WASHINGTON — A woman suffered a miscarriage in the lobby bathroom of a Texas emergency room after front desk staff refused to check her in. Another woman learned that her baby’s heartbeat had stopped at a Florida hospital the day after security guards turned her away. facility. In North Carolina, a woman gave birth in her car because an ultrasound was not available in the emergency room. The baby later died.
Federal documents obtained by The Associated Press reveal that complaints of pregnant women being turned away from U.S. emergency rooms spiked in 2022 after the U.S. Supreme Court struck down Roe v. Wade.
The cases raise alarm about the current state of emergency pregnancy care in the United States, particularly in states that have enacted strict abortion laws and created confusion over what treatment doctors can provide.
“It’s shocking. Absolutely shocking,” said Amelia Huntzberger, an obstetrician-gynecologist in Oregon. She said: “It’s horrible for someone to come to the emergency room and not be treated. This is unthinkable.”
This happened despite federal orders to provide medical treatment to the women.
Federal law requires emergency rooms to treat or stabilize patients in active labor and provide medical transportation to another hospital if they do not have the staff or resources to treat them. Healthcare facilities must comply with the law when accepting Medicare funding.
The Supreme Court is scheduled to hear arguments Wednesday that could weaken those protections. The Biden administration has sued the state of Idaho over its ban on abortion even in medical emergencies, alleging it violates federal law.
“No woman should be denied the care she needs,” Jennifer Klein, director of the White House Gender Policy Council, said in a statement. She said, “All patients, including women facing pregnancy-related emergencies, should have access to the emergency medical care they require under the Emergency Medical Labor Act (EMTALA).”
Pregnancy care after ROE
Sarah Rosenbaum, a health law and policy professor at George Washington University, said that in states where abortion is extremely restrictive, pregnant patients are “releasing radioactive materials into emergency departments.”
“They’re so scared of pregnant patients that emergency medical staff don’t even look at them. They just want these people to go away,” Rosenbaum said.
Consider what happened to a woman who was nine months pregnant and in labor when she arrived at Falls Community Hospital in Marlin, Texas, in July 2022, one week after the Supreme Court’s decision on abortion. . The doctor on duty refused to examine her.
“A doctor came to the triage desk and told the patient that the hospital did not have obstetric services or obstetric capabilities,” hospital employees told federal investigators during questioning, according to the documents. “Nursing staff told the doctor that they could test for the presence of amniotic fluid. However, the doctor was adamant that the patient drive to the hospital in Waco.”
Investigators with the Centers for Medicare and Medicaid Services concluded that Falls Community Hospital violated the law.
When contacted by phone, hospital administrators declined to comment on the incident.
The investigation was one of dozens obtained by The Associated Press from a Freedom of Information Act request filed in February 2023 seeking all EMTALA complaints related to pregnancy in the previous year. A year after filing the request, the federal government has agreed to release only a portion of the complaints and investigation documents filed in just 19 states. Names of patients, doctors and medical staff were redacted from the document.
Federal investigators investigated more than a dozen pregnancy-related complaints in those states in the months leading up to the U.S. Supreme Court’s landmark decision on abortion in 2022. However, more than 20 complaints regarding emergency pregnancy care were filed in the months following the ruling. was unveiled. It’s unclear how many complaints were filed last year, as the records request only seeks complaints for 2022 and no other information is made public.
The documents do not detail what happened to patients who were turned away from Falls Community Hospital.
“She’s bleeding a lot.”
Other pregnancies ended in disaster, documents show.
In September of that year, front desk staff at Sacred Heart Emergency Center in Houston refused to check in a woman whose husband had asked for help giving birth. She miscarried in the lobby bathroom of her emergency room while her husband called 911 for help.
“She was bleeding profusely and had a miscarriage,” her husband told first responders over the phone. The call was transcribed from Spanish into federal documents. “I come to the hospital and they say they can’t help us because we’re not their customers.”
Paramedics arrived 20 minutes later and took the woman to the hospital, but appeared confused as staff refused to help her, according to the 911 call.
