Texas banned abortions - and then sepsis rates started to soar
ProPublica analyzed seven years of Texas hospitals' discharge data — from 2017 through 2023 — and found that since 2021, when the southern state's initial abortion ban went into effect, the rate of sepsis surged by more than 50 percent for women hospitalized when they experienced miscarriages in the second trimester.
Sepsis is a medical emergency that occurs when a patient's body improperly reacts to an infection. It can lead to organ failure or death if not treated quickly enough.
In September 2021, the state banned most abortions after a fetal heartbeat was detected. Then, in August 2022 following the Supreme Court's decision to overturn Roe v Wade, Texas's 'trigger law' took effect, criminalizing abortion. Doctors who perform abortions could face life in prison and fines of up to $100,000. Now, abortions are banned in all cases except if the mother's health or life is at risk — a definition that the state's supreme court has refused to clarify.
The rate of sepsis among patients experiencing second-trimester pregnancy loss remained pretty steady until the state added criminal penalties for abortion providers, the analysis shows.
In 2021, before they were introduced, 67 patients who miscarried in the second trimester were diagnosed with sepsis but after, in 2022, that figure increased to 90. That number increased again to 99 in 2023.
ProPublica believe those figures could be 'conservative.'
Treating miscarriages has also become complicated as a result of these laws. Medical professionals are constrained by either having to wait for the mother's life to be in jeopardy or having to wait for the fetus' heart to stop beating.
For example, three days after the fetal heartbeat law took effect, on September 3, 2021, Josseli Barnica went to a Houston hospital at 17 weeks pregnant to discover she was battling a deadly infection as a result of a miscarriage. But doctors were restricted in how they could treat her, since her fetus still had a heartbeat. After 40 hours in pain from the infection, Barnica delivered the fetus after there was no longer a detectable heartbeat. Three days after being treated and discharged, she died from sepsis. Medical experts who reviewed her case told ProPublica that they believed her death was 'preventable.'
Another patient cited in the study, Nevaeh Crain, died after doctor's waited for her fetus' heart to stop beating as her organs failed. Before rushing the teenager to the operating theter, they conducted another test to confirm her fetus had expired, the outlet reported.
The data also underscores the confusion around miscarriage treatment. The rate of sepsis was less severe for pregnant patients who were admitted to the hospital without a fetal heartbeat. The rate moved from 2.1 percent in 2017 to 3.1 percent in 2023 for those admitted with fetal death, and from 3.7 percent to 6.9 percent for those without fetal death.
'What this says to me is that once a fetal death is diagnosed, doctors can appropriately take care of someone to prevent sepsis, but if the fetus still has a heartbeat, then they aren't able to act and the risk for maternal sepsis goes way up,' Dr. Kristina Adams Waldorf, professor of obstetrics and gynecology at UW Medicine, told the outlet. 'This is needlessly putting a woman's life in danger.'
Other indicators suggest pregnancy in Texas has become more dangerous. Since 2021, dozens more pregnant and postpartum women have died in Texas hospitals than had before the Covid-19 pandemic — despite a drop in maternal mortality rates at a national level in the same period.
There were 79 maternal hospital deaths in 2018 and 2019 compared to 2022 and 2023 when there were 120. Despite this alarming uptick, the Texas Maternal Mortality and Morbidity Review Committee opted not to review pregnancy-related deaths in 2022 and 2023.
'The fact that Texas is not reviewing those years does a disservice to the 120 individuals you identified who died inpatient and were pregnant,' said Dr. Jonas Swartz, an assistant professor of obstetrics and gynecology at Duke University. 'And that is an underestimation of the number of people who died.'
The laws in place appear to be interfering with patient care, one doctor suggested.
'We have the ability to intervene before these patients get sick,' Dr. Sarah Prager, a professor of obstetrics and gynecology at the University of Washington, told the outlet. 'This is evidence that we aren't doing that.'
