Abortion laws triggered dozens of health complications, new report says (2023)


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A new report has identified dozens of examples in which medical providers say pregnant patients received care in the past year that deviated from care they would have received before the Supreme Court overturned Roe v. Wade — a sign, researchers said, of a pattern of serious health complications triggered by abortion bans.

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While no nationwide data has yet emerged to show the extent of these complications, the report, being released Tuesday by researchers at the University of California at San Francisco and shared with The Washington Post, offers a first-of-its-kind summary of anonymized examples from medical providers across the country.

The two research groups that conducted the report — UCSF’s Advancing New Standards in Reproductive Health and the Texas Policy Evaluation Project at the University of Texas at Austin — support abortion rights.


(Video) Abortion rights advocates push back on trigger laws

Individual cases of health complications related to abortion bans have emerged since the June ruling, including stories of women turned away from hospitals with life-threatening pregnancy conditions as doctors and hospital administrators fear the legal risk that could come with terminating even a pregnancy that could jeopardize the mother’s well-being. But the new report, which listed 50 examples shared by providers who chose to participate in a national survey, represented an effort to capture a more expansive picture of how health care has been affected by abortion bans.

Patients “are being harmed in significant ways because care is being denied or delayed,” said Daniel Grossman, a professor at UCSF and the lead author of the report. “These laws are having a broader impact beyond people who are seeking abortion because they have an undesired pregnancy.”

Two friends were denied care after Florida banned abortion. One almost died.

The findings include examples of one patient who developed a severe infection after she was sent home from the hospital, leaving her in critical condition — and another who could not obtain an abortion for a Caesarean scar ectopic pregnancy, a life-threatening condition where a pregnancy implants in the scar of a prior Caesarean section.


The medical exceptions to protect the life of the mother that are included in abortion bans are often described in vague language, Grossman said, creating uncertainty among medical providers who say the laws do not clearly allow them to terminate pregnancies for patients with serious health risks.

Antiabortion lawmakers who drafted existing abortion bans say the language in the laws permits doctors to intervene in a wide range of medical emergencies, with some claiming that doctors are willfully misinterpreting the medical exceptions to make a political point.

“In situations where a doctor is acting in good faith, I believe they can act in that moment,” said former Florida state senator Kelli Stargel, who sponsored Florida’s 15-week abortion ban. “It’s not anyone’s intention to have things go to court.”


(Video) New Texas Study Finds Women Face Higher Health Risks In Abortion-Restrictive States

Grossman said the responses to the report showed that many doctors did not feel they could safely perform abortions in high-risk situations. Hospitals, he added, often do not provide any additional guidance for physicians beyond the language in the law, leaving doctors unsure of how to act in any given situation.

“Medicine isn’t black and white,” said Grossman. “It’s not like suddenly you know that a patient is at a very high risk of dying in a certain situation. There’s a lot of gray and that risk will slowly change over time.”

To collect submissions for the report, Grossman and his team established an online portal that would allow medical providers to submit their experiences anonymously if they chose, Grossman said, which was important because many hospitals have barred medical providers from speaking to the media about policies related to abortion bans. The research team shared the portal through various medical and nursing associations, soliciting submissions from a wide range of medical providers, including doctors, nurse practitioners, midwives and nurses.


The most common type of complication among the respondents was preterm premature rupture of the membranes, or PPROM, a condition where a woman’s water breaks before the fetus can survive on its own, putting the patient at a high risk for infection and hemorrhage.

When abortion was legal across the country, doctors in all states would typically offer to induce or perform a surgical procedure to end the pregnancy when faced with a pre-viability PPROM case — which is the standard of care, according to the American College of Obstetricians and Gynecologists (ACOG), and an option that many women choose. Especially before the 20-week mark, a fetus is extremely unlikely to survive without any amniotic fluid.

Many doctors have been turning away PPROM patients since Roe was overturned, according to the report, no longer offering the option to induce the pregnancy or perform an abortion.


In one case cited in the report, a patient was sent home after her water broke between 16 and 18 weeks of pregnancy in a state where abortion is banned — only to return to the intensive care unit two days later with a severe infection, according to a physician involved in the case.

