The patient was pregnant in Texas for 7 weeks and experienced renal failure. This is what many doctors consider to be a life-threatening condition.
However, after the fetal heartbeat is detected (about 6 weeks after pregnancy), abortion is prohibited unless "the doctor believes there is a medical emergency that interferes with compliance". .. Roe v. With the overthrow of Wade, a complete ban on abortion will come into effect in Texas in about a month.
"I was like,'Don't make a promise to her,'" Dr. Jessical Vino, a mischief provider at the Austin Women's Health Center, told her staff. "Get her out of the state. Call someone in another clinic and make sure she can get an abortion because I can't do it here. I she You have to wait until you actually die.'"
Rubino no longer offers abortion because of the risk of legal liability under Texas law.
Texas's current heartbeat ban allows civilians to sue anyone to help someone abort after about six weeks. If the lawsuit is successful, the plaintiff can receive up to $ 10,000. Next, there is a trigger method designed to come into effect 30 days after the Supreme Court has ruled. This makes abortion a ferrony, with no exceptions to rape and incest. The provider will be fined at least $ 100,000 for each breach. Lawyers also warned Rubino that Texas has an old ban on abortion that was not officially abolished after the first Roe's decision.
"My lawyer said,'You can't abort them or you're in breach of the law unless they're at that table dying in front of you.'" "She added. It is supposed to help people from prison.
Many doctors are currently facing similar predicaments. Most abortion bans that come into effect after Friday or are to become legal are with the exception of life-threatening situations that occur during pregnancy. However, there is no clear legal definition of which conditions are subject to these exceptions or how serious they must be in order for the doctor to perform an abortion without liability.
"What is the risk of death and how imminent it must be?" Lisa Harris, a professor of reproductive medicine at the University of Michigan,said earlier this month in the New England Journal. Written in Obmedicin. "Patients with pulmonary hypertension may tolerate abortion. With pulmonary hypertension, there is a 30-50% chance of dying during pregnancy, or 100%. "
Harris told NBC News when a doctor in a state where abortion is currently illegal (not in Michigan) said," When it was revealed that a patient would die to perform an operation. I will wait until the very end. " And it's not the ideal time to do all sorts of interventions.
Experts expect more mothers to die as a result.
Already, about 700 women die each year from pregnancy-related complications in the United States.According to the Center for Disease Control and PreventionAbout three-fifths of these deaths are preventable. Last year'sstudyfound that states with restricted access to abortion had a higher maternal mortality rate than states without it.
The most obvious threat to the life of a pregnant person
Harris is one condition that is likely to be considered a threat to the life of a pregnant person is the Faropius tube. Said to be an ectopic pregnancy that bursts. It occurs when the fetus develops outside the womb, causing internal bleeding and may require immediate surgery.
Intrauterine infections can quickly be life-threatening, Harris said. The same is true for patients who begin to bleed due to problems such as ongoing abortion or trauma.
"Often there is a rule that she must be in imminent danger of dying," said Prisila Smith, director of the Reproductive Justice Research Program at Yale Law School. .. "That is, it's not about endangering her life as this pregnancy progresses, but rather killing people on the spot."
But it's not clear if the patient is near death. There are many.
Instead of switching off or on, saying "OK, this person is bleeding a lot, but not enough to kill" suddenly causes enough bleeding. increase. Kill them, "Harris said. "Because it's a continuum, even the way to know where someone is in the process is really tricky."
Symptoms such as cancer may not be eligible
Pregnancy If a person inside is diagnosed with cancer, or if a person with cancer becomes pregnant, it may be necessary to decide whether to end the pregnancy in order to undergo surgery, radiation, or chemotherapy. Because those treatments can hurt the fetus.
The situation is unlikely to be considered life-threatening enough, Smith said.
Dayton Daily News reportedon one such case already this week. She is a woman who said she had to end her pregnancy before the doctor received chemotherapy and she had to leave the state for that. So. A judge lifted an injunction on Friday that was blocking Ohio's ban on abortion after the fetal heartbeat was detected.
"There are a great many health conditions that may have existed before pregnancy or may have occurred for the first time during pregnancy," Harris said. "This is where there is a lot of ambiguity as the patient may be okay in the early stages of pregnancy, but may not be okay in the late stages of pregnancy if the demands for pregnancy are much higher in all body systems. "
She said she was still worried about patients with pulmonary hypertension, a hypertension that affects the arteries of the lungs and heart.
"Can a patient request an abortion to avoid dying with a 50% chance?" She said. "To me, that seems very likely."
Smith says there are still few legal norms surrounding this issue, as few lawsuits have addressed it. Said not. But even if they do, the medical problems are very diverse.
For example, Harris said, "Normal hypertension does not fall into this life-threatening category, but for some, everyone and every body. It's different. "
The threat of litigation can change the way doctors care for patients
Most abortion bans make it a ferrony to offer or attempt to provide a abortion. That is, doctors and clinics can be prosecuted. I tried it, not the individual patient.
Smith said in many states where abortion is banned, "whatever you can do to close the clinic, put a doctor in prison, or deprive you of your license." He said he thinks there is a "government".
Therefore, doctors can make mistakes on the part of their own legal safety when making decisions about patient care. Rubino said she wasn't convinced that her Texas practices could secure enough money to cover the costs and fines from civil lawsuits, even before Rho's reversal.
"No one knew how many times I would be sued," she said. "How many miscarriage will you be sued. Multiple people will be sued for me with the same thing."
Even if the clinic stops conducting emergency miscarriage, the hospital does. However, according to Harris, some hospitals do not have many doctors capable of performing emergency expansion and evacuation procedures, so this is a common method of mischief after the first semester.
In such cases, if the doctor resorts to major abdominal surgery instead, it "provides a great risk to the patient, the cost of complications is much higher and threatens the ability to conceive in the future". Give, "Harris said. ..
Rubino expects more pregnancy-related deaths in her state.
"I'm pregnant in Texas, I'm stuck in the state, I'm sick, medically complicated, I just die from pregnancy," she said. "I think that's where we're heading."