Pregnant women, some bleeding or in labor, being turned away from ERs in Florida and elsewhere despite federal law (2024)

WASHINGTON – Bleeding and in pain, Kyleigh Thurman didn’t know her doomed pregnancy could kill her.

Emergency room doctors at Ascension Seton Williamson in Texas handed her a pamphlet on miscarriage and told her to “let nature take its course" before discharging her without treatment for her ectopic pregnancy.

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When she returned three days later, still bleeding, doctors finally agreed to give her an injection to end the pregnancy. It was too late. The fertilized egg growing on Thurman’s fallopian tube ruptured it, destroying part of her reproductive system.

That’s according to a complaint Thurman and the Center for Reproductive Rights filed last week asking the government to investigate whether the hospital violated federal law when staff failed to treat her initially in February 2023.

“I was left to flail," said Thurman, 35. “It was nothing short of being misled.”

The Biden administration says hospitals must offer abortions when needed to save a woman's life, despite state bans enacted after the Supreme Court overturned the constitutional right to an abortion more than two years ago. Texas is challenging that guidance and, earlier this summer, the Supreme Court declined to resolve the issue.

More than 100 pregnant women in medical distress who sought help from emergency rooms were turned away or negligently treated since 2022, an Associated Press analysis of federal hospital investigations found.

Two women — one in Florida and one in Texas — were left to miscarry in public restrooms. In Arkansas, a woman went into septic shock and her fetus died after an emergency room sent her home. At least four other women with ectopic pregnancies had trouble getting treatment, including one in California who needed a blood transfusion after she sat for nine hours in an emergency waiting room.

Abortion bans complicate risky pregnancy care

In Texas, where doctors face up to 99 years of prison if convicted of performing an illegal abortion, medical and legal experts say the law is complicating decision-making around emergency pregnancy care.

Although the state law says termination of ectopic pregnancies isn't considered abortion, the draconian penalties scare Texas doctors from treating those patients, the Center for Reproductive Rights argues.

“As fearful as hospitals and doctors are of running afoul of these state abortion bans, they also need to be concerned about running afoul of federal law,” said Marc Hearron, a center attorney. Hospitals face a federal investigation, hefty penalties and threats to their Medicare funding if they violate the federal law.

The organization filed complaints last week with the Centers for Medicare and Medicaid Service alleging that different Texas emergency rooms failed to treat two patients, including Thurman, with ectopic pregnancies.

One complaint says Kelsie Norris-De La Cruz, 25, lost a fallopian tube and most of an ovary after an Arlington, Texas, hospital sent her home without treating her ectopic pregnancy, even after a doctor said discharge was “not in her best interest.”

“The doctors knew I needed an abortion, but these bans are making it nearly impossible to get basic emergency healthcare,” she said in a statement. “I’m filing this complaint because women like me deserve justice and accountability from those that hurt us.”

Conclusively diagnosing an ectopic pregnancy can be difficult. Doctors cannot always find the pregnancy’s location on an ultrasound, three doctors consulted for this article explained. Hormone levels, bleeding, a positive pregnancy test and an ultrasound of an empty uterus all indicate an ectopic pregnancy.

“You can't be 100% — that's the tricky part," said Kate Arnold, an OB-GYN in Washington. “They're literally time bombs. It's a pregnancy growing in this thing that can only grow so much."

Texas Right to Life Director John Seago said state law protects doctors from prosecution for terminating ectopic pregnancies, even if a doctor “makes a mistake” in diagnosing it.

“Sending a woman back home is completely unnecessary, completely dangerous," Seago said.

But the state law has “absolutely” made doctors afraid of treating pregnant patients, said Hannah Gordon, an emergency medicine physician who worked in a Dallas hospital until last year.

She recalled a patient with signs of an ectopic pregnancy at her Dallas emergency room. Because OB-GYNs said they couldn't definitively diagnose the problem, they waited to end the pregnancy until she came back the next day.

“It left a bad taste in my mouth," said Gordon, who left Texas hoping to become pregnant and worried about the care she'd receive there.

“Oh my God, I’m dying”

When Thurman returned to Ascension Seton Williamson a third time, her OB-GYN told her she'd need surgery to remove the fallopian tube, which had ruptured. Thurman, still heavily bleeding, balked. Losing the tube would jeopardize her fertility.

