Texas Abortion Law: Does It Protect Women With Ectopic Pregnancies?

Texas has one of the strictest abortion bans in the US, but treatment for ectopic pregnancy is explicitly allowed under state law. Ectopic pregnancy is a dangerous condition in which the fertilized egg implants outside the uterus, typically in the fallopian tube, and has no chance of developing into a healthy pregnancy. In August 2023, Texas Governor Greg Abbott signed HB 3058 into law, allowing doctors to terminate pregnancies in the case of an ectopic pregnancy or if a pregnant patient's water breaks too early, rendering the fetus unviable. Despite this exception, the severe penalties physicians face for violating the state's abortion ban have instilled fear in doctors, compromising their willingness to provide care.

Ectopic pregnancies are allowed to be terminated under Texas law

Despite this exception, Texas has one of the strictest abortion bans in the US, and the severe penalties physicians face for violating the state's abortion ban have instilled fear in doctors, compromising their willingness to provide care. Under Texas's abortion bans, doctors face up to 99 years in prison, loss of their medical license, and at least $100,000 in fines for providing care. The vague language used in the abortion ban has left doctors unsure of how sick a woman must be before they can legally terminate a pregnancy.

The exception for ectopic pregnancies in Texas law was reaffirmed by a law passed during the state's last legislative session. However, the exception has not prevented hospitals from violating federal law by denying treatment for life-threatening ectopic pregnancies. Two women from Texas, Kyleigh Thurman and Kelsie Norris-De La Cruz, have filed complaints with the Biden administration, detailing how they were turned away by hospitals despite their life-threatening conditions. By the time they received treatment, both women had suffered severe complications, including the loss of a fallopian tube and damage to their fertility.

The complaints filed by Thurman and Norris-De La Cruz allege that the hospitals violated the Emergency Medical Treatment and Labor Act (EMTALA), which mandates hospitals to provide stabilizing care, including abortions, to patients facing emergency medical situations. The Biden administration has supported this interpretation of EMTALA, but Texas state officials have sued the federal health department and secured a block on that guidance in 2022. The conflict between state and federal laws has created confusion and left doctors in Texas in a challenging situation, unsure of when they can legally provide abortions without risking prosecution.

Ectopic pregnancies are the leading cause of maternal mortality in the first trimester

Ectopic pregnancy is a life-threatening condition and a leading cause of maternal mortality in the first trimester, accounting for 10-15% of all pregnancy-related deaths. It occurs when a fertilized egg implants outside the uterine cavity, most commonly in the fallopian tubes. The condition can lead to serious complications and even death if left untreated.

The implantation of the fertilized egg outside the uterus can cause fallopian tube rupture, resulting in severe bleeding. This can lead to hypovolemic shock, a life-threatening condition where the body loses a significant amount of blood supply. Ectopic pregnancy is considered a medical emergency, and immediate treatment is necessary to prevent maternal death.

The signs and symptoms of ectopic pregnancy include abdominal pain, vaginal bleeding, amenorrhea, dizziness, and fainting. However, it can sometimes be asymptomatic, especially before rupture. The diagnosis of ectopic pregnancy is made through a combination of history-taking, clinical examination, and medical imaging, such as ultrasound.

The treatment options for ectopic pregnancy include surgical and medical management. Salpingectomy, or the removal of the fallopian tube, is the most common surgical procedure performed in cases of ruptured ectopic pregnancy. In some cases, conservative surgeries, such as salpingotomy, may be considered if the fallopian tube can be preserved. Medical management, such as the use of methotrexate, is also an option for unruptured ectopic pregnancies.

The incidence of ectopic pregnancy varies globally, with a reported incidence of 0.67% in Western countries and up to 4.38% in Nigeria. The true incidence is difficult to determine due to variations in diagnostic capabilities and reporting systems across different regions. However, the overall incidence is increasing worldwide.

The etiology of ectopic pregnancy is not fully understood, but several risk factors have been identified. These include pelvic inflammatory disease, previous abortion, use of intrauterine contraceptive devices, tubal/pelvic surgeries, and smoking.

The management of ectopic pregnancy is time-sensitive, and delays in diagnosis and treatment can have devastating consequences. As seen in the cases of Kyleigh Thurman and Kelsie Norris-De La Cruz in Texas, the failure to provide timely treatment for ectopic pregnancy can result in severe complications and even compromise future fertility.

To conclude, ectopic pregnancy is a leading cause of maternal mortality in the first trimester, and prompt diagnosis and treatment are crucial to prevent adverse outcomes. The condition requires immediate medical attention, and the implementation of effective strategies to improve early detection and management is essential to reduce the associated morbidity and mortality.

Texas abortion law is ambiguous, and life-threatening pregnancies do not constitute an exception

Texas has one of the strictest abortion bans in the US, but treatment for ectopic pregnancy is explicitly allowed under state law. Ectopic pregnancy is a dangerous condition in which the fertilized egg implants in the fallopian tube instead of the uterus, and it has no chance of developing into a healthy pregnancy. Despite this exception, the severe penalties physicians face for violating the state's abortion ban have instilled fear in doctors, jeopardizing their willingness to provide care.

