Hospitals and ERs increasingly refuse to admit pregnant women
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https://www.theguardian.com/us-news/2024/apr/19/pregnant-women-denied-care-us-hospitals
Complaints that pregnant women were turned away from US emergency rooms spiked in 2022 after the US supreme court overturned Roe v Wade, federal documents obtained by the Associated Press reveal.
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The cases raise alarms about the state of emergency pregnancy care, especially in states that enacted strict abortion laws and sparked confusion around the treatment doctors can legally provide. -
@Axtremus said in Hospitals and ERs increasingly refuse to admit pregnant women:
https://www.theguardian.com/us-news/2024/apr/19/pregnant-women-denied-care-us-hospitals
One woman miscarried in the restroom lobby of a Texas emergency room as front desk staff refused to admit her to the hospital.
Was the miscarriage due to a refusal to admit? How far along was the pregnancy?
Another woman learned that her fetus had no heartbeat at a Florida hospital, the day after a security guard turned her away from the facility.
I'd like to hear the guard's side of the story. Ah, it's because she brought her kid to the ER with her.
And in North Carolina, a woman gave birth in a car after an emergency room couldn’t offer an ultrasound, and the baby later died.
"Couldn't" or "wouldn't?" There's a difference.
Then...
A woman who was nine months pregnant and having contractions arrived at the Falls Community hospital in Marlin, Texas, in July 2022, a week after the supreme court’s ruling on abortion. The doctor on duty refused to see her.
“The physician came to the triage desk and told the patient that we did not have obstetric services or capabilities,” hospital staff told federal investigators during interviews, according to documents. “The nursing staff informed the physician that we could test her for the presence of amniotic fluid. However, the physician adamantly recommended the patient drive to a Waco hospital.”
ER doc is understandably concerned about a patient who might be in labor. If she is in labor, and the hospital doesn't have OB services, what should he do - keep her in the ER and let her deliver there? Or, perhaps, go to a place that does have OB services? It's a 30 minute drive according to Google Maps.
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So, you're going into labor, or miscarrying.
Nothing says "good judgment" like going to a walk-in place in a strip mall without OB services.
Next to a Pedi-Spa.
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@George-K said in Hospitals and ERs increasingly refuse to admit pregnant women:
And...what is the relationship between these incidents and Dobbs?
The article explains that the incidents happened around the same time as Dobbs, and in states that enacted harsher abortion laws at that time.
I hope the journalist investigates the morgues to see if there was any activity there in those states at that time. The public deserves to know about any deaths which occurred around the time of Dobbs, in states with strict abortion regulations.
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@Horace said in Hospitals and ERs increasingly refuse to admit pregnant women:
the incidents happened around the same time as Dobbs
Ya know, I had a bowel movement around the same time as Dobbs.
Now, show me there's a correlation.
ETA: The article -
Complaints that pregnant women were turned away from US emergency rooms spiked in 2022 after the US supreme court overturned Roe v Wade, federal documents obtained by the Associated Press reveal.
The cases raise alarms about the state of emergency pregnancy care, especially in states that enacted strict abortion laws and sparked confusion around the treatment doctors can legally provide.
Has the state of emergency pregnancy care changed? Was this urgent care center doing obstetrical stuff before Dobbs? Something tells me..."no."
“It is shocking, it’s absolutely shocking,” said Amelia Huntsberger, an obstetrician/gynecologist in Oregon.
In Oregon...did Dr. H review the cases, or only the pearl-clutching narrative the Guardian provided? Do urgent care centers in Oregon do OB? Something tells me..."no."
Pregnant patients have “become ‘radioactive’ to emergency departments” in states with extreme abortion restrictions, said Sara Rosenbaum, a George Washington University health law and policy professor, adding: “They are so scared of a pregnant patient, that the emergency medicine staff won’t even look. They just want these people gone.”
With good reason. If you don't do OB, you're opening a huge can of worms. If an ER doc encounters a shoulder dystocia, or a previa and tries to deal with it. "See you in court, Doc. And I'll be sure to wheel in the CP 5 year old in a wheelchair who's drooling onto his shirt."
For Huntsberger, Emtala law was one of the few ways she felt protected to treat pregnant patients in Idaho, despite the state’s abortion ban. She left Idaho last year because of the ban, to practice in Oregon instead.
Ah, Dr. H left Idaho because she couldn't perform abortions. It apparently has nothing to do with turning away pregnant patients from urgent care centers.
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@Klaus said in Hospitals and ERs increasingly refuse to admit pregnant women:
I don't get it.