Her doctor told her she risked death if she waited any longer.

“She came in and she’s like, you're either going to have to have a blood transfusion, or you’re going to have to have surgery or you’re going to bleed out,” Thurman said, through tears. “That’s when I just kind of was like, ‘Oh my God, I’m, I’m dying.’”

The hospital declined to comment on Thurman’s case, but said in a statement it “is committed to providing high-quality care to all who seek our services.”

In Florida, a 15-week pregnant woman leaked amniotic fluid for an hour in Broward Health Coral Springs' emergency wait room, according to federal documents. An ultrasound revealed the patient had no amniotic fluid surrounding the fetus, a dangerous situation that can cause serious infection.

The woman miscarried in a public bathroom that day, after the emergency room doctor listed her condition as “improved” and discharged her, without consulting the hospital's OB-GYN.

Emergency crews rushed her to another hospital, where she was placed on a ventilator and discharged after six days.

Abortions after 15 weeks were banned in Florida at the time. Broward Health Coral Springs’ obstetrics medical director told an investigator that inducing labor for anyone who presents with pre-viable premature rupture of membranes is "the standard of care, has been a while, regardless of heartbeat, due to the risk to the mother.”

The hospital declined comment.

In another Florida case, a doctor admitted state law had complicated emergency pregnancy care.

“Because of the new laws ... staff cannot intervene unless there is a danger to the patient's health," a doctor at Memorial Regional Hospital in Hollywood, Florida, told an investigator who was probing the hospital's failure to offer an abortion to a woman whose water broke at 15 weeks, well before the fetus could survive.

Troubles extend beyond abortion ban states

Serious violations that jeopardized a mother or her fetus’ health occurred in states with and without abortion bans, the AP’s review found.

Two short-staffed hospitals — in Idaho and Washington — admitted to investigators they routinely directed pregnant patients to other hospitals.

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.

Nursing and doctor shortages, trouble staffing ultrasounds around-the-clock and new abortion laws are making the emergency room a dangerous place for pregnant women, warned Dara Kass, an emergency medicine doctor and former U.S. Health and Human Services official.

“It is increasingly less safe to be pregnant and seeking emergency care in an emergency department,” she said.

__

This story was first published on Aug. 12, 2024. It was updated on Aug. 14, 2024, to correct that Kyleigh Thurman is 35, not 25.

Copyright 2024 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed without permission.

Pregnant women, some bleeding or in labor, being turned away from ERs in Florida and elsewhere despite federal law (2024)

FAQs

Pregnant women, some bleeding or in labor, being turned away from ERs in Florida and elsewhere despite federal law? ›

More than 100 pregnant women in medical distress who sought help from emergency rooms were turned away or negligently treated since 2022, an Associated Press analysis of federal hospital investigations has found. Two women – one in Florida and one in Texas – were left to miscarry in public restrooms.

What are the labor laws for pregnant women in Florida? ›

Leave – Pregnant employees must be permitted to work if they can perform their jobs. If an employee is absent from work because of a pregnancy-related condition and recovers, the employer cannot force her to remain on leave until the baby's birth.

What is the Stop Shackling and Detaining Pregnant Women Act? ›

The Stop Shackling and Detaining Pregnant Women Act will protect the health and safety of pregnant women in immigration detention by reinstituting their presumption of release, prohibiting the U.S. Department of Homeland Security from shackling pregnant women in its custody, and setting new standards of care and ...

Does an ectopic pregnancy show up on a pregnancy test? ›

You may not notice any symptoms at first. However, some women who have an ectopic pregnancy have the usual early signs or symptoms of pregnancy — a missed period, breast tenderness and nausea. If you take a pregnancy test, the result will be positive. Still, an ectopic pregnancy can't continue as normal.

How is an ectopic pregnancy diagnosed? ›

Vaginal ultrasound

An ectopic pregnancy is usually diagnosed by carrying out a transvaginal ultrasound scan.

What is the new maternity law in Florida? ›

The new state employee leave policy: Provides 280 hours (seven weeks) of paid maternity leave within the first 12 months of the birth of a child. Provides 80 hours (two weeks) of paid parental leave within the first 12 months of the birth or adoption of a child.

