A Texas Woman Was Denied Medical Care For Her Miscarriage For Over Two Weeks

Even before the Supreme Court reversal of Roe v. Wade, Texas has jockeyed for position at the forefront of anti-abortion legislation, most famously with the 2021 “Texas Heartbeat Act” banning abortion once cardiac activity could be detected (usually around six weeks gestation). But as one Texas woman’s experience shows, this impulse has led to delayed care for patients who desperately want to be pregnant, and may even risk future pregnancies.

Makeup artist Marlena Stell and her husband have longed for a second child to join their daughter, she shared in a recent interview with CNN. After seven months of trying, she discovered, to her delighted surprise, that she was pregnant in the summer of last year. But at her second ultrasound at just nine and a half weeks, her doctor informed her that there was no heartbeat and that her pregnancy was not viable. But when Stell requested a surgery to remove embryonic remains — called a dilation and curettage or D&C, the same procedure used in abortion of live embryos and fetuses — her doctor informed her that the Texas Heartbeat Act, which was enacted in September 2021, meant that she would have to get another ultrasound.

The physical pain of her miscarriage between her first and second ultrasounds could be debilitating, and the emotional pain of having to have yet another transvaginal ultrasound was similarly raw. To make matters worse, she told CNN, her doctor still refused a D&C after the second ultrasound, prompting Stell to have to get a third before finally receiving appropriate care two weeks after discovering her pregnancy was no longer viable.

“I get so angry that I was treated this way because of laws that were passed by men who have never been pregnant and never will be,” she told CNN.

While Stell, fortunately, did not suffer long-term medical consequences as a result of her delayed care, the risk for patients who have miscarried is real. Approximately 2% of patients who suffer miscarriage will have a septic miscarriage, a potentially life-threatening medical concern when tissue remaining in the uterus becomes infected. While 2% doesn’t seem like an overwhelming number, the fact that 10% of all clinically recognized pregnancies end in miscarriage highlights just how many patients a delay in care might affect.

According to the American College of Obstetricians and Gynecologists (ACOG), this infection could result in an inability to have more children, or even organ failure and death and should be treated immediately via surgery. ACOG also suggests that while “expectant management” of miscarriage (ie allowing the contents of the uterus to expel on their own) is appropriate for most patients, some instances will require either surgical (D&C) or medically (via misoprostol-based regimens) intervention and that the patient should be involved in which method is right for them.

Unfortunately, it would seem that Stell is not the only victim of Texas’ strict abortion laws. Recently, the Texas Medical Association (TMA) issued a letter to the Texas Medical Board (TMB) highlighting various complaints alleging that hospital administrations and lawyers have prohibited physicians from providing necessary care for pregnant patients, including necessary care for ectopic pregnancy and impending miscarriage. The TMA goes on to highlight that the lack of clarity in the management of non-viable pregnancies opens practitioners up to costly lawsuits (particularly in light of the fact that the state incentivizes reporting even a suspicion of abortion with a $10,000 bounty) and potentially even lose their medical license.

Unfortunately, Stell’s unhappy ending has been compounded as a result of her traumatic experience. “My husband and I decided to not try for more children while in the state of Texas because of the care I received here,” she said in a statement on Twitter. “If a pregnant mom goes septic, she can die in literally hours. Meanwhile it takes days to get multiple ultrasounds and/or just legal clearance for doctors to perform a D&C, thus putting pregnant women at risk while they wait.

“I will never get pregnant as long as I live in Texas.”