thomas."
Dr. Michelle Au, an anesthesiologist and Democratic member of the Georgia House of Representatives for the 50th District, stressed that "standards of care haven't changed. EMTALA hasn't changed. What has changed are state laws inhibiting doctors from caring for patients."
Au took aim at former President Donald Trump, the Republican nominee for the November election, declaring that "Trump did this."
American Bridge 21st Century, a super political action committee and research group that supports Democrats, similarly said Monday that "Trump overturned Roe and American women are paying the price."
Although Trump has recently tried to downplay the significance of abortion rights in this cycle and distance himself from some restrictions, recognizing them as politically risky, he has previously backed anti-abortion laws and bragged about appointing half of the justices who overturned Roe. Rights advocates fear what his return to office would mean for reproductive freedom.
Trump and his vice presidential candidate, anti-choice U.S. Sen. JD Vance (R-Ohio), are set to face Democratic Vice President Kamala Harris and her running mate, Minnesota Gov. Tim Walz, on November 5.
"If Trump is elected again, he will appoint even more justices who could uphold future abortion bans and endanger our fundamental freedoms for decades."
Reproductive rights advocates across the United States on Thursday were "hardly celebrating" the Supreme Court's one-sentence decision in a case regarding whether emergency departments can provide abortion care to people who have urgent pregnancy complications, and the court left open the possibility that such care could ultimately be banned.
In Moyle v. United States and Idaho v. United States, Idaho officials asked the court to intervene in an earlier decision by the U.S. Court of Appeals for the Ninth Circuit, which temporarily blocked the state's near-total abortion ban after the Biden administration argued it violated the Emergency Medical Treatment and Labor Act (EMTALA).
EMTALA requires hospital emergency departments that accept Medicare to provide "necessary stabilizing treatment" to all patients, and the Biden administration argued abortion care is included in that requirement and that federal law should override Idaho's abortion ban.
But a day after a draft decision was mistakenly posted on the Supreme Court's website, the release of the ruling confirmed that the court had dismissed the case without ruling on its merits and was sending it back to the lower courts.
The decision temporarily restores Idaho medical providers' ability to provide emergency abortions, but as the Center for Reproductive Rights (CRR) said, "it still leaves millions of people in states with abortion bans vulnerable."
"Hospitals in the 14 states that completely ban abortion, as well as many others with bans and restrictions, have shown they are afraid to provide emergency abortions due to the risk of severe criminal penalties under their states' vague and confusing abortion bans," said the organization. "For patients needing abortion care in those states, they will continue to largely rely on their state's medical exceptions, which often do not work in practice."
Nancy Northrup, CRR's president and CEO, explained that the court had "kicked the can down the road on whether states with abortion bans can override the federal law requirement that hospitals must provide abortion care to patients in the throes of life-threatening pregnancy complications."
"The court's refusal to clearly affirm the rights of all pregnant people to emergency abortion care, and put an unequivocal end to extremist attacks by anti-abortion politicians on this essential healthcare, is a dangerous preview for what could come."
"The Supreme Court created this healthcare crisis by overturning Roe v. Wade and should have decided the issue," said Northrup. "Women with dire pregnancy complications and the hospital staff who care for them need clarity right now."
Two of the court's liberal members, Justices Ketanji Brown Jackson and Elena Kagan, agreed with Northrup and other advocates in a dissenting opinion that the panel should have ruled on the merits of the case.
Kagan wrote that EMTALA "unambiguously requires" hospitals to provide emergency treatment including abortion care, while Jackson said Idaho's ban on nearly all abortions created a "monthslong catastrophe" when it was in effect.
"Idaho physicians were forced to step back and watch as their patients suffered, or arrange for their patients to be airlifted out," Jackson wrote of the state's law, which bans abortions except in cases of rape, incest, certain nonviable pregnancies, and those in which a pregnant patient's life is at risk. "There is simply no good reason not to resolve this conflict now."
