Two Georgia mothers, Amber Thurman and Candi Miller, died in 2022 because of a lack of care most likely tied to the state\u2019s abortion ban, the nonprofit news outlet ProPublica reported this week. Both experienced complications after taking abortion medications, the reporting said \u2014 complications, doctors emphasized, that are exceedingly rare and entirely treatable. <\/p>\n
\u201cTo read about a mom just trying to make the best decisions for herself and her family die from something completely preventable in the United States \u2013 I don\u2019t think \u2018tragedy\u2019 is a strong enough word,\u201d said Dr. Ghazaleh Moayedi, an obstetrician\/gynecologist and founder of Pegasus Health Justice Center in Dallas. <\/p>\n
According to the report, Thurman received abortion medication from a clinic in North Carolina shortly after abortion was banned after six weeks in her home state of Georgia, and she went to her local hospital with a severe infection days later, after her body didn\u2019t expel all of the fetal tissue. <\/p>\n
Instead, ProPublica reported, Thurman didn\u2019t receive surgical care to remove the fetal tissue for 20 hours. The report said it\u2019s not clear from Thurman\u2019s records why doctors waited so long, but noted the procedure had been criminalized just weeks before by the state\u2019s abortion ban, after the US Supreme Court\u2019s overturning of Roe v. Wade that summer. Thurman\u2019s heart stopped during surgery, the outlet reported, after she\u2019d been diagnosed at the hospital with acute severe sepsis and went into organ failure. <\/p>\n
The reports have enflamed the political debate over access to abortion, with Vice President Kamala Harris saying this week that \u201cthis is exactly what we feared when Roe was struck down.\u201d Harris will visit Georgia on Friday to deliver further remarks on women\u2019s reproductive rights. <\/p>\n
Abortion rights opponents blamed Thurman\u2019s doctors for not providing immediate care \u2013 and blamed medication abortion itself. <\/p>\n
Medication abortion has been approved by the US Food and Drug Administration since 2000 and is currently cleared to end a pregnancy through 10 weeks of gestation. <\/p>\n
Data shows that it\u2019s now the most common way people in the US access abortion, making up about two-thirds of the approximately 1 million abortions in the formal health-care system in the US last year, according to the Guttmacher Institute, a research group that supports abortion rights. <\/p>\n
It consists of two drugs, mifepristone and misoprostol. Mifepristone blocks the hormone progesterone, which is needed for a pregnancy to continue, and is taken first. It\u2019s followed a day or two later by misoprostol, which causes the uterus to contract, leading to cramping and bleeding, during which the pregnancy tissue is expelled. <\/p>\n
The process, Moayedi explained, is \u201dphysiologically really the same\u201d as a miscarriage. <\/p>\n
Serious adverse events with medication abortion happen less than 0.5% of the time, according to Dr. Daniel Grossman, director of the Advancing New Standards in Reproductive Health (ANSIRH) program at the University of California, San Francisco. Those adverse events can include hospitalization, blood transfusions and surgery, he said. <\/p>\n
Retaining pregnancy tissue and requiring vacuum aspiration happens for 3% to 5% of people who have a medication abortion, Grossman noted, but it\u2019s not considered a serious complication and is typically managed in an outpatient setting; Moayedi said retained pregnancy tissue rarely leads to infection. <\/p>\n
Deaths after medication abortion are very rare too, Grossman noted: There were 32 reported among people using mifepristone between 2000 and 2022, a time when approximately 5.9 million women used the medicine. He said his team reviewed the causes reported to the FDA, and almost half were probably not related to the abortion. <\/p>\n
\u201cI have cared for thousands upon thousands of people with medication abortion,\u201d said Moayedi, whose clinic provides \u201cwraparound\u201d care, seeing people before or after abortion in Texas, where abortions are illegal with rare exceptions. \u201cI can count on my one hand \u2014 less than one hand \u2014 the number that have had an infection afterwards. So this is exceedingly rare.\u201d <\/p>\n
Rare particularly, Moayedi said, because women \u201ccould immediately seek help\u201d if they experienced a problem \u2014 something she worries, as the ProPublica reporting suggests, may be less accessible in states with abortion bans. <\/p>\n
Signs of complications include fever, severe abdominal pain and bleeding that soaks through more than two menstrual pads an hour for two hours, Moayedi said. Grossman added that feeling very weak or having nausea, vomiting or diarrhea more than a day after taking the last pill can also be a sign of an infection. <\/p>\n
He advises people experiencing any worrisome symptoms to try to reach the clinic or service that provided the medications, or to call the Miscarriage and Abortion Hotline at 1-833-246-2632; it\u2019s a free hotline staffed by clinicians to answer questions and provide support. <\/p>\n
\u201cBut if a patient is experiencing one of the symptoms mentioned above and they cannot talk with a clinician by phone,\u201d Grossman said, \u201cthey should go to an emergency department.\u201d <\/p>\n
But the onus can\u2019t be only on the patient to ensure that they get care, Moayedi emphasized; hospital systems need to ensure that they understand the laws and have plans in place that enable physicians to provide necessary treatment, she said. <\/p>\n
Grossman also pointed out that \u201cthe same complications that occur with medication abortion can also occur with miscarriage, and the treatment is the same.\u201d <\/p>\n
\u201cI would never advise a patient to lie, but I am very concerned about these reports that patients\u2019 care is being delayed in states with abortion bans when they present with complications after an abortion \u2014 even though the law should not apply to these cases,\u201d he said, noting that his team has heard through its research about similar delays in care for other patients. \u201cThe doctors can treat the patient presenting with bleeding or an infection without knowing whether the patient took medications or not.\u201d <\/p>\n
He said he advises clinicians not to ask patients whether they took medications to end their pregnancies, \u201csince it doesn\u2019t affect their care, and instead may just increase legal risks for the patients.\u201d <\/p>\n<\/p>\n
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