Bleeding and in pain, Kyleigh Thurman didn’t know her doomed pregnancy could kill her.
Emergency room doctors at Ascension Seton Williamson in Texas handed her a pamphlet on miscarriage and told her to “let nature take its course” before discharging her without treatment for her ectopic pregnancy.
When the 25-year-old returned three days later, still bleeding, doctors finally agreed to give her an injection to end the pregnancy. It was too late. The fertilized egg growing on Thurman’s fallopian tube ruptured it, destroying part of her reproductive system.
That’s according to a complaint Thurman and the Center for Reproductive Rights filed last week asking the government to investigate whether the hospital violated federal law when staff failed to treat her initially in February 2023.
“I was left to flail,” Thurman said. “It was nothing short of being misled.”
The Biden administration says hospitals must offer abortions when needed to save a woman’s life, despite state bans enacted after the Supreme Court overturned the constitutional right to abortion more than two years ago. Texas is challenging that guidance and, earlier this summer, the Supreme Court declined to resolve the issue.
More than 100 pregnant women in medical distress who sought help from emergency rooms were turned away or negligently treated since 2022, an Associated Press analysis of federal hospital investigations found.
Two women — one in Florida and one in Texas — were left to miscarry in public restrooms. In Arkansas, a woman went into septic shock and her fetus died after an emergency room sent her home. At least four other women with ectopic pregnancies had trouble getting treatment, including one in California who needed a blood transfusion after she sat for nine hours in an emergency waiting room.
Abortion bans complicate risky pregnancy care
In Texas, where doctors face up to 99 years of prison if convicted of performing an illegal abortion, medical and legal experts say the law is complicating decision-making around emergency pregnancy care.
Although the state law says termination of ectopic pregnancies isn’t considered abortion, the draconian penalties scare Texas doctors from treating those patients, the Center for Reproductive Rights argues.
“As fearful as hospitals and doctors are of running afoul of these state abortion bans, they also need to be concerned about running afoul of federal law,” said Marc Hearron, a center attorney. Hospitals face a federal investigation, hefty penalties, and threats to their Medicare funding if they violate the federal law.
The organization filed complaints last week with the Centers for Medicare and Medicaid Service alleging that different Texas emergency rooms failed to treat two patients, including Thurman, with ectopic pregnancies.
One complaint says Kelsie Norris-De La Cruz, 25, lost a fallopian tube and most of an ovary after an Arlington, Texas, hospital sent her home without treating her ectopic pregnancy, even after a doctor said discharge was “not in her best interest.”
“The doctors knew I needed an abortion, but these bans are making it nearly impossible to get basic emergency healthcare,” she said in a statement. “I’m filing this complaint because women like me deserve justice and accountability from those who hurt us.”
Conclusively diagnosing an ectopic pregnancy can be difficult. Doctors cannot always find the pregnancy’s location on an ultrasound, as three doctors consulted for this article explained. Hormone levels, bleeding, a positive pregnancy test, and an ultrasound of an empty uterus all indicate an ectopic pregnancy.
“You can’t be 100% — that’s the tricky part,” said Kate Arnold, an OB-GYN in Washington. “They’re literally time bombs. It’s a pregnancy growing in this thing that can only grow so much.”
Texas Right to Life Director John Seago said state law protects doctors from prosecution for terminating ectopic pregnancies, even if a doctor “makes a mistake” in diagnosing it.
“Sending a woman back home is completely unnecessary, completely dangerous,” Seago said.
But the state law has “absolutely” made doctors afraid of treating pregnant patients, said Hannah Gordon, an emergency medicine physician who worked in a Dallas hospital until last year.
She recalled a patient with signs of an ectopic pregnancy at her Dallas emergency room. Because OB-GYNs said they couldn’t definitively diagnose the problem, they waited to end the pregnancy until she came back the next day.
“It left a bad taste in my mouth,” said Gordon, who left Texas hoping to become pregnant and worried about the care she’d receive there.