Even though the Texas Supreme Court rejected a lawsuit asking for clarification over who qualifies for an abortion in the state, Lt. Gov. Dan Patrick called on the state legislature to clear up the language of the law. 'I do think we need to clarify any language so that doctors are not in fear of being penalized if they think the life of the mother is at risk,' he said last month.
Gov. Greg Abbott, however, doesn't seem to be convinced that any clarification is necessary. 'There have been hundreds of abortions that have been provided under this law, so there are plenty of doctors and plenty of mothers that have been able to get an abortion that saved their lives and protect their health and safety,' he told the Houston Chronicle this week before ProPublica's report was released. 'So I know as the law as it currently exists can work if it is properly applied.'
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The Guardian
6 days ago
- The Guardian
Republicans wanted fewer abortions and more births. They are getting the opposite
Dobbs v Jackson Women's Health Organization, the US supreme court case that rescinded the constitutional right to abortion, is failing on its own terms. Since the ruling, in June 2022, the number of abortions in the US has risen. Support for reproductive rights is on the upswing. And the rate of voluntary sterilization among young women – a repudiation of Trumpian pronatalism, if a desperate one – jumped abruptly after Dobbs, and there's no reason to believe it will drop off. Also rising at an alarming clip are preventable maternal deaths and criminal prosecutions of pregnant people. Yet the 21 state legislatures that have imposed total or near-total bans are doing little or nothing to give doctors legal leeway to save the health and lives of pregnant women in medical distress, even if that means inducing abortion. In fact, rather than trying to save lives, they are prosecuting pregnant people who handle those emergencies on their own. The first three – more abortions, more pro-abortion sentiment, more contraception –have frustrated the anti-abortion crowd no end. They know they need stronger disincentives to abortion. Which brings us to the latter two: more punishment and more death. Was punishment the aim all along? And has the anti-abortion movement accepted pregnant people's deaths as an unfortunate consequence of saving the pre-born? According to the Guttmacher Institute, abortions rose 1.5% in 2024 from 2023, on top of a 11.1% leap in the first year after Dobbs, compared with 2020, before the near-bans enacted in several states that presaged the ruling. It's also probably an undercount. The statistics include only 'clinician-provided abortions', either surgical or medical (using abortion pills), performed in healthcare facilities or via telemedicine. Guttmacher does not estimate how many abortions are happening outside the formal healthcare system, with drugs obtained directly from suppliers or through feminist underground networks. Indeed, Plan C, the country's biggest clearinghouse for pill access, reports 2m visits to its website and 500,000 click-throughs to resources and care in 2024, a 25% increase from the year before. How many of those people ended their pregnancies at home, with only a friend or lover in attendance? Anecdotal evidence gleaned from activists suggests they number in the tens of thousands. At the same time, rather than making abortion 'unthinkable', as the anti-abortion activists pledge, the bans may be having the opposite effect. An analysis of two restrictive states, Arizona and Wisconsin, and one with broad access, New Jersey, found that negative attitudes toward abortion are down and positive ones up, in both red and blue states. And if the goal of banning abortion is to produce more children, that's not working either. Public health researchers saw 'an abrupt increase in permanent contraception procedures' – sterilization – following Dobbs among adults in their prime reproductive years, ages 18 to 30. Unsurprisingly, the increase in procedures for women (tubal ligations) was twice that for men (vasectomies). The Trump administration is cheerleading for procreation. 