Reproductive rights activists demonstrated outside the Supreme Court in Washington, DC on Monday.
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Jim Watson/AFP via Getty Images
The Supreme Court’s ruling on abortion issued Thursday is a narrow ruling that applies only to Idaho and sends the case back to the appeals court. Confusion among doctors in states that strictly prohibit abortion remains widespread.
The case concerns situations in which emergency doctors can terminate a pregnancy. Under Idaho law, performing almost all abortions is a misdemeanor unless the mother’s life is in danger. But what happens if pregnancy puts your health at risk? For now, these abortions can take place in Idaho emergency departments.
“Essentially, what we got is not much relief for people in Idaho or other states that ban abortion,” says Dr. Nisha Verma, an obstetrician-gynecologist in Atlanta. “Uncertainty persists about what will happen in the future.”
The federal government has a law known as the Emergency Medical Treatment and Active Labor Act – or EMTALA – which states that anyone who presents to the emergency room must be stabilized before being released or transferred. The Biden administration has argued that this should apply even if the treatment is an abortion, and the patient is in a state that prohibits abortion with very limited exceptions. The court, by 6 votes to 3, dismissed the case, without ruling on the merits.
Verma notes that the court did not establish that EMTALA was the norm throughout the country.
Exceptions to “mother’s life”
Idaho is one of six states that have banned abortion without providing exceptions for the mother’s health. The other states are South Dakota, Texas, Oklahoma, Arkansas and Mississippi, according to KFF, the health policy research organization.
Anti-abortion protesters gathered outside the Supreme Court on Wednesday, the day a copy of the Idaho ruling was accidentally posted on the court’s website.
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Anna Rose Layden/Getty Images
Returning the decision to the trial court, the ruling allows Idaho doctors to treat pregnancy complications in emergency rooms again, but perhaps only until the Ninth Circuit Court of Appeals rules on the case. It offers no such instruction in other states that have strict bans.
Idaho Attorney General Raul Labrador said he was optimistic about the appeals court decision. “The decision by the Ninth Circuit Court of Appeals should be easy,” he said at a news conference after the ruling. He was confident that Idaho law would prevail. “I remain committed to protecting unborn life and ensuring that Idaho women receive the medical care they need.”
Labrador said he has been in contact with doctors and hospitals across the state and acknowledged that doctors are concerned about being sued. “As long as (doctors) have a good faith judgment that the disease could lead to death, that (a patient’s) life could be in danger, even if it’s not immediate, they can perform the abortion.”
The Department of Justice, which filed suit against the state of Idaho, was also optimistic. “Today’s order means that, while we continue to litigate our case, Idaho women will once again have access to the emergency care guaranteed to them under federal law,” the prosecutor said General Merrick Garland in a statement. “The Department of Justice will continue to use every tool available to ensure that women in every state have access to this care. »
A quiet relief for an Idaho obstetrician-gynecologist
Dr. Sara Thomson, an obstetrician-gynecologist in Boise, was one of Health Secretary Xavier Becerra’s panelists at an event on reproductive rights Wednesday when Becerra’s press secretary shared news of the decision that had accidentally been posted on the Supreme Court’s website.
“I didn’t have my phone with me the entire time this event happened, I walked out of the building and I got 42 text messages about the whole thing,” Thomson says. “I’m starting to sort it out and process it. At first, of course, I was relieved when I saw the title, but my relief was mitigated by learning that this might just be another temporary decision.
For now, she and other Idaho ob-gyns have more clarity and legal certainty when treating patients facing emergencies early in pregnancy, she said, adding that they are still devastating conversations.
“I am relieved for the patients I will have to care for in the near future. I still find it tragic that pregnant women had to suffer emergency complications and their care was delayed or denied while our state fought this situation and the Supreme Court took six months to review the case,” says Thomson.
Idaho’s abortion law has also worsened the state’s doctor shortage. According to a recent report, nearly one in four obstetrician-gynecologists have left the state or retired since the law took effect, and hospitals are struggling to recruit new doctors. Three hospitals have closed their labor and delivery units in Idaho.
Disappointment everywhere
Lawyers and experts on both sides expressed frustration and disappointment that the Supreme Court failed to address the substance of the issues raised in the case.
“We urge the courts to uphold the availability of stabilizing emergency abortion care in every state,” Dr. Stella M. Dantas, president of the American College of Obstetricians and Gynecologists, wrote in response to the ruling. “We are truly disappointed that this decision provides no long-term legal clarity for doctors, no comfort and peace of mind for pregnant women living under abortion bans across the country, and no real protections for provision of evidence-based essential health care. care or for those who provide this care.
“The Supreme Court created this health care crisis by overturning Roe v. Wade and should have decided the issue,” wrote Nancy Northup, president and CEO of the Center for Reproductive Rights, which has filed lawsuits against the state representing dozens of patients who claim the abortion ban has harmed them. “Women facing serious pregnancy complications and the hospital staff who care for them need clarity now.”
Dr. Ingrid Skop, an obstetrician-gynecologist and director of medical affairs at the Charlotte Lozier Institute, an anti-abortion research organization, was also disappointed with the outcome. “Forcing physicians to end an unborn patient’s life through an abortion when there is no threat to the mother’s life is coercive, unnecessary and goes against our oath to do no harm,” she wrote in a statement. Her organization wrote a brief in support of the Idaho case.
A case in the “gray zone”
Patient stories published since Roe v. Wade The Supreme Court’s decisions, which were overturned in June 2022, illustrated the conflicts that can arise during pregnancy complications in states with very limited exceptions to abortion.
Jaci Statton, a 27-year-old from Oklahoma, had a partial molar pregnancy last year – a type of pregnancy that is not viable. Even though she was too nauseous to eat and was in danger of hemorrhaging, hospital staff wouldn’t give her an abortion. She lived too far from the hospital to wait at home.
Jaci Statton and her husband, Dustin, in an engagement photo in 2021. Jaci had a partial molar pregnancy and was not treated at the Oklahoma emergency room. She traveled to Kansas to have an abortion.
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Photography by Rachel Megan
Jaci Statton and her husband, Dustin, in an engagement photo in 2021. Jaci had a partial molar pregnancy and was not treated at the Oklahoma emergency room. She traveled to Kansas to have an abortion.
Rachel Megan Photography
The team at Oklahoma Children’s Hospital “was very sincere, they weren’t trying to be mean,” Statton told NPR last year. “They said, ‘The best we can tell you is to sit in the parking lot, and if something else happens, we’ll be ready to help you. But we can’t touch you unless that you crash in front of us or your blood pressure rises so high that you’re about to have a heart attack.” » She then filed a federal lawsuit against the hospital, but it was dismissed.
Reached this week, Statton explained that until she had to abort due to a pregnancy complication, she didn’t know it could happen. “I’ve always been pro-life — I didn’t even know there was a gray area,” she said. “A lot of people, especially in the more conservative states, I don’t think they know there’s a gray area. I think they think it’s very black and white. It’s either a good thing or it’s a bad thing. I think a lot of people need to be more educated about these kinds of things, like molar pregnancies, ectopic pregnancies, and serious genetic fetal abnormalities.”
She said state lawmakers dismissed what happened to her, which made her angry. “Oklahoma is a very proud state for being abortion-free, and I’m like, ‘Yeah, that’s really good for a pro-life (state), but at what cost to people in need? ‘”
News Source : www.npr.org
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