“Oh my God, I’m dying”
When Thurman returned to Ascension Seton Williamson a third time, her OB-GYN told her she’d need surgery to remove the fallopian tube, which had ruptured. Thurman, still heavily bleeding, balked. Losing the tube would jeopardize her fertility.
Her doctor told her she risked death if she waited any longer.
“She came in and she’s like, you’re either going to have to have a blood transfusion, or you’re going to have to have surgery or you’re going to bleed out,” Thurman said, through tears. “That’s when I just kind of was like, ‘Oh my God, I’m, I’m dying.’”
The hospital declined to comment on Thurman’s case, but said in a statement it “is committed to providing high-quality care to all who seek our services.”
In Florida, a 15-week pregnant woman leaked amniotic fluid for an hour in Broward Health Coral Springs’ emergency wait room, according to federal documents. An ultrasound revealed the patient had no amniotic fluid surrounding the fetus, a dangerous situation that can cause serious infection.
The woman miscarried in a public bathroom that day after the emergency room doctor listed her condition as “improved” and discharged her, without consulting the hospital’s OB-GYN.
Emergency crews rushed her to another hospital, where she was placed on a ventilator and discharged after six days.
Abortions after 15 weeks were banned in Florida at the time. Broward Health Coral Springs’ obstetrics medical director told an investigator that inducing labor for anyone who presents with pre-viable premature rupture of membranes is “the standard of care, has been a while, regardless of heartbeat, due to the risk to the mother.”
The hospital declined to comment.
In another Florida case, a doctor admitted state law had complicated emergency pregnancy care.
“Because of the new laws ... staff cannot intervene unless there is a danger to the patient’s health,” a doctor at Memorial Regional Hospital in Hollywood, Florida, told an investigator who was probing the hospital’s failure to offer an abortion to a woman whose water broke at 15 weeks, well before the fetus could survive.
Troubles extend beyond abortion ban states
Serious violations that jeopardized a mother or her fetus’ health occurred in states with and without abortion bans, the AP’s review found.
Two short-staffed hospitals — in Idaho and Washington — admitted to investigators they routinely directed pregnant patients to other hospitals.
A pregnant patient at a Bakersfield, California, emergency room was quickly triaged, but staff failed to realize the urgency of her condition, a uterine rupture. The delay, an investigator concluded, may have contributed to the baby’s death.
Doctors at emergency rooms in California, Nebraska, Arkansas, and South Carolina failed to check for fetal heartbeats or discharged patients who were in active labor, leaving them to deliver at home or in ambulances, according to the documents.
Nursing and doctor shortages, trouble staffing ultrasounds around the clock, and new abortion laws are making the emergency room a dangerous place for pregnant women, warned Dara Kass, an emergency medicine doctor and former U.S. Health and Human Services official.
“It is increasingly less safe to be pregnant and seeking emergency care in an emergency department,” she said.
Former Olympic runner Alexi Pappas recently revealed she froze her eggs in her early 30s because she wanted to buy herself time. To empower others to be proactive to preserve their fertility, she wrote in Outside, "I encourage any woman, whether you are single or partnered, whether you think you know what you want in the next five years or you have no idea, to consider freezing your eggs."
Pappas isn't the only top athlete to prioritize her fertility. Several other Olympians have followed this same proactive path, fearing age could impact their ability to build a family. This includes hurdler Lolo Jones, who froze her eggs in 2022, and four-time Olympic gold medalist in bobsledding, Kallie Humphries, who froze her eggs and underwent IVF in 2021.
This is a growing trend among young women under 38 who are planning ahead with cryopreservation of their eggs, and according to experts, it's the best way to ensure future motherhood. I wish I had done the same.
When I was single in my 20s, my career and social life took priority, and I didn't even think about trying to conceive. My mother got pregnant without any need for medical intervention, so I was surprised when my husband and I wound up struggling with infertility for a decade.
