Abortion law affects care for risky pregnancies
A few weeks after Texas adopted the most restrictive abortion law in the nation, Dr. Andrea Palmer delivered terrible news to a Fort Worth patient who was midway through her pregnancy.
The fetus had a rare neural tube defect. The brain would not develop, and the infant would die at birth or shortly afterward. Carrying the pregnancy to term would be emotionally grueling and would raise the mother’s risk of blood clots and severe postpartum bleeding, the doctor warned.
But the patient was past six weeks’ gestation, and under the new law, an abortion was not an option in Texas because the woman was not immediately facing a life-threatening medical crisis or risk of permanent disability.
“So we look at them like a ticking time bomb and wait for the complications to develop,” Palmer said of her patients.
In this case, the woman had the means to travel, and she obtained an abortion in another state, an option unavailable to many low-income and working-class women.
Texas’ new measure was intended to impose stringent limits on abortion. But it is also affecting women who have no desire for termination but are experiencing medically risky pregnancies. Many doctors say they are unable to discuss the procedure as an option until the patient’s condition deteriorates and her life is at risk.
Abortion is permitted in Texas after six weeks only when a woman is facing a life-threatening or disabling medical emergency linked to her pregnancy. The law makes no exceptions for nonviable pregnancies in which the fetus has no chance of survival.
The measure deputizes private citizens — even those with no connection to the patient, doctor or health center — to sue anyone who performs an abortion once cardiac activity can be detected in the embryo. This can occur as early as two weeks after a missed period, when most women do not yet know they are pregnant.
Anyone who “aids and abets” the procedure can also be sued, and the law promises plaintiffs $10,000 and legal fees if they win the lawsuit.
The Supreme Court is expected to rule soon on whether abortion providers and the Biden administration may challenge the law notwithstanding its novel structure. In September, the justices turned down an emergency request to block the law.
Many physicians say they cannot intervene in complex pregnancies that may not pose an immediate threat to the patient but can rapidly spin out of control.
Some hesitate to counsel patients about the option of termination or refer them to doctors in other states, for fear their advice could be interpreted as aiding an abortion.
Supporters of the law say their goal is to save the life of every embryo, regardless of the circumstances of conception.
“We never advocate taking a life of an unborn child unless it is necessary to protect the life of a woman,” said Joe Pojman, executive director of the Texas Alliance for Life.
Even in cases of rape or incest, “we don’t advocate for taking the life of an unborn child for the crime of the father,” he said.
The law’s supporters say that it provides enough leeway for physicians to act if a mother’s life or bodily functions are compromised, and they insist those cases are rare.
Dr. Ingrid Skop, an obstetrician in San Antonio who belongs to the American Association of Pro-Life Obstetricians and Gynecologists, said that even a girl as young as 9 or 10, impregnated by a father or a brother, could carry a baby to term without health risks.