Texas Women Say Hospitals Violated EMTALA By Denying Emergency Abortions

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Dive Brief:

• Two women have filed complaints with the HHS alleging Texas hospitals denied them emergency abortion care, damaging their future fertility and risking their lives. 
• The complaints argue Texas Health Arlington Memorial Hospital and Ascension Seton Williamson Hospital violated the Emergency Medical Treatment and Labor Act by not immediately treating their patients’ ectopic pregnancies, a condition where a pregnancy implants outside the uterus and can’t result in live births. 
• Kelsie Norris-De La Cruz and Kyleigh Thurman nearly died and both lost a fallopian tube after they were refused emergency treatment, according to the Center for Reproductive Rights, whose attorneys represent both women. They argue Texas’ strict abortion restrictions make it “impossible” to access critical care.

Dive Insight:

Since Roe v. Wade was overturned in 2022, about half of states have restricted access to abortion. In Texas, nearly all abortions are illegal and providers can be subject to severe criminal and civil penalties — doctors could face up to 99 years in prison, lose their medical licenses and face fines of at least $100,000 for performing abortions, according to the Center for Reproductive Rights.

Advocates argue the legal risk makes clinicians reluctant to offer care for suspected ectopic pregnancies in Texas, even though providing an abortion in that circumstance would be legal under state law.

The complaint argues fears of prosecution don’t justify violating EMTALA, a decades-old federal law that requires hospital emergency rooms to provide stabilizing medical care or transfer them to another facility. 

Federal regulators have already used the law to warn states with abortion restrictions that they are legally required to allow the procedure in emergencies. The Biden administration sued Idaho in 2022, alleging the state’s ban — which didn’t include exceptions for the health of the mother — violated EMTALA.

The case went to the Supreme Court, which ultimately allowed Idaho doctors to perform abortions to stabilize a patient’s life and health. But the court sidestepped the broader question of whether EMTALA supersedes near-total abortion bans.

The latest cases from Texas come two months after the Supreme Court’s ruling in the Idaho case. In her complaint, Norris-De La Cruz alleged Texas Health Arlington Memorial Hospital discharged her in February without providing treatment for her ectopic pregnancy, even though physicians acknowledged the pregnancy could rupture her fallopian tube. 

She found another provider that performed emergency surgery, but the physician had to remove most of her right right fallopian tube and about 75% of her right ovary due to the delay, according to the complaint.

In the second case, Thurman went to Ascension Seton Williamson Hospital in February 2023 after her physician suspected an ectopic pregnancy. The hospital allegedly sent her home and didn’t administer treatment until days later, after her gynecologist traveled to the facility to “plead with the medical staff” to give her medication to terminate the pregnancy.

But the drug was administered too late, and Thurman lost her right fallopian tube in an emergency surgery to save her life, according to the complaint. 

“This should have been an open and shut case. Yet, I was left completely in the dark without any information or options for the care I deserved,” Thurman said in a statement. “Pregnancy is not straightforward, and I now have to live with the consequences of these extreme laws every day.”

An Ascension spokesperson said the health system couldn’t comment on the specifics of the case, adding “Ascension is committed to providing quality care to all who seek our services.”

Texas Health Resources didn’t respond to a request for comment by press time.