During that time, I endured over a dozen fertility cycles, close to 40 gynecological procedures, and suffered four recurrent miscarriages in one year. Then, when I finally became pregnant with my son, I was labeled as being "advanced maternal age" and having a "geriatric pregnancy" due to being almost 40. This required additional monitoring and caused unexpected complications during pregnancy. If I'd frozen my eggs when I was younger, I would have had an easier path to motherhood.
While there are risks associated with the preservation process, this proactive method increases the likelihood of pregnancy and birth. In an NYU Langone study, 70 percent of women who yielded a rate of 20 oocytes or higher carried a child full term. The author of the study, James Grifo, MD, PhD, also indicated that multiple retrieval procedures increased success rates.
"The earlier you freeze your eggs, the better the quality will be," endocrinologist Jaime Knopman, MD, tells PS. "You will get more and they will have more potential for success," Dr. Knopman adds. "I always compare them to lottery tickets. When you are young and you freeze your eggs, it's like someone whispering the first three numbers in your ear; that increases your chances to win. As you get older, it's as though you have no intel, so your chances of winning go down."
Even though she ended up raising me alone, my mother believed in the traditional values of "settling down," getting married, and then having a child. I saw firsthand how hard being a mom was after my parents divorced. It solidified my intent to wait until I had a partner to raise a family.
I also assumed it would be easy for me to conceive, knowing my mom got pregnant right away at 22. When I was in high school and college, she advised me to protect myself by using contraceptives to avoid an unwanted pregnancy, so I tried a combination of the birth control pill and condoms. I was so focused on not getting pregnant too soon, that I never even considered what to do if I couldn't get pregnant when the time was right. That is until I couldn't conceive naturally on my own.
My perspective has changed since then, based on what I know now: freezing your eggs earlier increases your chances of having a baby and could prevent exhausting and expensive procedures, not to mention the heartache of infertility and pregnancy loss.
When I started IVF, I thought it would be a quick solution, but it didn't work right away. It took years of IUIs and then IVF to finally have our first child. We returned to try for our second, and once again my high expectations were shattered.
After another few years of failed cycles and recurrent miscarriages, I was thrilled to welcome my second child at 39. Due to my age, I had to be monitored by both an ob-gyn and a maternal-fetal medicine doctor for the entire pregnancy. It was anxiety-inducing and I wish I had frozen my eggs earlier; it could have prevented the prolonged treatments and factors that come with a high-risk pregnancy.
"As we age, our eggs get worse at repairing DNA, which leads to aneuploidy, a genetic abnormality," says embryologist Alease Barnes, BS. "Over the age of 35 our rate of chromosomal conditions such as trisomy 21, 18, and 13 rise in probability." These conditions can result in pregnancy loss, as well as a range of disabilities including Down syndrome.
As a result, egg freezing is becoming more common. The National Institute of Health found in January 2024 that women are "driven by feelings of fear" to freeze their eggs, which saw an increase during the pandemic. This concern is based on several factors, including age impacting egg quality, lack of a suitable partner, and the potential threat of access to fertility treatment.
This approach, referred to as "social egg freezing" by the NIH, affords women the opportunity to "finish their studies, become financially stable, and achieve their professional goals." It's no surprise then that there was a 400 percent increase in the rate of egg freezing between 2012 and 2020, according to a study in the Society of Assisted Reproductive Technology originally reported by The New York Times in 2022.
Egg retrievals cost between $8,000 and $15,000 per cycle, while storage fees can run from $500 to $1000 per year if you have to pay out of pocket. Some insurance plans now pay for IVF and fertility preservation coverage, depending upon your plan and the state you live in, although we should fight for more coverage. And yet, despite the financial and emotional costs, this uptick shows that more are taking control of their fertility, in hopes of having a better chance later on, once they are ready to conceive.
While I'm grateful for my two beautiful children, I wish I could have frozen my eggs years sooner. Alexi Pappas and these other Olympians have the right idea. I urge women to consider the option of cryopreservation, as early as they can. If you can afford it, it's worth the price to preserve your chance at motherhood.