The Austin Dennard Email: A Case Study in a Texas State’s Abortion Law After Water and Ectopic Pregnancies Breaks Early
On a recent Friday night, as her husband made dinner at the family’s home in Dallas and her toddlers ran around underfoot, Dr. Austin Dennard saw an email come in on her phone.
NPR has reported on many women in Texas whose lives were affected by the state’s abortion bans, including several who are now suing the state. After the water broke early, Weller was sent home from the hospital and eventually showed symptoms of an illness. Samantha Casiano, another plaintiff, had to carry a fetus with a fatal anomaly to term because she couldn’t afford to leave the state. Delmy Chavez, who had emergency surgery when she had an ectopic pregnancy that caused internal bleeding, worried in the hours afterwards she would be accused of murder.
She didn’t expect the amount of emotion that would come from it. I scrolled through it and cried.
She was told in the summer of last year that she was carrying a fetus with a fatal condition in which the skull and brain do not develop fully. She went for an abortion on the east coast.
So it may be surprising that just a few weeks ago, Abbott signed a law giving doctors leeway to provide abortions in Texas when a patient’s water breaks too early and for ectopic pregnancies. There was considerably less fanfare for that signing.
On talking to OB-Gyn patients and the case for abortions: a lawsuit filed in Texas by an attorney general and the U.S. Supreme Court
“My husband gave me a hug and he was crying as he hugged me.” And it just – it felt really good. It felt like a victory that you were looking for, but never really thought you would have to fight for. “I was reading it through tears, and there’s all this lawyer jargon in it. And so we have Google up, and I’m Googling different terms and we’re trying to really understand the whole thing.”
Dennard looked at the possibility of talking to her OB-GYN patients publicly when they face a medical problem. She says it felt validating for a person in power to listen to all of their stories and conclude the law needed to change.
The doctors and the hospitals were reading some of the Texas statutes from the early 1900s and say that they can’t tell you what to do.
“I went back to clinic and put on my white coat and just started seeing patients again with the same laws that are in place,” Dennard says. “It’s emotional whiplash.”
The witnesses were asked if Attorney General Ken Paxton had personally denied them an abortion. Dennard, who was the final patient to testify, said that he never thought to ask him.
O’Donnell was also present at the hearing in Austin, telling NPR she was there “just to keep an eye on it and watch how it unfolds.” She said she believes the laws are clear. “Doctors can exercise reasonable medical judgment; they can provide the standard of care,” she said.
Next in the case, attorneys for the state of Texas have to submit a filing to the Texas Supreme Court related to their appeal. Attorneys for the people who made the complaint will file a response before the court decides whether to hear the case. There is no preset time frame for this to unfold.
Dr. John Thoppil, MD, a Houston OB-GYN: “It’s not an ‘abortion’ thing”
Dr. Thoppil says Johnson is a great advocate for women’s health. He is very happy with the new law. The law will help save some of the heartbreaking circumstances patients have experienced since the bans took effect, and two conditions are common that OB-GYNs see.
She says it’s difficult to put the entire story of abortion out there in such a raw fashion, since it is such a taboo topic.
She says it has been fun to be a part of the lawsuit. She hopes it will change how people think about abortion restrictions.
The new law, which goes into effect Sept. 1, is the work of a Houston Democratic lawmaker who built bipartisan support to get the bill all the way to the governor’s desk. How did she do it? For starters, the new law has no mention of the word “abortion.”
Dr. John Thoppil is an Austin OB- GYN and past President of the Texas Association of Obstetricians and Gynecologists and he calls the idea that doctors are to blame for uncertainty false. “If you put the threat of a felony case and lose your license in a poorly written original law, it is irresponsible to blame the doctors who are trying to take care of patients,” he says.
The Texas Law of Non-Elective Abrobirth: Through the Lens of Sen. Hughes, the State, and the Governor’s Desk
Hughes helped in lining up key supporters in the legislature, according to Johnson. “I’m happy that we were able to have the honest conversations that we needed,” she says. “This would not have happened without having him in the Senate get this through.”
The bill passed with bipartisan support – in the Senate, it passed unanimously – and made it to the governor’s desk in the last few days of the session. According to a post by George Christian, senior counsel at the Texas Civil Justice League, that’s a tiny miracle.
“It happened because of the masterful and discreet way that the bill’s House author, Rep. Johnson, and Senate sponsor, Sen. Hughes, handled things in their respective chambers,” he wrote.
Johnson knows that it’s criticism. “Yes, there are absolutely other pregnancy complications,” she says. “This is what we can accomplish in this moment. In this moment, we could get bipartisan agreement of the recognition of ectopic pregnancy and ruptured membrane.”
She introduced a bill a few weeks after the beginning of the Texas legislative session. Originally, the bill broadly allowed doctors to provide “medically necessary” services.
She says that politicians who oppose abortion rights think abortion should be the only option for a healthy baby. The law of Texas does not make a distinction betweenelective and non-elective abortions.
In her blog post, she added that the Texas health department, the Texas Medical Board, the Texas Medical Association, and the Texas Hospital Association could all ward off these dangerous situations by educating and providing guidance to doctors and hospitals. “The prolonged silence of the medical, legal, and bureaucratic organizations that could end the confusion is unconscionable,” she wrote.
Some ardent supporters of the abortion bans are concerned by these stories. “Women are being hurt unnecessarily in the wake of physician confusion and refusal to intervene to protect a mother’s life, even when all obstetricians agree that offering intervention is the standard of care,” Dr. Ingrid Skop wrote in a blog post earlier this year. She works at the Charlotte Lozier Institute and is part of Susan B. Anthony Pro-life America. The Zurawski hearing last month was only the second time that Skop was called to testify.
There’s also research on the effects of delaying care. A study published last year documented how patients who had their water broken early for the fetus to survive. When they were first diagnosed, doctors waited for the fetal heart to stop to make sure they wouldn’t have an abortion. Nearly half of these patients developed a serious condition, including 10 who developed infections, five who needed blood transfusions, and one who required a hysterectomy.
A lawsuit against the state argues that language in the medical exception is vague and confusing, causing hospitals and doctors to delay care, which harms patients. The Center for Reproductive Rights is one of the groups that are represented by 13 patients and two physicians. The lead plaintiff, Amanda Zurawski, developed sepsis and nearly died when doctors delayed an abortion.
If a general doctor or a dermatologist prescribed a drug that prevented a woman who had no intentions of getting pregnant from having a baby, that doctor could get charged with a felony, according to Johnson.
The laws do not just affect OB-GYNs, Johnson says, pointing to a recent law that imposes criminal penalties on prescribers of certain medications that can cause abortions. A drug used to treat cancer and other disorders is highlighted by her. It can be used to perform early medication abortions and treat ectopic pregnancies.
Texas State Representative Ann Johnson represents District 134, which includes the Texas Medical Center. When Texas’s abortion bans took effect, she says she was stopped from taking walks around her district.
Texas’s Republican Governor Greg Abbott addressed a rally earlier this year, celebrating the abortion bans that took effect after the Supreme Court overturned Roe v. Wade.