'Women are going to die'—docs outraged as Trump team scraps emergency abortion protections
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“How this ‘protects life,’ I will never understand … This sort of interference in life-saving medical decisions by politicians with no medical expertise whatsoever is unconscionable. It's part of the reason that OB/GYNs are leaving states with strict abortion bans, and putting women at even higher risk of other OB complications.” — OB/GYN Karen Tang, MD @karentangmd
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The Trump administration just rescinded federal guidance directing hospitals to provide emergency abortions under the Emergency Medical Treatment and Active Labor Act (EMTALA), even in states with strict abortion bans.[]
“This action sends a clear message: the lives and health of pregnant people are not worth protecting,” said Jamila Perritt, an OB/GYN and President and CEO of Physicians for Reproductive Health in a June 3 press release.[]
This move has sparked concern among healthcare providers and reproductive rights advocates regarding the potential risks to pregnant patients who are facing life-threatening conditions.
Doctors react
Doctors commenting under an Instagram post from NPR about the news are expressing anger and confusion about the policy shift. OB/GYN Karen Tang, MD, wrote, “How this ‘protects life,’ I will never understand. As a board-certified OB/GYN, this sort of interference in life-saving medical decisions by politicians with no medical expertise whatsoever is unconscionable. It's part of the reason that OB/GYNs are leaving states with strict abortion bans, and putting women at even higher risk of other OB complications.”
“We just did a rupture ectopic pregnancy surgery emergency overnight at 12am over the weekend. A 22 yo female who was scared to death and crying her eyes out the whole time up to induction of anesthesia. Are you telling me now we have to watch her die? Bc she can’t get this life saving emergency surgery?” said Betelehem Asnake, MD, MS (@dr.beti).
History of emergency abortion care in the US
EMTALA, enacted in 1986, ensures that all patients, regardless of their ability to pay, receive services and treatment.[] Following the Supreme Court's 2022 decision to overturn Roe v. Wade, the Biden administration issued guidance clarifying that EMTALA obligates hospitals to perform abortions when necessary to stabilize a patient's emergency medical condition. This guidance aimed to ensure that patients experiencing severe complications, such as ectopic pregnancies, receive timely and appropriate care.
Policy reversal and its implications
The recent revocation of this guidance by the Trump administration removes the federal directive that hospitals must provide emergency abortions in life-threatening situations. While EMTALA remains in effect, the absence of explicit federal guidance may lead to increased uncertainty among healthcare providers, particularly in states with strict abortion laws.
Physicians may now face legal ambiguities when determining the permissibility of performing emergency abortions, potentially delaying critical care for patients.
Former Missouri Senator Claire McCaskill underscored the gravity of the situation, warning that "women are going to die because of this."[]
The dangers of such policy changes are exemplified by the case of Kyleigh Thurman, who suffered a life-threatening ectopic pregnancy.[] A federal investigation found that a Texas hospital violated EMTALA by discharging her without appropriate treatment, leading to emergency surgery and the loss of part of her reproductive system. This incident underscores the potential risks to patient health when emergency abortion care is not clearly mandated and accessible.
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Related: NY gov says she'll protect doc implicated in first-of-its-kind legal battleThe revocation of the guidance places physicians in a challenging position, balancing their ethical duty to provide necessary care against potential legal repercussions. In states with restrictive abortion laws, the lack of clear federal directives may lead to hesitation in providing emergency abortions, even when medically necessary. Healthcare providers must navigate these complexities, often without clear legal protections, which can impede their ability to deliver timely and effective care.