'I want more babies in the United States of America,' declared JD Vance in his first public appearance as vice-president, at the March for Life in Washington. He blamed the declining birth rate on 'a culture of abortion on demand' and the failure 'to help young parents achieve the ingredients they need to lead a happy and meaningful life'. The federal budget extends some of that help. It raises the annual child tax credit (CTC) from $2,000 to $2,200. It also creates 'Trump accounts', $1,000 per child, which parents or employers can add to. But only those with social security numbers are eligible for either program; the tax credit is available only to people who earn enough to pay taxes; and as with any investment, those able to sow more in the savings accounts reap more. It's clear what sort of baby the administration wishes to be born: white babies with 'American' parents, and not the poorest. The carrots are not appetizing enough. The stick is not effective enough. So red-state legislators and prosecutors are bringing out the AR-15s. This year, Republican lawmakers in at least 10 states introduced bills defining abortion as homicide, and, for the first time, criminalizing both the provider and the patient. No such bill has passed – yet – and anti-abortion organizations are usually quick to renounce them publicly, nervous about widespread opposition. But their passage might not be far off. The bills are based on fetal personhood – the concept of conferring full legal rights to a fetus from conception forward. The idea was introduced in 1884 and finally written into one state's law in 1986. By 2024, 39 states had fetal homicide laws. Last year, there were three bills criminalizing the person who has an abortion; now there are 10. And though the federal courts rejected fetal personhood for a century, it is the bedrock of anti-abortion politics, and this US supreme court is looking much more friendly toward it. While they work toward straightforward criminalization of ending one's own pregnancy, anti-abortion lawmakers and prosecutors are making creative use of existing law to punish miscarriage, an event indistinguishable from elective abortion, just in case the pregnant person induced the miscarriage. The most ghoulish is the prohibition on abusing corpses. For instance: last week a 31-year-old South Carolina woman who miscarried and disposed of the tissue in the trash was arrested for 'desecration of human remains', a crime carrying a 10-year sentence. In March, a woman found bleeding outside her Georgia apartment after a miscarriage was jailed for 'concealing the death of another person' and 'abandonment of a dead body' for placing the remains in the bin. A week before that, a Pennsylvania teenager was under investigation for corpse abuse after a self-managed pill abortion and burial of the fetus in her yard. In a grim sense, these are the lucky ones: they survived. Because Dobbs has indisputably been deadly. 'Mothers living in states that banned abortion were nearly twice as likely to die during pregnancy, childbirth, or soon after giving birth' as mothers living in states where abortion was legal and accessible, reports the Gender Equity Policy Institute. Maternal mortality rose 56% in Texas after it enacted a six-week ban; a Texan's risk was one and a half times that of a Californian's. The future isn't sunny. A study of 14 total-ban states predicts that in the four years beginning a year after Dobbs, up to 42 mothers will die and as many as 2,700 will be afflicted with 'severe maternal morbidity', defined by the CDC as 'unexpected outcomes of labor and delivery that result in significant short-term or long-term [health] consequences'. In one analysis Black women represented 63% of the deaths. The anti-abortion movement is indefatigable. 'We abolishioners will not rest until we have effected the abolishment of human abortion,' one leader told Oklahoma Voice. But this is an unattainable grail. Where abortion is illegal, people still have abortions. They just take more risks. Globally, more than 39,000 women die yearly from unsafe abortions. As they run out of options, red-state lawmakers will harden criminal penalties against people who refuse to give up their reproductive self-determination. It may grow less outré to endorse Trump's opinion, expressed in an unguarded moment, that women who get illegal abortions 'deserve some form of punishment'. Whether intentional or not, the sentence for some of those women will be death. Judith Levine is a Brooklyn journalist and essayist, a contributing writer to the Intercept and the author of five books
The Guardian
6 days ago
- The Guardian
Republicans wanted fewer abortions and more births. They are getting the opposite
