Doctors in Alabama Already Turn Away Miscarrying Patients. This Will Be America's New Normal.

[Nevilledog]

Link to tweet

https://slate.com/news-and-politics/2022/05/roe-dobbs-abortion-ban-reproductive-medicine-alabama.html

If you want to understand the future of medical care for pregnant women in a post-Roe world, look no further than what is happening in Alabama. As others have pointed out for Slate, the leaked draft majority opinion in Dobbs v. Jackson Women’s Health Organization paves the way for criminalizing many aspects of pregnancy. While Texas’ abortion ban, S.B. 8, has essentially halted all abortions in the state, Alabama offers a glimpse of a troubling future in which the provision of medical care for pregnant people is deeply intertwined with the cultural attitudes that seek to criminalize “undesirable” pregnancy outcomes.

In the summer of 2020, I got a firsthand experience of these attitudes in action. Three weeks after starting to practice at West Alabama Women’s Center, my application for a medical license was denied and my temporary medical license revoked for what we can’t help but question may have been political reasons. Although I had been hired to offer general gynecological care, the Women’s Center has historically been known as an abortion clinic, and I am open on social media about my views that abortion should be on demand. Because of the eight-month-long process to reverse and reinstate my license, I did not begin to understand how dire health care access was in Alabama until I was able to practice medicine in March 2021.

I was astounded by how often patients were turned away from emergency rooms and their doctor’s offices in the middle of their miscarriages. No wonder Alabama has the third-highest maternal mortality rate in the nation, I initially thought. People are denied urgent medical attention outright, which left me wondering at first if health care providers were simply negligent and not keeping up with their medical education. Or was this lack of care a reflection of discrimination? Eventually, I landed on discrimination as the cause.

But I was wrong. The reality is much worse. Instead, these medical professionals seem to know what they are supposed to do, but choose not to.

I came to this realization when I saw a patient in active miscarriage (bleeding, passing clots, cramping) who had just had an office visit with her primary physician. She was forced to wait more than 48 hours in order to get the results of her bloodwork. Doctors will sometimes check a patient’s levels of HCG, or human chorionic gonadotropin, to help distinguish miscarriages from ongoing pregnancies or ectopic pregnancies. I could not understand why someone with all of the clinical signs of a miscarriage in progress was required to wait for much-needed intervention, all the while bleeding and cramping and suffering.

*snip*

[Aristus]

1. Well, we knew that was going to happen.

Alabama is just a Third-World country with better wi-fi.

[RKP5637]

3. And working on being Fourth-World. n/t

[LastDemocratInSC]

4. A clever and accurate characterization.

[Demsrule86]

6. I almost died in Georgia because of a miscarriage. I had felt unwell all day and went to

to my doctor's office-I knew I was miscarrying and had gone to the hospital before where I had an ultrasound that showed the 'baby' was gone and bloodwork. I was devastated as I really wanted this baby. My doctor was a right to life asshole but I didn't know. I was informed by his office that until my hormone levels dropped nothing could be done. It can take days perhaps even weeks for hormone levels to drop...I had a D&C the last time I miscarried as I was bleeding excessively...so there was a history there. I went home having no other choice. That evening I hemorrhaged in my kitchen and passed out basically...in and out of consciousness. My then eight-year-old ran to a neighbor's house who came immediately. She and her husband decided to put me blood and all in their car fearing an ambulance would take too long.

This was near Atlanta and gridlock was an everyday event. Another neighbor came and took my kids home with her. I was taken to the hospital and I remember getting there...and being told I had to wait for the blood tests (hormone levels) and nothing would be done until then...no IV, nothing. That is the last thing I remember clearly.

My husband was out of town and had gotten on a plane when I called him earlier after the doctor's visit. He later said he had a bad feeling and left immediately. He arrived at the hospital maybe 1/2 hour after I did. He fired the doctor and screamed the place down and Ombudsmen came immediately took one look at the blood I was lying in a puddle of blood and it was dripping on the floor in large puddles as well He called for a different doctor who saved my life with an immediate D&C-I thought I was going to die at the time I already had three kids at home. I needed multiple transfusions and platelets too...I was in the hospital for several weeks and I was left infertile. And you know what? I was lucky. Under the current law in Georgia, I would have died.

[Hekate]

10. I'm so sorry this happened to you

What a ghastly experience.

[StevieM]

12. That story is incredible. And horrifying.

I can't believe the world that we are about to head into.

[Lonestarblue]

29. I'm so sorry you went through this. Some Republicans have called for outlawing D&Cs.

The thing that helped save your life! Many women who have miscarriages need D&Cs. The risks of not doing one are heavy bleeding or prevention of full expulsion of fetal cells and tissue, potentially leading to infection and sepsis.

All these issues need to be brought out in the open so we can wake people up make a case for stopping right-wing politicians from taking away the right of all women to good medical care. We do not need ill-informed politicians (or Supreme Court justices) making medical decisions.