"While this court dawdles and the country waits, pregnant people experiencing emergency medical conditions remain in a precarious position, as their doctors are kept in the dark about what the law requires," Jackson continued.
Right-wing Justice Samuel Alito also objected to the court's refusal to rule on the case's merits, but said Idaho's ban should apply to abortion care, arguing that EMTALA requires hospitals "to treat, not abort, an 'unborn child.'"
The American Civil Liberties Union (ACLU) said Alito's dissent, joined by Justices Neil Gorsuch and Clarence Thomas, "will embolden those who are pursuing a strategy to give legal rights to embryos and fetuses that will override the rights of the pregnant person and ban not only abortion, but other forms of reproductive healthcare like fertility treatment and birth control as well."
With the official release of the ruling, said Alexa Kolbi-Molinas, deputy director of the ACLU Reproductive Freedom Project, "it is now clear that the Supreme Court had the opportunity to hold once and for all that every pregnant person in this country is entitled to the emergency care they need to protect their health and lives, and it failed to do so."
"The court's refusal to clearly affirm the rights of all pregnant people to emergency abortion care, and put an unequivocal end to extremist attacks by anti-abortion politicians on this essential healthcare, is a dangerous preview for what could come," said Kolbi-Molinas. "This fight is far from over–anti-abortion politicians are trying to ban abortion in all 50 states, including in emergencies. These extremist politicians went all the way to the Supreme Court for the right to put doctors in jail for providing life- and health-saving emergency abortion care, and they will do it again, if we let them."
Since Roe v. Wade was overturned by the Supreme Court's right-wing majority in June 2022, a number of cases from states with abortion bans and restrictions have garnered national attention, with women speaking out about being denied abortion care when they were experiencing severe, sometimes life-threatening, complications or had learned their fetuses had fatal abnormalities.
Despite those cases, Indivisible co-executive director Leah Greenberg said Thursday's ruling leaves an "open question" on whether or not emergency rooms can "just let women die instead of treating them."
Mini Timmaraju, president and CEO of Reproductive Freedom for All, said the ruling should "serve as a reminder of what's at stake this November."
"While the Biden administration is fighting tooth and nail to ensure people can get the emergency abortion care they need, anti-abortion extremists will continue to do whatever they can to stop them," said Timmaraju. "We must secure reproductive freedom majorities in Congress and send President Biden back to the White House to restore the federal right to abortion and expand access for all."
Judicial reform group Stand Up America pointed to the Supreme Court Voter campaign it launched Monday, aiming to mobilize voters "on the impact the next president will have on the future of the U.S. Supreme Court."
"The Roberts court's decision to take up Idaho v. United States endangered the lives of pregnant Americans and did irreparable harm," said Stand Up America executive director Christina Harvey. "By staying the lower court's decision, the Supreme Court allowed Idaho's extreme abortion ban to take effect while it considered the case. In the meantime, for months, the lives of women in Idaho were callously put at risk, with multiple patients having to be medevacked out of the state to receive care.
"By overturning Roe, the MAGA majority on the court opened the door to extreme abortion bans like the one in Idaho," she added. "If Trump is elected again, he will appoint even more justices who could uphold future abortion bans and endanger our fundamental freedoms for decades."
"Women shouldn't have to wait to see if the Supreme Court will decide if they can get life-saving healthcare in all states," said one campaigner of a pending ruling on emergency abortion care.
Exactly two years after the right-wing majority on the U.S. Supreme Court cleared the way for nearly half of U.S. states so far to ban or severely restrict abortion care, reproductive justice advocates convened in Washington, D.C. on Monday to mark the anniversary and speak out ahead of another ruling that could have deadly consequences for pregnant people across the country.
As the country marks two years since the Dobbs v. Jackson Women's Health Organization decision, which overturned the 1973 ruling that affirmed Americans have the constitutional right to obtain abortions, advocates expressed a need to acknowledge the harm caused by Dobbs while also looking ahead to the pro-forced pregnancy movement's desire to further restrict reproductive rights.
