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How hospitals decide what qualifies as a life threatening emergency to allow abortion


Most states that ban abortion have exceptions for medical emergencies or for preserving the life of the mother. But since the Supreme Court overturned Roe v. Wade last June, there have been many cases where doctors weren't sure how to apply those exceptions. NPR's Selena Simmons-Duffin is here to tell us about how this is playing out in Oklahoma. Selena, hi.


BLOCK: So Oklahoma is a Republican-controlled state. It's got a governor who is staunchly opposed to abortion rights. What is the law there now?

SIMMONS-DUFFIN: Well, there are currently three overlapping abortion bans with different definitions and exceptions. So it gets pretty confusing. One law comes with felony charges and up to five years in prison for providers, so the stakes for interpreting the laws correctly are real for doctors and hospitals. And one of the big issues is how to understand the life exception.

BLOCK: And walk us through that. What is the confusion there about how to interpret that?

SIMMONS-DUFFIN: It kind of seems like a simple thing at first, but it's actually not. So let me give you an example. Jaci Statton is 25. She's a stay-at-home mom of three in central Oklahoma. In February, she learned she had a type of molar pregnancy in which some of the tissue was cancerous. Her OB-GYN told her she could hemorrhage or even die.

BLOCK: Which is a terrifying prospect. What happened next for Jaci Statton?

SIMMONS-DUFFIN: Well, she had trouble getting care. The treatment for a patient in her condition is a dilation and curettage, or D&C, which is an abortion procedure that clears pregnancy tissue from the uterus. Her OB-GYN would not give her that treatment. She was transferred to another hospital and another, and no one would provide the D&C. At one hospital, Jaci Statton said staff told her this.

JACI STATTON: They said, the best we can tell you to do is sit in the parking lot, and if anything else happens, we will be ready to help you. But we cannot touch you unless you are crashing in front of us or your blood pressure goes so high that you are fixing to have a heart attack.

SIMMONS-DUFFIN: She ended up having to leave the state for treatment, which gives you a sense for how stuck Oklahoma providers are when it comes to navigating these medical exceptions.

BLOCK: And, Selena, do you have a sense of the bigger picture of how those policies are playing out for other patients around Oklahoma?

SIMMONS-DUFFIN: Well, yeah, there's actually new research out today that gives a sense of that. So researchers surveyed hospitals in the state on their abortion policies using what's called a mystery shopper research methodology. So basically, several young women called 34 hospitals in Oklahoma with a script saying they were pregnant for the first time, trying to decide which Oklahoma hospital to go to for care and wanted to understand the hospital's policies and processes for providing abortions if complications arose during the pregnancy.

BLOCK: So they called 34 hospitals.


BLOCK: What did they find?

SIMMONS-DUFFIN: Well, basically a lot of confusion. Most hospitals could not provide any information about the policies. Three said they would never provide an abortion in any circumstance. These researchers were also told some really concerning things. I talked to Dr. Michele Heisler, professor at the University of Michigan and medical director of Physicians for Human Rights, who was one of the study's authors.

MICHELE HEISLER: In one of the hospitals, a person was trying to be reassuring. And she said, oh, well, you know, in the case of a medical emergency, we would try to use the woman's body as an incubator to just try to keep the pregnancy going as long as possible.

SIMMONS-DUFFIN: The full findings were published today, along with a commentary, in the Lancet Medical Journal.

BLOCK: And, Selena, any response from hospitals in Oklahoma about those findings?

SIMMONS-DUFFIN: Well, the Oklahoma Hospital Association did not provide anyone for an interview. Oklahomans for Life did not respond to my request for comment. There's ongoing legislation and court cases in Oklahoma, but it is a very conservative state. So it's not likely there will be significant changes to abortion laws there anytime soon.

BLOCK: That's NPR's Selena Simmons-Duffin. Selena, thanks for your reporting.

SIMMONS-DUFFIN: Thank you. Transcript provided by NPR, Copyright NPR.

Selena Simmons-Duffin reports on health policy for NPR.