“The anesthesiologist cries on the phone when discussing the case with me,” the physician wrote. “If the patient needs to be intubated, no one thinks she will make it out of the [operating room.]”

After the doctor ultimately decided to terminate the pregnancy, the doctor wrote, the patient asked if she or her doctor could face criminal penalties.

“She asks me: could she or I go to jail for this?” the doctor recounted in their submission. “Or did this count as life threatening yet?”

(Video) Roe v. Wade: Texas' abortion 'trigger law,' explained | KVUE

Republican lawmakers have repeatedly said that medical exceptions in abortion bans clearly cover patients with ectopic pregnancies.


But several clinicians in the report said that patients with Caesarean scar ectopic pregnancies experienced delays in their care due to abortion bans, putting patients at a high risk for hemorrhage, the placenta growing into surrounding organs and rupture of the uterus.

After greenlighting an abortion for a patient with a Caesarean scar ectopic pregnancy, one doctor described a situation where other colleagues who were necessary to safely complete the procedure were unwilling to help, saying they did not feel “legally protected.” The physician recommended that the patient travel elsewhere, but the patient did not have the means to leave the state.

The physician said their team continued to monitor the patient, who at the time of the physician’s submission was still pregnant, and developing placenta percreta, a life-threatening pregnancy complication that could prompt heavy bleeding or a uterine rupture any moment.


The research also highlighted a number of other pregnancy complications that medical providers said were impacted by the Supreme Court ruling. Patients were unable to terminate pregnancies with fetal anomalies, medical providers said, while others faced delays in obtaining the medication necessary to treat an early miscarriage.

Concerns surrounding abortion bans led doctors to delay or deny several treatments unrelated to abortion, according to the report. In one case, a clinician refused to remove an intrauterine device (IUD) for a patient who was between 10 and 12 weeks pregnant, despite the fact that the IUD had partially expelled, increasing the patient’s risk of infection or miscarriage.

“The doctor did not feel comfortable removing the IUD because it could cause a miscarriage,” wrote one physician consulted on the case. “The context provided was concern over the recent changes in law that create [the] possibility for felony charges for providers causing abortion in our state.”


(Video) The Medical Effects Of Abortion Bans (In The Loop)

One limitation of the report, Grossman said, is that he and his team were not able to collect enough examples to meaningfully observe changes over time. As more time passes, he added, doctors may become more aware of the types of care they can offer under the new laws — something Grossman and his team plan to continue to measure.

To help with these situations, Grossman said, hospitals in states where abortion is banned could provide a list of conditions that doctors can legally treat — specifying, for example, that providers can legally offer to induce a PPROM pregnancy. Alternatively, he said, Republican lawmakers could offer further laws or amendments to clarify the medical exceptions.

“It may be a first step,” Grossman said. “But I don’t think any list can ever be comprehensive. There will always be conditions that are not on the list that are dangerous.”

Last month in Florida, during debate on a proposed six-week abortion ban, a Democratic lawmaker, Rep. Robin Bartleman, introduced an amendment that would have explicitly allowed doctors to induce or perform an abortion if a woman presents at a hospital with PPROM.

Rep. Jenna Persons-Mulicka (R), who sponsored the six-week ban in the Republican-led legislature, said the medical exception already included in the bill covered that kind of situation, despite stories recounted on the House floor demonstrating that doctors did not feel they could act in a PPROM situation.

The amendment was defeated by a party-line vote of 80-33.

Abortion access in America

Tracking abortion access in the U.S.: After the Supreme Court struck down Roe v. Wade, the legality of abortion is left to individual states. The Post is tracking states where abortion is legal, banned or under threat.

Abortion pills: The Justice Department appealed a Texas judge’s decision that would block approval of the abortion pill mifepristone. The Supreme Court decided to retain full access to mifepristone as the appeal proceeds. Here’s an explanation of what happens next in the abortion pill case.

Post-Roe America: With Roe overturned, women who had secret abortions before Roe v. Wade felt compelled to speak out. Other women who were seeking abortions while living in states with strict abortion bans also shared their experiences with The Post through calls, text messages and other documentation. Here are photos and stories from across America since the reversal of Roe v. Wade.

