AUSTIN – A pair of Texas women have filed federal complaints against hospitals denying them termination of their ectopic pregnancies. The women say they nearly died and suffered loss of their fallopian tubes after repeatedly being turned away by the hospitals.
"For weeks, I was in and out of emergency rooms trying to get the abortion that I needed to save my future fertility and life," one of the women, Kyleigh Thurman said in a Monday statement.
"This should have been an open and shut case. Yet, I was left completely in the dark without any information or options for the care I deserved."
Physicians can terminate ectopic pregnancies under Texas law.
Texas law allows physicians to terminate pregnancies in cases such as these.
Ectopic pregnancies are one of the most common complications in women trying to conceive. According to the Cleveland Clinic, they occur in about two in every 100 pregnancies.
They occur when a fertilized egg grows outside the uterus, where it can't survive. Usually, the egg gets "stuck," in one of a woman's fallopian tubes (a "tubal ectopic pregnancy") connecting an ovary to the uterus. Left untreated, they can result in the loss of a fallopian tube, higher risks to women who try to conceive again. Ectopic pregnancies are nearly always fatal for the fetus, and can potentially be fatal for the mother, if they aren't treated.
Because they're so relatively common, they're usually easy to treat — often with a cheap, safe, widely-available drug called methotrexate, according to the American College of Obstetrics and Gynecology. The drug stops fetal cells from growing, terminating the pregnancy. The cells are then allowed to break down and pass safely.
Thurman, a 25-year-old woman from Burnet, Texas, was turned away at Ascension Williamson hospital in February, even though her OB-GYN told the hospital she probably had an ectopic pregnancy.
According to her complaint filed last week, Thurman experienced a month of nonstop bleeding, cramps, and dizziness. Her doctor didn't have medication in her office (the methotrexate), and instructed her to go to the emergency room — where she was informed the medication wasn't stocked.
Methotrexate in emergency rooms is most commonly used for ectopic pregnancies, but the medication can also be used to treat severe arthritis, psoriasis, and other conditions that can end up in hospitals.
Her local emergency room facility in Burnet County didn't stock the medication, requiring her to drive an hour to Ascension Seton Williamson in Round Rock.
The hospital found signs of a tubal ectopic pregnancy but discharged her, instructing her to return in two days.
She returned as instructed. The hospital found signs of a possible ectopic pregnancy after finding her uterus without a fetus — an intrauterine pregnancy. The hospital did not offer treatment.
Thurman's OB-GYN drove to the hospital herself to plead with staff for her patient to be given methotrexate as a treatment, according to the complaint.
But, by then, it was too late.
The ectopic pregnancy ruptured her fallopian tube just days later, leaving her bleeding heavily and in "blinding pain," according to the complaint.
She then received treatment, with surgeons removing her right fallopian tube to save her life — but reducing her chances of carrying to term in the future.
It was too late, her attorneys say. The ectopic pregnancy ruptured days later, leaving her bleeding heavily and in blinding pain. Doctors removed her right fallopian tube to save her life, the complaint said, effectively lowering her chances of having a successful pregnancy in the future.
Ascension Seton Williamson is part of one of the largest hospital chains in the country, a network of Catholic hospitals.
The central company, Ascension, has struggled with controversies over the last several years, including last year's nurses' strike and a 2022 New York Times investigation revealing systemic profiteering and cost-cutting during the COVID-19 pandemic (leading to numerous preventable deaths), and cuts in staffing, services, and medications carried by the hospitals despite the nominally nonprofit hospital chain sinking millions into wealth funds for executives.
Ascension Seton Williamson, which is part of a nationwide network of Catholic hospitals, declined to specifically address Thurman's allegations.
"While we cannot speak to specifics of this case, Ascension is committed to providing high-quality care to all who seek our services," a spokesperson for the hospital wrote in an email Monday to the Austin American-Statesman.
Nearly three hours away, Kelsie Norris-De La Cruz said she had a similarly harrowing experience at a hospital in Arlington – a city of roughly 400,000 people that sits halfway between Dallas and Fort Worth.
Norris-De La Cruz, a college student in her last year, suspecting she may be pregant, and, taking a test — it came back positive. She began planning for her baby.
Soon after, she began suffering from cramps, bleeding, and other systems, and attempted to seek treatment at Medical City Healthcare Center in Arlington. Staff told her she may have miscarried or may have an ectopic pregnancy, according to her complaint filed last week.
After enduring weeks of intense pain, she sought treatment at Texas Health Arlington. Physicians found a large mass near her uterus and other signs of an ectopic pregnancy. Her ER doctor told her she could choose between a methotrexate injection or surgery. She opted for surgery to try to prevent more bleeding, according to her complaint.
Then, per the complaint, two different on-call physicians "acknowledged that her pregnancy could rupture but still denied her medical care."
They instructed the woman to return in two days.
Records show they doubted her account of her sexual history and suspected she could be suffering a miscarriage from a new pregnancy as a result.
Convinced that Texas Health Arlington would not provide her care, the 25-year-old and her mother called an abortion clinic in New Mexico, which told them the treatment of ectopic pregnancies was legal in Texas, per the complaint.
They tried another OB-GYN that had been recommended to them by a friend, who then performed emergency surgery. The mass had grown so much that they had to remove most of Norris-De La Cruz’s right fallopian tube and roughly three-fourths of her right ovary, according to the complaint.
Norris-De La Cruz, as was the case with Thurman, now has a lower chance of successfully having a baby.
“The doctors knew I needed an abortion, but these bans are making it nearly impossible to get basic emergency health care," she said. "So, I’m filing this complaint because women like me deserve justice and accountability from those that hurt us. Texas state officials can’t keep ignoring us. We can’t let them.”
Texas Health Arlington hasn't responded to requests for comment as of this writing.
Both women argue that their rights under the Emergency Medical Treatment and Active Labor Act (EMTALA) were violated.
EMTALA ensures that anyone seeking emergency care at a hospital, regardless of their ability to pay, will be treated.
The Biden administration's guidance on emergency abortions, under which ectopic pregnancy termination may qualify, under EMTALA has been blocked in Texas since 2022 after Texas Attorney General Ken Paxton won an injunction in federal court against the order.
Paxton argued that the federal rule – which states that hospitals must terminate pregnancies when doing so is necessary to stabilize emergency patients – would force hospitals to provide abortions in cases when Texas law would not permit them.
Given the state's blocking of the new rule, it's unclear how EMTALA will apply, if at all, to the women's cases.
Molly Duane, attorney for both women, argues that EMTALA still requires hospitals to provide emergency termination of pregnancies when legal — including when a woman has an ectopic pregnancy.
"(EMTALA) is the most direct path towards getting this hospital in line and others in Texas in line as well," Duane told the Statesman in an interview Monday.
Duane noted the federal government can require noncompliant hospitals to provide proof that their policies and procedures will stop repeat incidents.
Texas' near-total abortion ban prohibits doctors from performing the procedure except when a patient faces "a life-threatening condition" that places them at risk of death or "substantial impairment of a major bodily function."
Physicians who are found guilty of violating the ban could face criminal penalties up to life in prison.
This has caused concern among physicians and other medical staff about how the state government is interfering with their ability to do their job — practice medicine.
Last year marked the beginning of an exodus of healthcare professionals from the state, and this year other states, namely New Mexico, are attempting to recruit doctors disillusioned with practicing in the state.
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