Pregnant Women Turned Away by ERs Despite Federal Law, Some in Labor

An analysis by the Associated Press reveals that over 100 pregnant women in urgent need of medical attention who turned to emergency rooms have been either turned away or given negligent care since 2021.

In one troubling case, Kyleigh Thurman arrived at Ascension Seton Williamson in Texas, suffering from bleeding and pain, unaware that her pregnancy was ectopic and could lead to severe health risks. Instead of receiving appropriate treatment, emergency room staff handed her a pamphlet on miscarriage and advised her to “let nature take its course.” She was discharged without medical intervention.

Upon returning three days later and still experiencing bleeding, she was finally given an injection meant to terminate the pregnancy—but by then it was too late. The ectopic pregnancy had caused a rupture in her fallopian tube, resulting in significant damage to her reproductive system.

In February 2023, Thurman, alongside the Center for Reproductive Rights, filed a complaint requesting that the government investigate whether the hospital violated federal law by failing to treat her properly initially.

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

Despite the Biden administration’s public warnings to hospitals regarding the treatment of pregnant patients in emergencies, violations of federal law persist. This issue gained attention following reports of inadequate care for pregnant women in emergency rooms after the Supreme Court’s decision to overturn abortion rights in June 2022.

According to the Associated Press analysis of federal hospital investigations, more than 100 women have been improperly treated in emergency situations. Some women faced shocking outcomes, including two cases in Florida and Texas where women miscarried in public restrooms. In another instance, a woman in Arkansas endured septic shock after being discharged without proper treatment, resulting in the death of her fetus. Additionally, several women suffering from ectopic pregnancies faced significant delays in receiving care.

The White House has maintained that hospitals must be prepared to provide abortions when necessary to protect a woman’s health, even in states with strict abortion bans. Texas is contesting this guidance, and the Supreme Court recently opted not to address this dilemma.

In Texas, where doctors risk facing up to 99 years in prison for conducting unauthorized abortions, both medical and legal experts note that these restrictions complicate emergency care choices for expectant mothers.

The Center for Reproductive Rights argues that even though state law specifies that terminating ectopic pregnancies does not fall under the abortion category, the severe penalties lead many physicians to hesitate in providing needed treatment.

“As fearful as hospitals and doctors are of running afoul of these state abortion bans, they need to be equally concerned about compliance with federal law,” stated Marc Hearron, an attorney for the Center. Hospitals could face federal investigations, substantial fines, and potential loss of Medicare funding for legal violations.

The Center has lodged two separate complaints with the Centers for Medicare and Medicaid Services alleging that different Texas emergency rooms failed to treat patients suffering from ectopic pregnancies, including Thurman.

Another complaint details the case of Kelsie Norris-De La Cruz, who faced similar challenges after an Arlington, Texas, hospital sent her home without treating her ectopic pregnancy, despite a doctor’s warning that discharge was unadvisable.

“I knew I needed an abortion, but these bans make it nearly impossible to get basic emergency healthcare,” she remarked. “I’m filing this complaint because women like me deserve justice and accountability for the harm done to us.”

Diagnosing an ectopic pregnancy can often be challenging. Three doctors consulted explained that obtaining accurate diagnoses through ultrasound is not always clear. Signs indicative of an ectopic pregnancy include hormone level changes, bleeding, positive pregnancy tests, and ultrasounds showing an empty uterus.

“You can’t be 100% certain—that’s the tricky part,” remarked Kate Arnold, an OB-GYN. “Ectopic pregnancies can become life-threatening quickly.”

John Seago, director of Texas Right to Life, insists that the state law provides clear protections for doctors who treat ectopic pregnancies. Still, many healthcare providers feel apprehensive about treating pregnant patients due to the overarching uncertainties posed by the law, as pointed out by emergency medicine physician Hannah Gordon.

After multiple visits to Ascension Seton Williamson, Thurman was eventually told that she would require surgery to address the ruptured fallopian tube. Despite her fears regarding the potential impact on her fertility, she was informed that her situation had become life-threatening.

“She came in and told me I needed either a blood transfusion, surgery, or risk bleeding out,” Thurman recalled, tearfully reflecting on the moment she realized the severity of her condition.

The hospital did not comment on Thurman’s specific case but assured the public of their commitment to providing high-quality care.

In another distressing case from Florida, a 15-week-pregnant woman experienced a rupture of her amniotic sac while in the emergency room, leading to a miscarriage in a public restroom. After being misdiagnosed and discharged, she was later rushed to another hospital, where she was put on a ventilator.

Emergency medical care complications are not limited to states with abortion bans. Serious health violations affecting mothers and their fetuses have occurred in both banned and non-banned states. Reports indicate that some hospitals have grown so short-staffed that they are directing pregnant patients to seek care elsewhere. Inadequate diagnoses and urgent treatment delays have been observed across multiple states, underscoring systemic issues compounded by staffing shortages and evolving abortion laws.

Dara Kass, an emergency medicine physician, warns, “It is increasingly less safe to be pregnant and seeking emergency care in an emergency department.”