The U.S. fight over abortion


  • Her baby has a deadly diagnosis. Her Florida doctors refused an abortion.May 19, 2023Her baby has a deadly diagnosis. Her Florida doctors refused an abortion.May 19, 2023
  • Two friends were denied care after Florida banned abortion. One almost died.April 10, 2023Two friends were denied care after Florida banned abortion. One almost died.April 10, 2023
  • This Texas teen wanted an abortion. She now has twins.June 20, 2022This Texas teen wanted an abortion. She now has twins.June 20, 2022


What are the consequences of the Dobbs decision? ›

The consequences of the Dobbs decision are wide ranging. Restrictions on access to healthcare places women's lives and health at risk, leading to increased maternal mortality and morbidity, a climate of fear among healthcare providers, and reduced access to all forms of care.

Who was the woman with the molar pregnancy in Oklahoma? ›

The molar pregnancy Jaci Statton had would never become a baby. It was cancerous, though. At the last hospital in Oklahoma she went to during her ordeal last month, Statton says staff told her and her husband that she could not get a surgical abortion until she became much sicker.

What is the trigger law in Wyoming? ›

The trigger ban, which prohibits abortions in all circumstances except rape, incest or if the mother is at serious risk of death or injury, was blocked by a court as litigation to determine its legality under the state constitution continues.

What is the trigger law in North Dakota? ›

The trigger abortion ban was set to take effect last August and would have made it a felony to perform an abortion in the state but it did allow exceptions in cases of rape or incest. With the trigger ban on pause, North Dakota law had allowed abortion up until 20 weeks or more post-fertilization.

What is the Dobbs theory? ›

Under Dobbs, in other words, state legislatures can ban abortion altogether or give only the weakest, most ineffective protections of women's health — even if they're less than what laws provided between 1868 and 1973, when Roe was decided.

What was the decision of Roe v. Wade? ›

Roe v. Wade, 410 U.S. 113 (1973), was a landmark decision of the U.S. Supreme Court in which the Court ruled that the Constitution of the United States generally protects a pregnant individual's liberty to have an abortion.

What is partial molar pregnancy? ›

In a partial or incomplete molar pregnancy, the mother's chromosomes are present, but the father supplies two sets of chromosomes. The embryo then has 69 chromosomes instead of 46. This most often occurs when two sperm fertilize an egg, resulting in an extra copy of the father's genes.

What is the trigger law for Texas? ›

Texas's Trigger Law

In 2021, the Texas Legislature passed a bill with a trigger provision. This bill, HB 1280, contained language that would ban abortion 30 days after one of the following events occurred: The issuance of a judgment by the United States Supreme Court overturning Roe v.

What is Wyoming Rule 9? ›

Rule 9. The Wyoming State Bar provides a way for students to get "real-world" experience prior to graduation. Rule 9 states that a student may practice in court as a normal attorney under the direct supervision of their supervising attorney.

What is the 301 law in Wyoming? ›

A court granting a 301 deferral usually requires the defendant to plead guilty or no contest to the charge and takes the matter under advisement or defers further sentencing until a later date. 1 The court then places the defendant on a period of probation for up to three years.

What is Rule 11 in North Dakota? ›

Every pleading, written motion, and other paper must be signed by at least one attorney of record in the attorney's name or by a party personally if the party is self-represented. The paper must state the signer's address, electronic mail address for electronic service, and telephone number.

What is the heartbeat bill in North Dakota? ›

The bill could potentially charge a doctor or a person performing an abortion with a 'C' felony, and could even apply if a doctor aborts a baby who's found to have a detectable heartbeat or a genetic disability. The law does not apply if the mother's life is in danger from potential childbirth.

What is a Rule 11 sanction in North Dakota? ›

The sanction may include nonmonetary directives; an order to pay a penalty into court; or, if imposed on motion and warranted for effective deterrence, an order directing payment to the movant of part or all of the reasonable attorney's fees and other expenses directly resulting from the violation.

