It was in the first trimester of her pregnancy last year when Amanda, a 35-year-old Dallas-Fort Worth woman, lost her baby. One of the most common surgical procedures for the removal of tissue from failed pregnancies was conducted at a big hospital.
To show their sympathy for her loss, the hospital sent her a bracelet of pink and blue with a butterfly pendant, signed by the nurses. ‘It was very wonderful since it’s such a terrible thing to go through,’ Amanda remarked.
Amanda, who requested anonymity to safeguard her privacy, had another first-trimester loss in January of this year. At Baylor Scott & White Medical Center in Dallas, she was in excruciating agony and screaming as she passed an enormous blood-clot, she claimed.
However, she claims that the hospital denied her request for the same surgical evacuation operation, known as dilatation and curettage or D&C.
Some abortions are performed using the same technique as a D&C. Between Amanda’s first and second miscarriages, in September of 2021, Texas passed a legislation prohibiting almost all abortions beyond six weeks of pregnancy.
The repeal of Roe v. Wade has resulted in a number of states banning or severely restricting abortion. However, some patients have experienced difficulties in accessing routine surgical methods or drugs for the termination of unwanted pregnancies, despite the fact that these rules are meant to apply solely to abortions.
Her doctor told her she may go home if she was bleeding profusely enough to fill a diaper more than once an hour; however, the hospital didn’t mention the state’s ban on abortions when they sent her home. An ultrasound taken a week before Amanda’s visit to the hospital revealed that her embryo had no cardiac activity. According to the documents, “she claims to be in a lot of pain” and “she seems disturbed.”
Waiting seven days to confirm “this looks to be a miscarriage in progress,” the medical records said.
After Amanda got home, she sat on the toilet and scratched “fingernail marks in my wall” because of the anguish she was experiencing. The two of them sobbed together in the bathtub as he held her hand and comforted her. Amanda remembered the water being a dark crimson colour. There was “a continual heavy haemorrhage with large clots” for 48 hours, according to the patient.
Compared to her first encounter, she said, “It was so different from now just feeling alone and afraid.”
There was no mention of a possible effect of Texas’s restrictive abortion laws on the hospital’s medical services. Statement: “Although we are unable to comment about an individual’s case because of privacy rules, our multidisciplinary team of physicians works collaboratively to identify the right treatment strategy on an individual case-by-case basis,” the hospital stated.
According to Texas Right to Life president John Seago, “extremely severe scenarios” include any hurdles miscarriage sufferers face. “I have seen instances of physicians being puzzled, but that is a failing of our medical organisations” to offer clear instructions, he said, blaming “a breakdown in communication of the legislation, not the law itself” for the confusion.
Pregnant women and their advocates claim that pharmacists are refusing or delaying filling prescriptions for medicines to end miscarriages because they are afraid of being accused of assisting an abortion in this uncertain atmosphere. According to the Biden administration, a pharmacy may be violating anti-discrimination laws by refusing to fill prescriptions for drugs “such as medication required to treat a miscarriage or problems from pregnancy loss, since these pharmaceuticals may also be used to terminate a pregnancy”
Obstetricians warn that delaying the removal of tissue from a no longer viable pregnancy may result in bleeding, infections, and the potentially fatal condition known as sepsis.
Dr. Monica Saxena, an emergency care specialist at Stanford Hospital, warned, “In our post-Roe reality, women having miscarriages may die.”
A miscarriage is a pregnancy that spontaneously terminates before the 20th week of gestation, according to medical professionals. The vast majority of miscarriages occur in the first 13 weeks of pregnancy, whereas stillbirths occur beyond 20 weeks. One in every ten pregnancies ends in miscarriage, and that number rises to one in every four if you include losses that occur before the woman even realises she is pregnant.
Miscarriage is commonly referred to in medical parlance as “spontaneous abortion,” a label that might exacerbate patients’ or providers’ fears of being targeted under abortion prohibitions. A “threatened abortion: established and deteriorating” diagnosis was given to Amanda after her second loss.
Patients should be given three alternatives to remove tissue in typical early miscarriages when heart activity has ceased, according to Dr. Sarah Prager, a professor of obstetrics and gynaecology at the University of Washington Medical School.
D&C is indicated by Dr. Prager when a patient is bleeding excessively or is otherwise medically frail (e.g. anaemia, problems with blood coagulation). D&C’s are also preferred by some patients because they believe they are less emotionally taxing than a protracted treatment at home.
Mifepristone weakens the membrane that covers the uterus and softens the cervical canal, and is followed by the contraction-inducing drug misoprostol, which induces labour. Same tablets are used for medication abortion.
Waiting for the tissue to dissipate on its own, which might take weeks, is the third alternative. Dr. Prager, who co-authored the American College of Obstetricians and Gynecologists’ recommendations on miscarriage care, noted that 20% of patients require surgery or medication.