"It was a waiting game, the most horrific version of a staring contest," wrote Texas woman Amanda Zurawski this week on the feminist website The Meteor. "Whose life would end first? Mine, or my daughter's?"
Zurawski's tale of a tragic, "inevitable" miscarriage, followed by a seemingly legally compelled denial of medical care, is likely to become more and more common in states with strict abortion bans. Whether these vaguely written laws would actually be used against a doctor who performed an abortion to save a woman's life is unclear. But it seems that in states where abortion is banned, cautious physicians often delay abortions even when that delay places a woman's life in danger. As long as anti-abortion laws remain vague regarding medically necessary abortions, the lives of women like Zurawski will continue to hang in the balance.
One day in late August of this year, when Zurawski was 18 weeks pregnant, she "knew something was wrong." After an examination from her doctor, she was diagnosed with an "incompetent cervix," a condition where the cervix dilates too early in the pregnancy, often leading to premature birth or miscarriage. She claims that she was told by doctors that a miscarriage was "inevitable."
According to University of California, Davis Heath Department of Obstetrics and Gynecology, a doctor would typically offer a woman experiencing a second-trimester miscarriage several options to prevent infection, including labor induction or surgical evacuation—a standard abortion procedure. While Texas law has an exception for women experiencing a "life-threatening physical condition aggravated by, caused by, or arising from a pregnancy that, as certified by a physician, places the woman in danger of death or a serious risk of substantial impairment of a major bodily function unless an abortion is performed," Zurawski's doctors told her abortion would be off the table unless her daughter's heart stopped beating or Zurawski developed an infection so severe that her life became endangered.
"I knew I was going to lose my baby. And I knew it could be days—or weeks—of living with paralyzing agony before we could move forward," Zurawski wrote. Her limited options left her in an extremely difficult position. Zurawski lives in Austin, making the nearest abortion clinic, in New Mexico, an eight-hour drive away. To make matters scarier, infection can strike rapidly. "[Traveling] was off the table as soon as we knew that she could get sick quickly or she could go into delivery quickly," Zurawski's husband, Josh, told The Meteor in a separate interview.
Three days after her diagnosis, Zurawski developed sepsis, a life-threatening infection that allowed doctors to justify the early delivery of her now-stillborn daughter. "I thought, OK, let's get this horrific thing over where I have to deliver my daughter 22 weeks early, and then I'll go home, and we can start the healing process," Zurawski told The Meteor. "I don't think I understood at that point that I was septic, but I knew that it was more sick than I was supposed to be." Zurawski was admitted to the intensive care unit (ICU) after delivery.
"Tests found both my blood and my placenta teeming with bacteria that had multiplied, probably as a result of the wait. I would stay in the ICU for three more days as medical professionals battled to save my life," she wrote. "I didn't realize until nearly a month later that my doctors, nurses, and loved ones feared I was going to die."
Zurawski luckily survived her battle with sepsis. According to one study, the case fatality rate for pregnancy-related sepsis has been estimated to be as high as 8 percent. Further, her bout with the infection possibly left long-term damage to her uterus. "I'm having surgery to remove the massive amount of scar tissue plaguing my uterus as a result of the infections," Zurawski wrote. "We don't know yet whether the baby we want more than anything will ever be possible."
Stories like Zurawski's have piled up in recent months. Following the overturn of 1973's Roe v. Wade, 13 states have passed full abortion bans from conception. Five contain no exceptions for the mother's physical health, including Texas. In these states, state governments functionally deny doctors their ability to protect their patients in cases where miscarriage is inevitable and risk to the mother's life is high. "[The doctors] were just as furious as we were because their hands were tied," Zurawski told The Meteor.
Often, supporters of anti-abortion legislation claim that anti-abortion laws like Texas'— with exceptions allowing abortion to save a woman's life—would allow abortions in cases like Zurawski's. "While some laws contain definitions and exceptions that more explicitly speak to certain situations, each law reviewed does not prevent mothers from receiving the medical care necessary," wrote Mary Harned and Ingrid Skop of the Charlotte Lozier Institute, a pro-life group. "A plain reading of any of these statutes easily refutes the false and dangerous misinformation being spread by pro-abortion activists."
However, women have repeatedly claimed they were denied nonemergency, yet "lifesaving" abortions. For example, The 19th reports that, despite Ohio having an exception allowing abortions after six weeks to save the mother's life, affidavits from abortion providers in the state claimed that at least two women were denied abortions despite cancer diagnoses—a condition the Lozier Institute directly notes should "fall under exemptions for the 'life of the mother.'"
Most anti-abortion legislation is vague. And a vaguely written law with steep consequences for violators (life in prison in some cases), leaves both hospitals and doctors unwilling to risk prosecution—even if it means allowing a woman's preventable death. Zurawski describes a harrowing ordeal—the loss of her child. But what turned her ordeal into a life-threatening event was an unclear state law and the nervous hospitals and doctors such laws create.