Was Roe v Wade a law? ›

The Supreme Court's ruling in Roe v. Wade on January 22, 1973, decriminalized abortion nationwide. It protected the right to access abortion legally all across the country, and freed many patients to access the care they needed when they needed it — without fear.

Is Roe v Wade substantive due process? ›

The Court in Roe reaffirmed the doctrine of Substantive Due Process and the fundamental right of personal privacy, holding that the right of personal privacy “is broad enough to encompass a woman's decision whether or not to terminate her pregnancy,” but declined to make that right absolute.

Which of the following reflects the Supreme Court decision in Roe v Wade 1973? ›

Which of the following reflects the Supreme Court decision in Roe v. Wade (1973) ? It ruled that a woman's right to an abortion was a privacy right incorporated to all of the states.

Why did the Supreme Court overturn Roe v. Wade? ›

Justice Clarence Thomas, who was in the Dobbs majority, has written that Roe was “grievously wrong for many reasons, but the most fundamental is that its core holding — that the Constitution protects a woman's right to abort her unborn child — finds no support in the text of the Fourteenth Amendment.”

Can Congress overturn a Supreme Court decision? ›

Court can declare a law unconstitutional; allowing Congress to override Supreme Court decisions; imposing new judicial ethics rules for Justices; and expanding transparency through means such as allowing video recordings of Supreme Court proceedings.

What case overturned Roe v. Wade? ›

Share. The Supreme Court overruled the landmark cases Roe v. Wade and Planned Parenthood v. Casey, which held that women have the constitutional right to seek pre-viability abortions.

What is sad fetus syndrome? ›

Sad fetus syndrome, also known as molar pregnancy with concomitant live fetus, is a rare phenomenon. Its incidence is reported at 0.005% to 0.01% of all pregnancies [1]. Molar pregnancies with a coexistent live fetus occur in three variations [2].

Is a molar pregnancy a miscarriage? ›

What is a molar pregnancy? A molar pregnancy is an uncommon type of pregnancy loss where an egg is fertilised but a baby does not develop. If you have a molar pregnancy, it wasn't caused by anything you did or didn't do.

Do molar pregnancies have a heartbeat? ›

Diagnosis of Molar Pregnancy

If women have a molar pregnancy, results are positive, but no fetal movement and no fetal heartbeat are detected. Blood tests to measure the level of human chorionic gonadotropin (hCG—a hormone normally produced early in pregnancy) are done.

What is the Abbott trigger law? ›

The trigger law criminalizes performing an abortion from the moment of fertilization unless the pregnant patient is facing “a life-threatening physical condition aggravated by, caused by, or arising from a pregnancy.” The statute specifically prohibits prosecuting a pregnant patient who undergoes an abortion.

Is the abortion trigger law a felony in Texas? ›

Laws Taking Effect with the Activation of the "Trigger Law"

This section specifically protects the patient who obtains an abortion from civil, criminal, or administrative liability. This section makes performing or attempting an abortion a first or second degree felony.

What 3 states have trigger laws? ›

Trigger bans took effect on Thursday, August 25, 2022, in Tennessee, Idaho, and Texas, banning abortion from conception in Tennessee and Idaho and enacting harsher penalties for providers in Texas.

What is Rule 54 in Wyoming? ›

A default judgment must not differ in kind from, or exceed in amount, what is demanded in the pleadings. Every other final judgment should grant the relief to which each party is entitled, even if the party has not demanded that relief in its pleadings.

What is Wyoming Rule 33? ›

(1) Responding Party. The interrogatories must be answered: (A) by the party to whom they are directed; or (B) if that party is a public or private corporation, a partnership, an association, or a governmental agency, by any officer or agent, who must furnish the information available to the party. (2) Time to Respond.

What is Wyoming Rule 45? ›

Failure of any person without adequate excuse to obey a subpoena served upon that person may be deemed a contempt of the court from which the subpoena issued.

What is Rule 58 Wyoming? ›

Every judgment shall be set forth on a separate document, shall be identified as such, and may include findings of fact and conclusions of law.

What is Wyoming Rule 11? ›

Rule 11 - Signing pleadings, motions, and other papers; representations to the court; sanctions (a) Signature. Every pleading, written motion, and other paper must be signed by at least one attorney of record in the attorney's name-or by a party personally if the party is unrepresented.