One first responder told federal investigators that when an employee at Sacred Heart Emergency Center was asked about the gestational age of the fetus, the employee replied: That’s why you’re here. ”
A manager at Sacred Heart Emergency Center declined to comment. The facility is licensed in Texas as a freestanding emergency room, meaning it is not physically connected to a hospital. A Texas Department of Health and Human Services spokesperson said in an email to The Associated Press that state law requires these facilities to treat and stabilize patients.
According to archives published on the center’s website, Sacred Heart Emergency’s website states that it does not currently accept Medicare, but the change was made some time after a woman had a miscarriage. It is said that it was done.
Meanwhile, staff at Parson Memorial Hospital in Roxboro, North Carolina, told a pregnant woman complaining of abdominal pain that she could not undergo an ultrasound. According to federal investigators, staff did not tell her how dangerous it was to leave without stabilizing her body. The woman gave birth to the baby in her car on the way to another hospital 45 minutes away, but her life did not survive.
Parson Memorial Hospital self-reported the incident. A spokesperson said the hospital “continues to provide continuing education to staff and healthcare professionals to ensure compliance.”
In Melbourne, Florida, security guards at Holmes Regional Medical Center refused to let a pregnant woman with her child into the triage area. When the patient returned the next day, medical staff could not detect a heartbeat in the fetus. The center declined to comment on the matter.
What are the penalties?
Emergency rooms face steep fines if they turn away patients, fail to stabilize them or transfer them to another hospital for treatment. Violations could also jeopardize hospitals’ Medicare funding.
But it’s unclear what fines the Biden administration will impose in 2022 on more than a dozen hospitals that the administration says failed to properly treat pregnant patients.
In these cases, it can take years for fines to be imposed. The Health and Human Services Agency, which enforces the law, did not say whether the hospital had been referred to the agency’s Office of Inspector General for penalties.
For Huntzberger, an obstetrician-gynecologist, EMTALA was one of the few ways she felt protected treating pregnant patients in Idaho, despite the state’s abortion ban. She left Idaho last year because of the ban and practiced in Oregon.
The threat of fines or loss of Medicare funding for violating EMTALA is a big deterrent to hospitals from cutting patients, she said. If we lose Medicare funding, many people won’t be able to keep their doors open.
She asked what penalties HHS would impose on two hospitals in Missouri and Kansas that the agency announced last year were investigating after a pregnant woman in premature labor at 17 weeks was denied an abortion. I was waiting for someone.
“Many of these situations go unreported, but even in situations that do occur, like the cases in the Midwest, there are investigations and nothing is really learned,” Huntzberger said. he said. “People just continue to provide substandard care or no care at all. The only way things change is in situations like this.”
Next, go to Emtara
President Joe Biden and top U.S. health official Xavier Becerra have both publicly vowed to be vigilant in enforcing the law.
Despite states enacting strict abortion laws, the White House has insisted that hospitals must provide reliable medical care, including abortions, if they receive Medicare funding.
In a statement to The Associated Press, Becerra called it “the nation’s bedrock law that protects Americans’ right to receive life-saving and health-saving emergency medical care.”
“And doctors, not politicians, should decide what is a medical emergency,” he added.
Idaho law only allows abortions when the mother’s life, not her health, is at risk. But the state’s attorney general argued that the state’s abortion ban is “consistent” with federal law that requires emergency rooms to protect unborn children in medical emergencies.
“There is no need for the Biden administration to override the Idaho law and rewrite federal law to force doctors to perform abortions,” Idaho Attorney General Raul Labrador said in a statement earlier this year.
The Supreme Court will now consider this matter. The lawsuit could also impact other states, including Arizona, which is reinstating an 1864 law that bans all abortions, with exceptions only when the mother’s life is in danger. There is.
Alexa Corbi-Molinas of the American Civil Liberties Union said EMTALA was first introduced decades ago because private hospitals often dumped patients into county or state hospitals; This is because he did not have insurance.
Some hospitals refused to examine pregnant women if they did not have an established relationship with a staff physician. If courts strike down or weaken those protections, more hospitals could turn away patients without fear of federal penalties, she said.
“The government knows there’s a problem, it’s looking into it and it’s doing something about it,” Kolbi-Molinas said. “We couldn’t have done it without EMTALA.”
