Ahead of state legislative sessions this year, lawmakers are filing more than a dozen bills to expand access to abortion in at least seven states, and a separate bill introduced in Texas aims to examine the impact of a state abortion ban on maternal outcomes.
Some were filed in direct response to ProPublica’s reports of the fatal consequences of such laws. Others were filing for the second or third year in a row, but with renewed optimism that this time they would make a comeback.
The difference now is the inescapable reality that several women in various states with abortion bans, died after failing to receive life-saving treatment.
All of them required a hysterectomy, either dilation and curettage, or its second-trimester equivalent. Both are used for abortions, but they are also standard medical care for miscarriages, helping patients avoid complications such as bleeding and sepsis. But ProPublica found that doctors who face jail time if they violate state abortion restrictions are hesitant to perform the procedures.
Three Texas women with a miscarriagemourning the loss of her pregnancy died without procedure; one was a teenager. Two women in Georgia suffered complications after home abortions; one was afraid to ask for help and the other died of sepsis after doctors failed to provide a D&C for 20 hours.
Florida State Senator Tina Polsky said bill she introduced Thursday was “100%” inspired by ProPublica’s reporting. It expands exceptions to the state’s abortion ban to make it easier for doctors and hospitals to treat patients with complications. “We’ve had lives lost in Texas and Georgia, and we don’t need to follow suit,” the Democrat said. “It’s just a matter of time before that happens in Florida.”
Texas Rep. Donna Howard, who is appearing clicking on an expanded list of medical conditions that fall under her state’s exclusionssaid she’s had encouraging conversations with fellow Republicans about her bill. The revelations that the women died after they did not receive CPR “moved the needle here in Texas,” Howard said, leading to more bipartisan support for the change.
Republican lawmakers in other states told ProPublica they are similarly motivated.
Among them is Kentucky state representative Jim Gooch Jr., a Baptist great-grandfather who tries a second time expand the circumstances under which doctors can perform abortions, including partial miscarriages and fatal fetal abnormalities. He believes the bill may be better received now that his colleagues know the women have died. “We don’t want that in Kentucky,” he said. “I hope my colleagues agree.”
He said doctors need more clearly defined exemptions so they can do their jobs without fear. “They should have some clarity and not worry about being accused of some crime or abuse.”
After a judge in North Dakota struck down the state’s blanket ban on abortion, Republican Representative Eric James Murphy moved quickly to prevent any similar bans by preparing bill allowing abortion for any reason until week 16, and then until about week 26 if doctors deem it medically necessary.
“We need other states to understand that there is an approach that doesn’t have to be so controversial,” said Murphy, who is also an assistant professor of pharmacology at the University of North Dakota School of Medicine and Health Sciences. “What if we start a debate and find out there are rational Republicans out there? Maybe others will come too.”
Under state rules, North Dakota lawmakers are required to hold a full hearing on his bill, he said, and he plans to introduce ProPublica’s stories as evidence. “Will it get easier? I really hope for that,” he said. “Lord willing, and the streams will not rise, I very much hope so.”
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So far, efforts to expand access to abortion in more than a dozen states with bans have faced stiff opposition, and lawmakers who introduced the bills said they don’t expect that to change. And some lawmakers, advocates and medical experts argue that even if there are exemptions, doctors and hospitals will still be afraid to intervene.
As ProPublica reported, women were dying even in states where bans allowed abortions to save “the life of the mother.” Doctors told ProPublica that because the language of the laws is often vague and not rooted in real-world medical scenarios, their colleagues hesitate to act until patients are on the brink of death.
Experts also say it’s important to study maternal deaths in states with bans to understand exactly how the laws interfere with resuscitation. yet Texas law prohibits the state’s Maternal Mortality Review Commission from examining the deaths of patients who received abortive intervention or treatment, even in cases of miscarriage. Under those restrictions, the circumstances surrounding the deaths of the two Texas deaths documented by ProPublica will never be reviewed.
“I think it creates a problem for us if we don’t know what the hell is going on,” Texas state Sen. Jose Menendez said.
In response to ProPublica’s reports, the Democrat filed a bill that would lift the restrictions and order a state committee to study deaths related to abortion access, including miscarriages. “Some of my colleagues said that the only reason these women died was poor medical practice or medical negligence,” he said. “Then what’s the harm in doing some research … into what really happened?”
US Representative Jasmine Crockett agreed. The Texas Democrat and three other members of the House Oversight and Accountability Committee sent a letter to Texas officials on Dec. 19 with the requirement to report the decision not to review the death cases which took place in 2022 and 2023.
Crockett said the state did not respond to a letter sent to Texas Health Commissioner Jennifer Shuford.
“If you think your politics are right on the money, show us the money, show us the goods,” she said. “This should be a wake-up call to Texans, and Texans should demand more. If you think this policy is good, you should also see the numbers.’
Doctors are beginning to hear about the increased anxiety in conversations at their hospitals.
Dr. Austin Dennard, an OB/GYN in Dallas, said her hospital recently convened a meeting with lawyers, administrators and various professionals focused on “how to keep our pregnant patients safe in our hospital system and how to keep our doctors safe.” They discussed the creation of additional instructions for doctors.
Dennard, who noted that she speaks for herself, said she gets more in-depth questions from her patients. “We’ve talked before about vitamins and certain medications that need to be avoided and vaccines,” she said. “Now we’re doing all of this, and there’s a whole additional conversation about pregnancy in Texas, and we’re just talking about, ‘What’s the safest way to do this?'”
In addition to being a doctor, Dennard was one of 20 women who sued the state after being denied abortions because of miscarriages and complications from high-risk pregnancies. When she learned that her fetus had anencephaly — a condition in which the brain and skull do not fully develop — she had to travel out of state to have an abortion. (The lawsuit asked the state courts to explain the exceptions to the law, but The state Supreme Court refused.)
Dennard said stories like ProPublica’s have crystallized a new level of patient awareness: “If you have the ability to be pregnant, then you can easily become one of these women.”
Mariam Elba contributed research and Kavita Surana filed a report.