"Complaints that pregnant women were turned away from US emergency rooms spiked in 2022 after the US supreme court overturned Roe v Wade, federal documents obtained by the Associated Press reveal."
What is the (implied) connection here?
That Hospitals in states with abortion bans are concerned that medical treatments provided to pregnant birthing people would be seen as providing abortion service if the clump of cells didn’t survive.
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@LuFins-Dad said in Hospitals and ERs increasingly refuse to admit pregnant women:
That Hospitals in states with abortion bans are concerned that medical treatments provided to pregnant birthing people would be seen as providing abortion service if the clump of cells didn’t survive.
Sounds rather absurd to me, but maybe I'm missing something.
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@Klaus said in Hospitals and ERs increasingly refuse to admit pregnant women:
Sounds rather absurd to me, but maybe I'm missing something.
It's beyond absurd. And you're not missing anything.
The handful of stories they relate have nothing to do with Dobbs and everything to do with fear-mongering and misrepresenting facts.
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Univariate Fallacy.
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EMTALA
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@Jolly said in Hospitals and ERs increasingly refuse to admit pregnant women:
EMTALA
The article never explains how a standalone walk-in urgent care center is to treat a pregnancy-related emergency.
Hell, in the "old days," whenever we did an emergency c-section, I was the only one around to resuscitate, or intubate, the newborn. Hated it. It was such a relief when we started having a neonatologist on call for c-sections and other emergencies.
Now, should the urgent care center contract with a group of pediatricians/neonatologists to be on call..."just in case?"
Nonsense.
A woman who was nine months pregnant and having contractions arrived at the Falls Community hospital in Marlin, Texas, in July 2022, a week after the supreme court’s ruling on abortion. The doctor on duty refused to see her.
“The physician came to the triage desk and told the patient that we did not have obstetric services or capabilities,” hospital staff told federal investigators during interviews, according to documents. “The nursing staff informed the physician that we could test her for the presence of amniotic fluid. However, the physician adamantly recommended the patient drive to a Waco hospital.”
Note how they frame that...they explicitly do NOT say that the doc didn't check for amniotic fluid. He correctly advised her to travel 30 minutes to Waco.
“They are so scared of a pregnant patient, that the emergency medicine staff won’t even look. They just want these people gone.”
And rightly so. There's NOTHING THEY CAN DO, other than get sued when things go south. I wonder if the (unnamed) author has ever sat though a three-week trial as the defendant.
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@George-K said in Hospitals and ERs increasingly refuse to admit pregnant women:
“The nursing staff informed the physician that we could test her for the presence of amniotic fluid. However, the physician adamantly recommended the patient drive to a Waco hospital.”
WTF do the nurses know? Who is going to do the Fern test? That's a high complexity test according to CLIA, and is performed only by physicians and lab techs with appropiate education, training and documented proficiency.
If you've got nursing staff doing Fern tests, somebody needs to lawyer up.
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@Jolly said in Hospitals and ERs increasingly refuse to admit pregnant women:
EMTALA
https://www.theguardian.com/law/2024/apr/21/emtala-supreme-court-abortion
Justices to rule whether abortion bans should undo Emtala, the Reagan-era law requiring hospitals to treat emergency patients
EMTALA is also under court review in light of state abortion bans post Roe v. Wade.
The supreme court will hear oral arguments on Wednesday in a case called Idaho v United States. The case was brought after Idaho imposed a near-total abortion ban that allowed doctors to perform an emergency abortion only if a pregnant patient was on the brink of death.
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That law is in direct conflict with Emtala, which requires doctors to stabilize emergency patients so they won’t face severe health consequences – a radically lower standard than Idaho’s. Shortly after Roe was overturned, the Biden administration issued a guidance stating that the federal law pre-empts state abortion bans, ultimately suing Idaho over its ban. -
@Axtremus said in Hospitals and ERs increasingly refuse to admit pregnant women:
Justices to rule whether abortion bans should undo Emtala, the Reagan-era law requiring hospitals to treat emergency patients
What is a "hospital?"
Is an urgent care walk-in clinic a "hospital?" Presumably, there are no overnight beds, no surgery performed and no babies delivered.
emergency patients
What is an "emergency." If I don't have the ability to treat the situation at hand, am I obligated to do my best, or is it more prudent, as long as no life is in danger, to transfer to another location? If I'm having a heart attack, and the cath lab sees I need a CABG, should I just stay there, or be transferred to a place that does OHS?