The Texas abortion law is written ambiguously, and life-threatening or harmful pregnancies do not explicitly constitute an exception. The law nominally allows for abortions to save the mother's life or prevent "substantial impairment of [a] major bodily function", but the language is vague and open to interpretation. This ambiguity has prompted expecting mothers with health complications to leave the state or give birth while jeopardizing their health.

In August 2023, Texas Governor Greg Abbott signed HB 3058 into law, which explicitly allows doctors to provide abortions in the case of an ectopic pregnancy or if a pregnant patient's water breaks too early, rendering the fetus unviable. This bill provides legal cover for doctors performing emergency abortions in these specific situations. However, the broader Texas abortion law remains ambiguous and does not clearly outline exceptions for life-threatening pregnancies.

The severe penalties for violating the state's abortion ban have created a climate of fear among physicians, even when they are legally allowed to perform abortions in certain circumstances. Under the state's abortion bans, doctors face up to 99 years in prison, loss of their medical license, and fines of at least $100,000. These extreme threats of prosecution have left doctors afraid to provide any abortion care, even in cases of ectopic pregnancy where the procedure is explicitly permitted by state law.

The ambiguity of the Texas abortion law and the severe penalties for violations have created a situation where doctors are reluctant to provide abortions, even in cases of life-threatening pregnancies. This has put pregnant individuals at risk and led to situations where women have suffered permanent damage to their reproductive organs or nearly died due to delays in receiving treatment for ectopic pregnancies.

Ectopic pregnancies are dangerous and have no chance of resulting in a healthy pregnancy

Ectopic pregnancies are dangerous and can be life-threatening. They occur when a fertilized egg implants and grows outside the uterus, usually in the fallopian tube. This tube carries eggs from the ovaries to the uterus, and if a fertilized egg gets stuck there, it cannot develop into a baby. The egg will not receive the blood supply and support it needs to grow, and the growing tissue may cause life-threatening bleeding if left untreated.

The first warning signs of an ectopic pregnancy are often light vaginal bleeding and pelvic pain. If blood leaks from the fallopian tube, this can cause shoulder pain or an urge to have a bowel movement. As the fertilized egg grows, it can cause the tube to rupture, leading to heavy bleeding inside the abdomen and symptoms such as extreme lightheadedness, fainting, and shock.

Ectopic pregnancies are the leading cause of maternal mortality in the first trimester, accounting for up to 10% of all pregnancy-related deaths in the US. They always result in pregnancy loss and can compromise a person's ability to have children in the future.

While Texas has one of the strictest abortion bans in the US, treatment for ectopic pregnancy is explicitly allowed under state law. However, the severe penalties physicians face for violating the state's abortion ban have instilled fear in doctors, putting them in a difficult situation and jeopardizing their willingness to provide care.

Women in Texas have been denied abortions for ectopic pregnancies

Texas has one of the strictest abortion bans in the US, but treatment for ectopic pregnancy is explicitly allowed under state law. Ectopic pregnancy occurs when a fertilized egg implants in the fallopian tube instead of the uterus, and it has no chance of developing into a healthy pregnancy. Despite this exception, women in Texas have been denied abortions for ectopic pregnancies, and this has led to life-threatening situations and permanent damage to their reproductive organs.

In August 2024, two Texas women, Kyleigh Thurman and Kelsie Norris-De La Cruz, filed federal complaints after losing their fallopian tubes and suffering permanent fertility damage when denied treatment for their ectopic pregnancies at Texas hospitals. The hospitals violated the longstanding Emergency Medical Treatment and Labor Act (Emtala), which requires hospitals to provide stabilizing care, including abortions, to patients with emergency medical conditions.

Thurman was turned away at Ascension Williamson Hospital in February, even though her OB-GYN told the hospital she probably had an ectopic pregnancy. Days later, she returned, bleeding and in severe pain, but only received treatment after her OB-GYN travelled to the hospital to plead with the medical staff to terminate her ectopic pregnancy. The delay caused her ectopic pregnancy to rupture, and she nearly bled to death, forcing her into emergency surgery to remove her fallopian tube. Her ability to have children is now compromised.

Norris-De La Cruz experienced a similar ordeal at Texas Health Arlington Memorial Hospital, outside Dallas. By the time she received treatment, her pregnancy was near rupture. She lost a fallopian tube and most of her right ovary. "I ended up losing half of my fertility and if I was made to wait any longer, it's very likely I would have died," she said in a press release.

The severe penalties physicians face for violating the state's abortion ban, which include $100,000 in fines and up to life in prison, have instilled fear in doctors, jeopardizing their willingness to provide care. The Texas Supreme Court has also ruled against abortion rights, further deterring doctors from providing abortions in emergency situations.

The complaints filed by Thurman and Norris-De La Cruz with the US Department of Health and Human Services allege that hospitals violated Emtala and ask the Centers for Medicare and Medicaid Services to conduct an investigation and enforce Emtala to hold the hospitals accountable. Ectopic pregnancy is the leading cause of maternal mortality in the first trimester, comprising up to 10% of all pregnancy-related deaths nationwide. The denial of abortions for ectopic pregnancies in Texas has put women's lives at risk and caused permanent fertility damage, highlighting the dangers of abortion bans even with exceptions for life-threatening conditions.

Frequently asked questions