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[quote=Anonymous]Horrifying story about a Texas woman who died because of the dismal state of maternal health care there, including the strictures deterring doctors from saying what they think regarding whether a patient should continue to carry her potentially life-endandering pregnancy to term.

https://www.newyorker.com/magazine/2024/01/15/abortion-high-risk-pregnancy-yeni-glick

[quote]What conservative lawmakers hailed as the saving of infant lives, medical professionals I interviewed in rural Texas saw as a beleaguering challenge. According to state data, even before S.B. 8 half the counties in Texas were unequipped to treat pregnant women, lacking a single specialist in women’s health, such as an ob-gyn or a certified midwife. Multiple doctors told me that the overturning of Roe v. Wade, in June of 2022, exacerbated the crisis, as practitioners retired early or moved to states where they’d have more liberty to make medical judgments. So who, exactly, was supposed to handle the extra deliveries in women’s-health deserts such as Caldwell County? What would become of women in remote locales who experienced a hemorrhage or a ruptured fallopian tube?

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Although some women with the same conditions as Yeni—hypertension, diabetes, a history of pulmonary edema, severe obesity—end up safely delivering healthy babies, others become so unwell that a difficult question arises: Is this a pregnancy that the patient can safely continue? Some studies show that cardiovascular diseases account for more than a third of pregnancy-related deaths in the U.S. “When a pregnant patient comes to you with a history of pulmonary edema, the question is: What is the cause, and can it be managed or reversed?,” Uri Elkayam, the director of the maternal-cardiology program at the University of Southern California, told me. “Pregnancy increases blood volume, and with limited cardiac reserves the pressure from the heart may be reflected into the lungs, causing pulmonary edema and heart failure.” His rule of thumb is that, if a patient is fairly sick early on, “one needs to assume that as pregnancy progresses things only will get worse.” In those cases, he said, termination lowers the risk of death.

According to Yeni’s medical records, doctors didn’t raise the possibility of a therapeutic termination with her. Ascension Seton, a network of Catholic hospitals whose mission is “rooted in the loving ministry of Jesus,” is averse to abortions. But, as some medical professionals familiar with Yeni’s care told me, the hospitals can make an exception when a woman’s life is at risk. The field of obstetrics is replete with gray areas, and in the past a physician with a borderline case could direct the patient to another facility, with fewer restrictions on abortion. But that option effectively disappeared in the months before Yeni got pregnant.

When S.B. 8 banned abortions past the six-week limit, it included an exception in cases of “medical emergency.” At the same time, the law made it tricky for health-care workers to raise the emergency flag, by enabling citizens to initiate lawsuits against people who “aid or abet” banned abortions, incentivizing them with the possibility of a ten-thousand-dollar reward. A person involved with Yeni’s medical case told me, “One of the things that S.B. 8 does is undermine a sense of common mission and trust, even within a care-giving team—you know, who’s going to go behind your back and sue you because they watched you do your care?”[/quote]
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