What is Florida labor law? ›

Florida is a “right-to-work” state, meaning union membership cannot be a condition of employment. This law supports individual choice regarding union participation. Immigration compliance. Finally, employers must verify the legal work status of new hires using the federal E-Verify system.

Is the anti shackling law against pregnancy? ›

A DHS detention facility may not use a restraint on a detainee who is known to be pregnant, including during labor, transport to a medical facility or birthing center, and delivery, or during postpartum recovery, except for medical or safety purposes.

Is pregnancy protected by federal law? ›

The Pregnancy Discrimination Act of 1978, which amended Title VII of the Civil Rights Act of 1964, 42 U.S.C. §§ 2000e et seq., prohibits discrimination on the basis of pregnancy, childbirth, or related medical conditions.

Which states have passed laws that forbid the practice of shackling pregnant inmates during labor and delivery? ›

Eighteen states – AZ, CA, CO, DE, FL, HI, ID, IL, LA, PA, NM, NV, NY, RI, TX, VT, WA and WV – have laws prohibiting or restricting shackling pregnant prisoners. 757% between 1977 and 2004, a number nearly twice as great as the increase in the incarcerated male population during the same period. NATASHA A.

What are four types of pregnancy? ›

How many different types of pregnancy are there?
  • INTRAUTERINE PREGNANCY (NORMAL PREGNANCY) A normal pregnancy develops favorably when the embryo correctly implants into the lining of the uterus. ...
  • MULTIPLE PREGNANCY. ...
  • ECTOPIC PREGNANCY (EXTRAUTERINE) ...
  • MOLAR PREGNANCY.

Does your belly grow with an ectopic pregnancy? ›

During a typical pregnancy, your bump grows as your uterus gets bigger, Greves says. “The belly doesn't grow with ectopic pregnancy because the pregnancy doesn't have enough space to expand and grow normally in the fallopian tubes,” Chuang says.

Can I be three months pregnant and still test negative? ›

The hook effect incorrectly gives you a negative result on a pregnancy test. This can happen during early pregnancy or in rare cases — even into the third trimester, when it's pretty clear you're preggers. During pregnancy your body makes a hormone called human chorionic gonadotrophin (hCG).

How long can an ectopic pregnancy go unnoticed? ›

Symptoms of an ectopic pregnancy usually develop between the 4th and 12th weeks of pregnancy. Some women don't have any symptoms at first. They may not find out they have an ectopic pregnancy until an early scan shows the problem or they develop more serious symptoms later on.

Is ectopic pregnancy seen on an ultrasound? ›

Ultrasonography is the diagnostic imaging study of choice for ectopic pregnancy. Even if an ectopic pregnancy cannot be visualized on ultrasound, diagnosing an intrauterine pregnancy greatly reduces the risk of an ectopic pregnancy being present.

Where would you feel pain from ectopic pregnancy? ›

Often, the first warning signs of an ectopic pregnancy are pain or vaginal bleeding. There might be pain in the pelvis, abdomen, or even the shoulder or neck (if blood from a ruptured ectopic pregnancy builds up and irritates certain nerves). The pain can range from mild and dull to severe and sharp.

What are your rights and obligations as a pregnant employee? ›

It is illegal to pay you less because you are pregnant; It is illegal to demote you because you are pregnant; It is illegal to terminate your because you are pregnant; Your employer must evaluate opportunities for advancement, promotions, and professional development without regard to your pregnancy; and.

Do women in Florida get paid on maternity leave? ›

Specifically, the leave benefits provide seven weeks of paid maternity leave for the mother's recovery immediately following the birth of a child and two weeks of paid parental leave to mothers and fathers (birth or adoptive) to care for and bond with a new child within the first 12 months of the birth or adoption.

What is the pregnancy policy for workers? ›

Your rights at work while you're pregnant

Once you tell your employer that you're pregnant, they should do a risk assessment with you to see if your job poses any risks to you or your baby. If there are any risks, they have to make reasonable adjustments to remove them. This can include changing your working hours.

What are the rights of giving birth in Florida? ›

You have the right to choose your birth setting—in a hospital, birth center, or home. You have the right to choose your provider (a midwife or a doctor) to attend your birth. You have the right to support during your labor and birth, from a family member, partner and/or a birth support worker such as a doula.

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