The law protecting women who want emergency abortions is the target of the U.S. Supreme Court case

Mylissa Farmer’s pregnancy was doomed. But no one would help her end it.

Over the course of a few days in August 2022, Farmer visited two hospitals in Missouri and Kansas, where doctors agreed that because the 41-year-old’s waters had broken just 18 weeks into her pregnancy, there was no chance of her would like. to a healthy child. Continuing the pregnancy could endanger Farmer’s health and life, but doctors could not act.

Weeks earlier, the U.S. Supreme Court had overturned Roe v Wade and struck down the nation’s right to abortion. One hospital’s legal counsel said it was “too risky to intervene in this heated political environment,” according to legal documents.

In immense pain and fear, Farmer eventually traveled several hours to Illinois, where abortion is legal. There doctors were able to terminate her pregnancy.

The farmer’s bill is detailed in a legal complaint she filed a complaint against the hospitals, arguing that they violated a federal law that requires hospitals to treat patients in medical emergencies. In a first-of-its-kind study, the The US government sided with Farmer and declared that the two hospitals had broken the law.

The future of the government’s ability to rely on that law to protect women seeking emergency abortions is now in question. The law, the Emergency Medical Treatment and Labor Act (Emtala), is at the heart of the U.S. Supreme Court’s latest abortion case. from Idaho.

On Friday evening, the Supreme Court announced that it would hear oral arguments in a case involving Emtala. Under the law, which dates to 1986, hospitals that receive federal Medicare dollars — the vast majority of hospitals in the U.S. — must stabilize people in emergency situations, regardless of their ability to pay. The Biden administration has argued that the law protects access to emergency abortions, while abortion enemies argue that it does not.

Emergency abortions, like Farmer’s, have taken center stage in the fight over abortion access after Roe v Wade, as dozens of women in the United States have come forward to say they were denied medically necessary abortions. The Emtala case, which the justices will hear in April, will add fuel to that fight because it raises questions about whether the federal government has any role in protecting citizens. doctors and patients who feel like they are at war with the state abortion ban.

“There are many physicians who, despite state abortion restrictions, still want to return and still want to serve the communities that need the care,” said Dr. Alexandria Wells, a gynecologist in Washington state and fellow at Physicians for Reproductive Health. “One of the arguments they had was Emtala, and the ability to say to the hospital administration, ‘There is a federal status that we have to provide this level of care.’ And so they were able to provide the care they knew patients needed.

Protesters march through downtown Boise, Idaho on May 3, 2022. Photo: Sarah A Miller/AP

“Without Emtala, I think many providers are concerned that facilities will be less afraid to say ‘no’” when abortions are needed in emergency situations, Wells added.

As part of its decision to hear the case, the Supreme Court agreed to let Idaho enforce a law that would ban nearly all abortions. below The state’s abortion ban means Idaho doctors who perform the procedure could face criminal consequences. In court, they can use an “affirmative defense” to argue that they only performed the abortion to save a patient’s life.

“Separating abortion from the rest of health care protected by Emtala means treating pregnant people differently than everyone else,” said Alison Tanner, senior counsel at the National Women’s Law Center, which is representing Farmer.

“Abortion may be necessary to save someone’s life. It is also sometimes necessary to save a person’s health and future fertility,” Tanner continued.

In Oklahoma, another woman, Jaci Statton, has also filed a complaint accusing a hospital of violating Emtala. In her complaint, Statton said she had been diagnosed with a partial molar pregnancy — a condition that would not result in a healthy baby and would endanger her life. An abortion would stabilize Statton, the complaint said, but one The Oklahoma hospital did not offer the procedure to Statton.

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Instead, providers of the The hospital “told Jaci they could not perform an abortion until she was actively collapsing in front of them or on the verge of a heart attack,” the complaint said. “In the meantime, the best they could offer was to let Jaci sit in the parking lot so she would be close to the hospital if her condition deteriorated further.”

Researchers at the University of California, San Francisco, are currently working on one ongoing study about how the demise of Roe has affected healthcare providers’ ability to meet America’s standard of care. A doctor in a state with an abortion ban described to researchers a case where: medical providers refused to even go near a patient who went into labor too early to deliver a healthy pregnancy. The situation was so bad, the doctor said, that they considered leaving the state.

“I will never forget this case because I heard the GP say to a nurse that offering a helping hand to a patient who is being put on a stretcher while in the throes of a miscarriage could be interpreted as ‘helping and incitement to an abortion’. “It is best not to even touch the patient who is having a miscarriage,” the doctor said, according to the preliminary findings of the study. “A gross violation of common sense and the oath I took when I entered this profession to alleviate the suffering of my patients.”

“This is no way to provide health care,” said Carole Joffe, a professor in the department of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco. Joffe is one of the authors of the study’s preliminary findings. “All these medical emergencies make it clear that pregnancy can be very dangerous and that it should of course be treated within the health care system.”

In helping to overturn Roe, U.S. Supreme Court Justice Brett Kavanaugh wrote in a unanimous opinion that Roe’s death “returns the court to a position of neutrality” on abortion and allows states to make their own decisions about how to conduct the procedure need to tackle.

However, that outcome did not materialize. Instead, a wave of abortion-related lawsuits has drawn federal courts, including the Supreme Court, back into the fray of the abortion wars. Last week, the famously conservative U.S. Court of Appeals for the Fifth Circuit upheld a Texas ruling finding that the Biden administration had overstepped its bounds when, shortly after overturning Roe, the administration issued guidelines claiming that Emtala should be among emergency abortions fell. (That case is not related to the Idaho case.)

Emtala, wrote Kurt Engelhardt, “does not mandate any specific form of medical treatment, let alone abortion.”

In December 2023, the U.S. Supreme Court also agreed to hear another abortion case involving the availability of abortion pills. The justices are likely to rule in both cases by the summer — just months before the 2024 presidential election, in which abortion will become a major issue.