Californian Woman Almost Died After Catholic Hospital Refused to Perform Emergency Abortion
Despite doctor's orders and state law, a Catholic hospital refused to perform an abortion on a woman because a fetal heartbeat could already be heard in her womb, writes New York TimesThis refusal almost cost the patient her life.
Anna Nusslock, 36, didn't expect a hospital in California, the most pro-choice state in the world, to refuse her an emergency termination.
In February of this year, Dr. Nusslock, a chiropractor in Eureka, California, went to the nearest emergency room at Providence St. Joseph Hospital after her water broke just 15 weeks into her pregnancy. Doctors told her that one of the twins she was carrying would definitely not survive, and the other had little chance. They warned that if the pregnancy was not terminated, there was a risk of infection, as well as bleeding, and she could be left sterile.
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But because the fetus's heartbeat could still be heard, the doctor at the Catholic hospital said the institution's policy was to not perform abortions unless the mother's life was in danger. A few hours later, Anna's husband took her to another nearby hospital, where she arrived bleeding: she was passing apple-sized blood clots, causing one of the fetuses to be expelled. The mother was then rushed to the operating room so that the other fetus could be removed.
Similar cases have occurred in states where abortion is illegal, but California Attorney General Rob Bonta said Dr. Nusslock's situation shows it can happen "even in California, a staunchly pro-choice state."
On Sept. 30, the attorney general filed a lawsuit against the company that runs Providence St. Joseph, saying the hospital violated a California law requiring hospitals with emergency departments to provide emergency care to prevent not just death but also “serious injury or illness.”
Officials in the attorney general's office say they believe this is the first lawsuit California has filed against a hospital under the Emergency Services Act, which says hospitals must provide care "necessary to alleviate or eliminate an urgent medical condition."
The hospital said in a statement: "Providence is deeply committed to the health and well-being of women, including pregnant patients, and provides emergency care to everyone who walks through our doors in accordance with state and federal laws. We are heartbroken by Dr. Nusslock's experience earlier this year. This morning, Providence first heard about the California Attorney General's lawsuit, and we are currently reviewing the documents to understand what it alleges."
California, which accuses the hospital of violating state civil rights and business conduct laws, is seeking a preliminary injunction immediately barring the hospital from following its policies while the case is pending.
"We don't want another Anna," Bonta said.
In its motion for an injunction, the state anticipates that the hospital could argue that changing its policy would violate its religious beliefs. The EMS Act makes no mention of religious or ideological beliefs. The state argues that a law intended to ensure equal access to health care trumps religious beliefs, and that in other cases, the California Supreme Court “has upheld laws requiring hospitals to provide health care even when it conflicts with religious beliefs.”
Dr. Nusslock, who spoke out in part out of concern about “access to health care for other women in the community,” said she and her husband, Daniel, were desperate to have a baby and had lost several previous pregnancies. After learning last November that she was pregnant with twin girls, the expectant mother made nursery decorations and knitted blankets, sweaters and hats for the girls.
"I was delighted and very excited," she admitted.
Because of her age, previous miscarriages and other factors, her pregnancy was considered high-risk, so in addition to her doctor in Eureka, she worked with maternal-fetal medicine specialists at the University of California, San Francisco, a five-hour drive from home.
In February, Anna learned that the pregnancy had characteristics that could increase risk. Soon after, she wrote in the lawsuit, she “began to experience severe cramping, pain, and bleeding.” Following her doctors’ advice, Anna visited Providence St. Joseph’s Hospital twice, which had the most advanced emergency room equipment in her area.
"Each time I was told that both fetuses had heart sounds and sent home despite bleeding and severe pain," Dr. Nusslock noted.
Later that month, Anna’s water broke while she was cooking dinner. She went to the doctor and a few hours later went to Providence Emergency Room with severe cramping and heavy bleeding. Medical records show she was diagnosed with premature rupture of membranes, which can quickly and suddenly lead to infection or bleeding. It’s one of several pregnancy complications for which abortion is the standard solution.
One of the twins had a ruptured amniotic sac that lost all its fluid, making survival impossible, the records say. Dr. Nusslock asked whether the other twin might survive. The Providence doctor consulted with the University of California, San Francisco, department of maternal-fetal medicine, which said the fetus had an “extremely low chance of surviving the pregnancy” and an “even lower chance” that it would be “neurologically intact.”
A maternal-fetal medicine specialist said trying to continue the pregnancy posed a grave risk to the mother’s health. He recommended terminating the pregnancy by inducing labor or performing an abortion. But the Providence doctor wrote that, because of hospital policy, he could not offer an abortion while the fetus’s heart was still audible. The Providence doctor recommended transporting Dr. Nusslock by helicopter to the University of California, San Francisco. But Anna says that would have cost $40, which her insurance would not cover. When she asked if they could drive to San Francisco, the doctor told her, “If you try to drive, you’ll bleed and die before you can get to someone who can help you.”
They eventually drove 20 minutes to Mad River Community Hospital. When Nusslock was discharged from Providence, a nurse, realizing that her condition could quickly deteriorate, gave her a bucket and towels “in case something happened in the car.”
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A Mad River doctor wrote in a court filing that Dr. Nusslock was “actively bleeding” and had lost significantly more blood than expected during a surgical procedure performed there. Later records noted that she likely had an infection in the placenta and amniotic fluid. She had treated other patients who had been denied abortions by Providence under similar circumstances. And Mad River’s maternity ward is set to close soon, making emergency medical abortions in the area even more limited.
Dr Nusslock has recovered physically, but says the stress she experienced has left her with insomnia and hair loss.
"This experience left me deeply traumatized. Since then, I have struggled with tremendous anxiety, grief, and depression," Anna wrote.
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