What is Wyoming Rule 16? ›

If, prior to or during trial, a party discovers additional evidence or material previously demanded or ordered, which is subject to discovery or inspection under this rule, such party shall promptly notify the other party or that other party's attorney or the court of the existence of the additional evidence or ...

What was Jackson's Women's Health Organization's argument? ›

Jackson Women's Health contends that viability is the central principle in Roe and Casey and there is no basis for overruling the viability line. Mississippi's argument “was raised in Casey, and the Court gave careful regard to the state's asserted interests, including in fetal life.

What was the Dobbs decision in Texas? ›

Last June, the Dobbs decision allowed roughly a dozen more states' abortion bans to take effect. That included the "trigger ban" in Texas, which made nearly all abortions a felony, and allowed only narrow exceptions to save a pregnant woman's life.

When was Dobbs v Jackson decided? ›

What amendment is Dobbs v Jackson? ›

3 Abortion, Dobbs v. Jackson Women's Health Organization, and Post-Dobbs Doctrine. Fourteenth Amendment, Section 1: All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside.

What was the final decision in Whole Woman's Health v Jackson? ›

Two months later, on June 24, the U.S. Supreme Court decided Dobbs v. Jackson Women's Health Organization, overruling Roe v. Wade (1973). As such, SB 8's approximately six-week ban on abortions was superseded by other Texas abortion bans starting from conception.

How many times has Roe v. Wade been challenged? ›

There are five notable U.S. Supreme Court cases that have reexamined the precedent set in Roe v. Wade. These are Webster v. Reproductive Health Services, Planned Parenthood v.

What was the conclusion of Dobbs v Jackson Women's Health Organization? ›

On June 24, 2022, the United States Supreme Court released its decision in Dobbs v. Jackson Women's Health Organization, overturning the constitutional right to abortion.

What was established in the Texas v Johnson decision? ›

Decision: The U.S. Supreme Court ruled in a 5-4 decision in favor of Johnson. The high court agreed that symbolic speech – no matter how offensive to some – is protected under the First Amendment.

What is the trigger ban law in Texas? ›

Texas's Trigger Law

In 2021, the Texas Legislature passed a bill with a trigger provision. This bill, HB 1280, contained language that would ban abortion 30 days after one of the following events occurred: The issuance of a judgment by the United States Supreme Court overturning Roe v.

What did the Hernandez v Texas 1954 decision acknowledge? ›

On May 2, 1954, under Chief Justice Earl Warren, who was governor of California during the Mendez v. Westminster case in 1947, the Court unanimously ruled that the 14th Amendment protects those beyond the members of the “two class theory” and that Mexican Americans were a “special class” in Jackson County, Texas.

Did the Supreme Court overturn Dobbs v Jackson? ›

The majority opinion, joined by five of the justices, held that abortion was not a protected right under the Constitution, overturning both Roe and Casey, and returned the decision regarding abortion regulations back to the states. As a result, Dobbs is considered a landmark decision of the Court.

Which of the following cases was overruled by Brown v Board of Education? ›

Board of Education. The Court overturned Plessy v. Ferguson, and declared that racial segregation in public schools violated the Equal Protection clause of the 14th Amendment.

What is the 14th Amendment? ›

What does the 14th Amendment say? Ratified in 1868, the 14th Amendment is best known for extending citizenship to former slaves and guaranteeing “equal protection of the laws.”

What is the 9th Amendment? ›

The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.

What is the Tenth Amendment? ›

The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.


1. State-By-State Abortion Laws Cause New Complications
2. Even after Utah's trigger law is in effect, lawmakers plan more abortion bills
(FOX 13 News Utah)
3. Texas abortion laws create unintended effects
(KHOU 11)
4. Uncertainty of abortion laws takes emotional toll on some patients | KVUE
5. Missouri becomes first state to use 'trigger laws' to ban abortion following Roe v. Wade
(CNBC Television)
6. New study finds Oklahoma hospitals confused over abortion laws
(KFOR Oklahoma's News 4)
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