Dobbs v Jackson Women's Health Organization, the US supreme court case that rescinded the constitutional right to abortion, is failing on its own terms. Since the ruling, in June 2022, the number of abortions in the US has risen. Support for reproductive rights is on the upswing. And the rate of voluntary sterilization among young women – a repudiation of Trumpian pronatalism, if a desperate one – jumped abruptly after Dobbs, and there's no reason to believe it will drop off. Also rising at an alarming clip are preventable maternal deaths and criminal prosecutions of pregnant people. Yet the 21 state legislatures that have imposed total or near-total bans are doing little or nothing to give doctors legal leeway to save the health and lives of pregnant women in medical distress, even if that means inducing abortion. In fact, rather than trying to save lives, they are prosecuting pregnant people who handle those emergencies on their own. The first three – more abortions, more pro-abortion sentiment, more contraception –have frustrated the anti-abortion crowd no end. They know they need stronger disincentives to abortion. Which brings us to the latter two: more punishment and more death. Was punishment the aim all along? And has the anti-abortion movement accepted pregnant people's deaths as an unfortunate consequence of saving the pre-born? According to the Guttmacher Institute, abortions rose 1.5% in 2024 from 2023, on top of a 11.1% leap in the first year after Dobbs, compared with 2020, before the near-bans enacted in several states that presaged the ruling. It's also probably an undercount. The statistics include only 'clinician-provided abortions', either surgical or medical (using abortion pills), performed in healthcare facilities or via telemedicine. Guttmacher does not estimate how many abortions are happening outside the formal healthcare system, with drugs obtained directly from suppliers or through feminist underground networks. Indeed, Plan C, the country's biggest clearinghouse for pill access, reports 2m visits to its website and 500,000 click-throughs to resources and care in 2024, a 25% increase from the year before. How many of those people ended their pregnancies at home, with only a friend or lover in attendance? Anecdotal evidence gleaned from activists suggests they number in the tens of thousands. At the same time, rather than making abortion 'unthinkable', as the anti-abortion activists pledge, the bans may be having the opposite effect. An analysis of two restrictive states, Arizona and Wisconsin, and one with broad access, New Jersey, found that negative attitudes toward abortion are down and positive ones up, in both red and blue states. And if the goal of banning abortion is to produce more children, that's not working either. Public health researchers saw 'an abrupt increase in permanent contraception procedures' – sterilization – following Dobbs among adults in their prime reproductive years, ages 18 to 30. Unsurprisingly, the increase in procedures for women (tubal ligations) was twice that for men (vasectomies). The Trump administration is cheerleading for procreation. 'I want more babies in the United States of America,' declared JD Vance in his first public appearance as vice-president, at the March for Life in Washington. He blamed the declining birth rate on 'a culture of abortion on demand' and the failure 'to help young parents achieve the ingredients they need to lead a happy and meaningful life'. The federal budget extends some of that help. It raises the annual child tax credit (CTC) from $2,000 to $2,200. It also creates 'Trump accounts', $1,000 per child, which parents or employers can add to. But only those with social security numbers are eligible for either program; the tax credit is available only to people who earn enough to pay taxes; and as with any investment, those able to sow more in the savings accounts reap more. It's clear what sort of baby the administration wishes to be born: white babies with 'American' parents, and not the poorest. The carrots are not appetizing enough. The stick is not effective enough. So red-state legislators and prosecutors are bringing out the AR-15s. This year, Republican lawmakers in at least 10 states introduced bills defining abortion as homicide, and, for the first time, criminalizing both the provider and the patient. No such bill has passed – yet – and anti-abortion organizations are usually quick to renounce them publicly, nervous about widespread opposition. But their passage might not be far off. The bills are based on fetal personhood – the concept of conferring full legal rights to a fetus from conception forward. The idea was introduced in 1884 and finally written into one state's law in 1986. By 2024, 39 states had fetal homicide laws. Last year, there were three bills criminalizing the person who has an abortion; now there are 10. And though the federal courts rejected fetal personhood for a century, it is the bedrock of anti-abortion politics, and this US supreme court is looking much more friendly toward it. While they work toward straightforward criminalization of ending one's own pregnancy, anti-abortion lawmakers and prosecutors are making creative use of existing law to punish miscarriage, an event indistinguishable from elective abortion, just in case the pregnant person induced