Why Do Doctors in Louisiana Need an Abortion Restriction?” Physicians in 2023 Reveal The Problems of Women’s Health
Beyond going to prison, she said, doctors fear being harassed or ostracized from the institutions where they work, and the communities in which they live.
The report draws on interviews with 30 health care providers and 13 patients conducted in 2023, and was jointly supported by four groups that support abortion access: Physicians for Human Rights, the Center for Reproductive Rights, Lift Louisiana and Reproductive Health Impact.
Clapper has said in the past that the concerns of women’s health were created by abortion rights supporters.
The law allows for the treatment of miscarriages and no change has occurred in the care of these women since the ban was enacted, according to Benjamin Clapper.
The doctors in the report said that they considered leaving Louisiana. Others warned that a possible exodus of OB-GYNs would exacerbate the state’s existing shortage of obstetricians.
Louisiana already suffers from some of the highest rates of maternal mortality and morbidity in the nation. Black women in the state are more likely to die when they give birth as compared to white women.
Physicians interviewed in the report and those interviewed separately by NPR agreed that women’s health and their lives were being put at risk because of the abortion ban, especially Black and low-income women.
Another physician in the report couldn’t get their colleagues to agree to an abortion for a patient with a history of multiple C-sections, hemorrhaging and infections in past pregnancies.
“And I’m thinking, but what if she doesn’t want to wait that long because she could have a heart attack and die?” the OB-GYN said. “At what point can you act? How many cardiac meds have to fail?”
In one case, an OB-GYN treating a patient with severe heart failure was first required to prescribe multiple cardiac medicines before being allowed to offer an abortion.
These included pregnant women with cancer; patients with heart problems and kidney failure, who were on dialysis and hospitalized; and women who’d experienced life-threatening complications from previous pregnancies and found themselves pregnant again.
“We were stunned by just how much regular medical practice for pregnant people has been disrupted,” said Michele Heisler, the medical director of Physicians for Human Rights and one of the report’s authors.
“There are going to be deaths that didn’t have to happen. There are going to be severe complications that didn’t have to happen,” said Dr. Nicole Freehill, a New Orleans OB-GYN interviewed for the report.
A C-section is major abdominal surgery. NPR consulted three OB-GYNs who were not interviewed for the report, all of whom said a C-section in a case like this is not standard care. Compared to an abortion procedure or an induction, it carries far greater risks for increased hemorrhaging, compromised future fertility, and other complications.
“That is ridiculous, absolutely ridiculous,” said Freehill. “The least safe thing that we do, no matter if it’s early in pregnancy or full-term at your due date, is a C-section.”
Describing one of these cases, Dr. Michele Heisler with Physicians for Human Rights explained that the C-section was done “to preserve the appearance of not doing an abortion.”
The doctors said that patients who had a C-section in that circumstance would not be able to deliver vaginally and risked a damaged uterus in the future.
One OB- GYN from New Orleans didn’t want to be named because she feared talking publicly would hurt her relationship with her employer. “This is what’s in the best interest of…the physician in protecting themselves from criminal prosecution.”
In what doctors described as another serious deviation from standard medical practice, OB-GYNs in Louisiana are now delaying routine prenatal care until patients reach 12 weeks of pregnancy — the point at which the risk of miscarriage drops significantly.
Delaying pregnancy care into the second trimester can be dangerous for people who might have complications, such as a history of blood clots or an ectopic pregnancy that goes undiagnosed, doctors told NPR. Without treatment, some pregnancy-related problems can lead to birth defects, stroke, heart attack, or even death.
Physicians are also delaying treatment of miscarriage and ectopic pregnancy out of fear of breaking the law, the report found — as previously reported in news stories from states operating under abortion bans. Ectopic pregnancies — when the embryo implants outside of the uterus — are never viable, and they can even be deadly.
In another case, Sukhavasi had a patient in her first trimester who came to the hospital bleeding and in pain. The patient wanted an abortion procedure called dilation and curettage, or D&C, which uses suction to empty the contents of the uterus and stop the pain and bleeding.
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“Institutions don’t want the government coming down on them, accusing us of doing something wrong when what we’re doing is just providing essential health care that people are coming to us for,” she said.
Hospitals in rural areas are increasingly moving miscarrying patients to urban hospitals to avoid having to take care of them all. It is possible that denying treatment could violate the Emergency Medical Treatment and Labor Act.
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