In states with total abortion bans, federal law requires physicians to provide an abortion if it stabilizes an emergency condition, but hospitals are leaving physicians to fend for themselves to navigate this "minefield," according to a Senate Finance Committee report.
In September, the committee sent letters to eight hospitals after receiving "concerning reports of pregnant women being denied or experiencing delays in accessing emergency, stabilizing health care at their facilities," the report said, from hospitals in Florida, Georgia, Louisiana, Missouri, North Carolina and Texas.
Five things to know:
1. Citing declining birth rates and legal challenges, several hospitals and systems have shuttered labor and delivery services. One Idaho hospital said on Facebook that it closed its obstetric services due to the state's legal and political climate.
"Highly respected, talented physicians are leaving," the hospital said. "Recruiting replacements will be extraordinarily difficult. In addition, the Idaho Legislature continues to introduce and pass bills that criminalize physicians for medical care nationally recognized as the standard of care. Consequences for Idaho Physicians providing the standard of care may include civil litigation and criminal prosecution, leading to jail time or fines."
2. Emergency medicine clinicians, OB-GYNs and family medicine physicians told the committee they receive limited communication from hospital leadership on navigating the conflict between state laws and Emergency Medical Treatment and Labor Act, a federal law passed in 1986.
A family physician who provides obstetrics services in a Texas hospital said the organization was "conspicuously and deliberately silent" on guiding employees through this tension.
3. At the same time, abortion laws are becoming murkier across state lines. Texas' attorney general filed a lawsuit against a New York physician of allegedly providing a Texas woman with abortion medication via telehealth.
4. Even in states where abortion is legal, health system policies can lead to confusion. In California, which does not have an abortion ban, the state's attorney general acted when a hospital allegedly denied abortion care to a woman experiencing an obstetric emergency, forcing her to seek care elsewhere.
5. The Supreme Court has refused to weigh in on several lawsuits that question whether EMTALA supersedes state law for abortion care. Idaho physicians are allowed to provide emergency abortion care, but Texas physicians are not.