"Women shouldn't have to wait to see if the Supreme Court will decide if they can get lifesaving healthcare in all states. This is a direct result of the disastrous Dobbs decision two years ago," said Margaret Viggiani, a campaigner who joined the National Mobilization for Reproductive Justice Monday at the rally and press conference in the nation's capital.
The decision expected by the end of the month is Idaho and Moyle, et al. v. United States, which stems from Idaho's near-total ban on abortion care. In August 2022, a federal judge barred the state from enforcing the ban due to its conflict with the Emergency Medical Treatment and Labor Act (EMTALA), which requires hospital emergency departments that accept Medicare to provide treatment to any patient with an emergency medical condition, including people facing pregnancy complications who need abortions.
Since the Dobbs decision was handed down two years ago, the real-world implications of abortion bans have become clear to many Americans as advocates have shared the stories of women like Kate Cox, who was forced to flee Texas to obtain abortion care when she learned her fetus had a fatal condition; Anya Cook and Shanae Smith-Cunningham, who faced the dangerous condition preterm prelabor rupture of the membranes (PPROM) but were unable to receive the standard of care recognized by obstetricians under Florida's 15-week abortion ban; and Amanda Zurawski, who was forced to become "sick enough" from a rapidly spreading infection before doctors would provide an abortion in Texas.
The life-threatening experiences of those women and others, said Human Rights Watch on Monday, exemplify "two years of outrage" since Roe v. Wade was overturned.
"The Supreme Court's revocation of national protections for abortion access, and the restrictive state laws that followed, means the United States is violating the rights to life, health, privacy, nondiscrimination, and freedom from cruel, inhuman, or degrading treatment, among others," said the global organization. "Access to legal abortion is essential to achieve gender equality. Every year, more leaders, legislatures, and courts abroad understand this. U.S. states should repeal restrictions on abortion, enshrine access to abortion in state constitutions, and advance the global trend of recognizing women's autonomy."
Last month, polling from the Pew Research Center suggested the stories of Zurawski, Cox, and other women have struck a chord with many Americans; more than 60% said they believed abortion should be legal in all or most cases, a four-percentage-point jump from 2021.
At the rally in Washington on Monday, reproductive rights advocates joined union members in calling on the American Federation of Labor and Congress of Industrial Organizations (AFL-CIO) to convene a national labor conference for reproductive justice, arguing that the largest federation of unions in the U.S. "is in the most powerful position to mobilize thousands of workers in defense of this fundamental right."
With 1 in 3 women of reproductive age in the U.S. now living in states with abortion bans, Reproductive Justice Maryland executive director Jakeya Johnson said at the rally that the Dobbs decision has "disproportionately impacted those who are marginalized and struggling to make ends meet."
"Today we're here to say, enough is enough," said Johnson. "The power of our collective voices cannot be underestimated. When labor and reproductive justice movements join forces, we are unstoppable. We're a force for change, and our strength lies in our numbers."
Meanwhile, groups including Reproductive Freedom for All, the Center for Reproductive Rights, the National Women's Law Center, and Planned Parenthood Federation of America marked the Dobbs anniversary by launching their Abortion Access Now campaign, pledging a $100 million investment to advance abortion rights and access through lobbying, grassroots organizing, public education, and other communications strategies.
"We envision a future where abortion, and all sexual and reproductive healthcare, is not only legal but also accessible, affordable, and free from stigma or fear," said the campaign. "This campaign is committed to building and leading a broad, inclusive vision for abortion access, ensuring everyone can make fundamental decisions about their health and bodies with dignity and support. Together, we will secure the freedom to control our own bodies and care for ourselves, our families, and our communities."
A separate campaign launched by the judicial reform group Stand Up America similarly marked the Dobbs anniversary and focused on warning U.S. voters that a victory by presumptive Republican presidential nominee Donald Trump in November would "ensure MAGA control of the [U.S. Supreme] Court for decades to come," with an impact on abortion rights and other crucial issues.
"We can't let that happen," said executive director Christina Harvey.