the miscarriage. The most ghoulish is the prohibition on abusing corpses. For instance: last week a 31-year-old South Carolina woman who miscarried and disposed of the tissue in the trash was arrested for 'desecration of human remains', a crime carrying a 10-year sentence. In March, a woman found bleeding outside her Georgia apartment after a miscarriage was jailed for 'concealing the death of another person' and 'abandonment of a dead body' for placing the remains in the bin. A week before that, a Pennsylvania teenager was under investigation for corpse abuse after a self-managed pill abortion and burial of the fetus in her yard. In a grim sense, these are the lucky ones: they survived. Because Dobbs has indisputably been deadly. 'Mothers living in states that banned abortion were nearly twice as likely to die during pregnancy, childbirth, or soon after giving birth' as mothers living in states where abortion was legal and accessible, reports the Gender Equity Policy Institute. Maternal mortality rose 56% in Texas after it enacted a six-week ban; a Texan's risk was one and a half times that of a Californian's. The future isn't sunny. A study of 14 total-ban states predicts that in the four years beginning a year after Dobbs, up to 42 mothers will die and as many as 2,700 will be afflicted with 'severe maternal morbidity', defined by the CDC as 'unexpected outcomes of labor and delivery that result in significant short-term or long-term [health] consequences'. In one analysis Black women represented 63% of the deaths. The anti-abortion movement is indefatigable. 'We abolishioners will not rest until we have effected the abolishment of human abortion,' one leader told Oklahoma Voice. But this is an unattainable grail. Where abortion is illegal, people still have abortions. They just take more risks. Globally, more than 39,000 women die yearly from unsafe abortions. As they run out of options, red-state lawmakers will harden criminal penalties against people who refuse to give up their reproductive self-determination. It may grow less outré to endorse Trump's opinion, expressed in an unguarded moment, that women who get illegal abortions 'deserve some form of punishment'. Whether intentional or not, the sentence for some of those women will be death. Judith Levine is a Brooklyn journalist and essayist, a contributing writer to the Intercept and the author of five books
Spectator
6 days ago
- Spectator
NHS diversity officer: I don't know my own sex
The Sandie Peggie case against NHS Fife is only getting stranger. The tribunal resumed on Wednesday morning, after first being heard in February after nurse Peggie lodged a complaint of harassment related to a protected belief under the 2010 Equality Act after being suspended for complaining about sharing a changing room with a transgender doctor. Just weeks after the case adjourned, the Supreme Court backed the biological definition of a woman – and just this week Peggie's lawyer announced NHS Fife had cleared Peggie of all gross misconduct allegations. Now those present have witnessed another baffling twist –the senior diversity officer who gave advice that allowed a transgender medic into a women's changing room has claimed that she, er, doesn't know her own sex. You couldn't make it up… The equalities and human rights lead at NHS Fife, Isla Bumba told the tribunal that while she was able to 'hazard a guess I would be female', she insisted 'no one knows' their chromosomes or hormonal composition unless they had undergone medical testing. Er, right. Bumba went on to say that she had given 'generalised' advice in 2023 that led to Dr Beth Upton, a transwoman, being allowed to access female changing facilities at the Kirkcaldy hospital where Peggie worked. The long-time nurse confronted Dr Upton the third time she came across the medic in the changing room, on Christmas Eve in 2023 – before being suspended after Upton reported Peggie for a 'hate incident'. Bumba added that while the health board did not have a formal policy on trans changing rooms, it had informally used national guidelines – prompting claims the Scottish health service had commenced a 'secret' trans policy. NHS Fife has come under increasing scrutiny throughout this case, with Scotland's information commissioner ruling that the health board had failed to comply with Freedom of Information requests regarding the cost of the case. It has since been revealed that NHS Fife has spent a whopping £220,000 defending itself thus far. First Minister John Swinney has said he has confidence in the health board – but since nurse Peggie was acquitted in the internal disciplinary process, health service bosses have come under pressure to concede the case. Will they now bow out? Watch this space…