[wryter2000]

15. Are you sure the wi-fi is better? n/t

[RKP5637]

2. The message in Alabama is go home and die! Other states will follow. Some of us remember the 50's

and what happened.

[Darwins_Retriever]

5. Here is a new business opportunity

A company staffed with OB/GYNs and med students. When a woman is having a miscarriage, doctors contract with the company to provide witnesses to provide 2nd opinions and watch the procedures they do. Then if there is a legal issue, they can be a witness.

[ck4829]

7. Welcome to dystopia

[Turbineguy]

8. Part of a republican plan

to turn the US into a shit-hole country.

If they are going to be in power, which is what they want, they have to have a country they can govern.

[durablend]

24. They want a country they can RULE.

FTFY

[Hekate]

9. A woman can die of a miscarriage. My mother almost bled out & needed emergency surgery...

Had an out of body experience and everything.

Have I mentioned yet today how very much I hate these fanatics? Yes, yes I have.

[ancianita]

14. ...

Who's counting? It can't be said too many times, imo

[Solly Mack]

11. K&R

[ancianita]

13. "First, do no harm." Either doctors made an oath to their profession & the law, or to a corporation.

Though doctors are under corporate umbrella networks, one miscarriage-turnaway death will eventually lead to a lawsuit and loss of a medical license. Maybe it won't be the first or even many after, but it will happen.

[wryter2000]

18. I worked in the legal department of a large medical center

I never saw a doctor lose his/her license. I saw many who had to write letters to the medical board to explain their behavior. After that, some had to be interviewed. One even had to go to some training. None ever lost their licenses. That could have been different if they'd broken a law. Maybe they can lose their license for breaking the law.

I'm not sure you could sustain a malpractice claim if there's a law against doing what's right for a patient. For a successful suit, a doctor has to breach the standard of care. What's the standard of care in a state where performing the necessary procedure is against the law? I honestly don't know.

[ancianita]

25. I'm not surprised, doctors being under a medical center's tort liability umbrella. Still,

Isn't HIPAA adhered to by medical centers?
And If a patient could get expert legal advice and medical evidence, why couldn't they prove cause-effect and win a medical tort case based on standard of care law, which is federal, right?

United Healthcare (which I call the Great Satan) has lost cases and paid the highest punitive damages on record; admittedly I don't know the the details of that, yet I've heard that doctors do feel trapped in being overridden by the insurance death panel bureaucracies they work in. I know mine up in Illinois did.

And now re women's health care, they face potential liability for living up to their Hippocratic Oath?

[wryter2000]

26. I don't know if they'd be subject to malpractice

For giving the right care, but if they break it law, they could be tried for that. I suspect they’d be in jeopardy of losing their licenses.

[wryter2000]

27. Medical boards are run by states

Not the federal government.

And standard of care isn’t a law. It’s an agreed upon standard among doctors on how patients are to be treated.

[ancianita]

28. Okay. Fair enough. Then I hope the best recourse for death & suffering the system causes women

& those who love them, will be to vote out the corporate capture of abortion rights by voting in candidates who vow to pass Medicare For All and the ERA, which already stands as ratified.

[wryter2000]

16. One of the commentators on MSNBC

Spoke about his wife's miscarriage. They wanted the baby, but something went wrong, and her water broke after 4 months. The doctor sent her home to have a miscarriage. It hadn't happened by the next day, so they went back. He sent her home again, and she still didn't miscarry. When they went back, the doctor told them he'd have to get permission from the hospital to perform an abortion because he was still getting a "heartbeat." Later the doctor left a message on their machine that he'd been denied permission and that they should find another doctor to perform the procedure immediately or she could lose her uterus or her life.

I presume they found another doctor and got the care she needed. In a situation like this, there's no way they can go to another state for help.

How many women are going to die because of this? Will anyone even give a damn?

[BlueSky3]

17. Yes, I will and

so will millions of others. We need to get these stories out to people who will understand. I've already been grieving for the women who are dying now and those who will die.

[wryter2000]

19. Of course, you will, as will everyone here

I guess I was talking about the anti-choice voters and politicians. Badly worded on my part. Welcome to DU, if no one's said that yet.

[BlueSky3]

23. Thanks, wryter,

I've been here ten years -- it's taken me this long to get a couple hundred posts. But I appreciate the welcome, and I really appreciate posts like yours.

[Raftergirl]

20. Just another reason never to live

in these shithole red states.

[milestogo]

21. The idea that a hospital or clinic would turn away a patient who is miscarrying

is outrageous and immoral.

Very Graphic Pictures of women bleeding out should be sent to the evil ones on our Supreme Court and in Congress. They are murderers.

[smirkymonkey]

22. What the ever loving fuck?!

This is a death sentence for many pregnant women! I honestly can't believe this is happening. Arghhhhh!

[Texaswitchy]

32. Knew this would happen.

Wouldn't take long.

Said the same thing on Twitter and was kicked off for 12 hours.

Some RW type got upset.