Photo by Pete Alexopoulos on Unsplash
The stories out of Texas are numerous and heartbreaking. In our third episode of Outlawed, we’ll meet two people from Texas. One is a high-risk OB-gyn physician who cares for some of the sickest patients and pregnancies. She talks about the impact of the Texas abortion ban (SB8) and Dobbs on the healthcare she can provide people and explains why these laws lead to substandard care. The second person we will meet is Lisa, a patient who had to flee Texas after receiving a devastating diagnosis during her routine second trimester ultrasound.
For reproductive rights in the US, Texas has represented the canary in the coalmine. In 2021, SB8 – the Texas vigilante abortion ban, went into effect. The law essentially banned abortion after cardiac activity was detected (around 6 weeks) and made it possible for any citizen to take civil action against a person that they presumed was providing care. The law effectively shut abortion clinic doors and sought to criminalize those who were providing abortion care. Because Texas got a jump on the rest of the country with their restrictions, we were able to see the impacts of those bans sooner than in states that waited until the Dobbs decision.
One important study that came out of Texas data early on showed these impacts. They found when doctors were unable to care for patients who developed medical complications in the second trimester unless they were more seriously ill, patients unsurprisingly had worse outcomes. In the second trimester, patients can break their water early or develop early preeclampsia. The textbooks teach us that these conditions have the potential to be deadly and intervention should be offered upon diagnosis. SB8 required hospitals to wait until patients were gravely ill before intervening.
Patients were twice as likely to have a serious health effect of waiting for care, including needing a blood transfusion, being admitted to the ICU, or getting a serious infection. Nambiar et al sum up their findings saying: “Because of the intense politicization of these issues nationally, some have questioned, “What does the threat of death have to be?” and “How imminent must it be?” As large academic medical centers prepare to navigate the potential for loss of access to services, more questions are raised than answers.”
Table from Nambiar et al. AJOG 2022
Another study showed in the year after SB8 went into effect, infant deaths also increased. They found a 10% increase in infant deaths in the year following the Texas abortion ban, many of these deaths due to lethal birth defects. The study authors conclude: “This study found that Texas’ 2021 ban on abortion in early pregnancy was associated with unexpected increases in infant and neonatal deaths in Texas between 2021 and 2022. Congenital anomalies, which are the leading cause of infant death, also increased in Texas but not the rest of the US.” When patients found out they were carrying pregnancies with medically futile diagnoses, they were forced to continue those pregnancies, only to watch their infants suffer and die. For patients with the means and resources to leave the state, they could seek care in an access state. This leads to increased disparities in suffering. Our two guests talk about these disparities in access to care.
This episode highlights some individual voices, illustrating in their own words what these statistics demonstrate for doctors and families.
Want to support Texans seeking reproductive healthcare? Check out the Texas Equal Access fund!
Here are some other recent news stories that highlight the ongoing reproductive healthcare crisis in Texas:
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