Georgia abortion law could limit care for pregnancy complications, some patients and doctors fear

Georgia’s recently enacted House Bill 481 has some patients who survived past life-threatening pregnancy complications and OB-GYNs worried the abortion restrictions may also limit medical care for patients who suffer a miscarriage or other serious complications.

Andrew Harnik / Associated Press

It’s been more than a month since a federal court enacted Georgia’s abortion law House Bill 481, banning nearly all abortions at about six weeks of pregnancy, when ultrasound machines can detect electrical pulsing in the womb and before many people know they are pregnant.

The law is already fueling fears in Georgia that it may also make it harder for some patients to access miscarriage management because the treatment uses the same procedures as abortion.  

Sitting in her office at work in Lithonia, Mykal Fraser remembers when things suddenly went wrong with her first pregnancy. 

“I sneezed and my water broke,” she said. “My amniotic fluid came out.”

This was several years ago. She was only four-and-a-half months pregnant. 

At the ER, doctors had bad news. Fraser was probably going to lose the baby — the baby she and her husband had wanted so much. 

To try and save it, her OB-GYN put her on bed rest at her home in Stone Mountain. Her mom came to keep her company and help out.                                                                                        

“And then a week later,” Fraser said, “that’s when I went to the bathroom and I saw that my umbilical cord was hanging out.”

She raced back to the hospital. This time the news was even worse. 

The fetus had died. And, doctors told Fraser she was at high risk for bleeding, infection, sepsis, hemorrhaging and death.

“And I have to move quickly,” she said, “so I have to make a split decision as to what I want to do”  

She could opt for a surgical abortion procedure called dilation and evacuation, or D&E, or have labor induced to deliver the dead fetus.

“I knew what delivery was, right? I knew that I would be awake, I knew that I would be pushing and I knew that, you know, there would be people in the room — and I knew I didn’t want that,” Fraser said. “I was already devastated by the loss and I just wanted it to be over with. And so, there was no doubt in my mind that I was going to have an abortion. No doubt, because the other way was inhumane to me.” 

She decided to travel to a surgical center for the abortion procedure to remove the fetal tissue from her uterus. 

mykal fraser
Mykal Fraser, 48, shown at her workplace with her face hidden. She survived life-threatening pregnancy complications and chose to undergo surgical miscarriage management. (Jess Mador/WABE)

Now, that choice may no longer be available for some patients experiencing miscarriage, said Atlanta OB-GYN Lisa Haddad, who also teaches at Emory University School of Medicine. 

She said the language in the new abortion law is too vague and confusing, especially for providers treating emergency complications.

“Now, at what point can you intervene?” Haddad said. “Do you have to wait until there’s no longer a heartbeat until you can go and save the mom’s life? If it’s a pre-viable pregnancy, do you have to wait until she actually shows signs of infection before you can do anything, or if she’s septic, wait until she’s at the point where she’s critically ill?”

The law includes exceptions for miscarriage and ectopic pregnancy and pregnancies deemed “medically futile.” 

But Haddad, a plaintiff in the ACLU of Georgia lawsuit challenging the state’s abortion law, said it lacks detail and creates too many gray areas for doctors.  

“I mean, that is not appropriate medical care,”  Haddad said. “And to be put in that situation where you can’t choose what’s right for your patient, which is what you’ve vowed to do, you’ve made an oath that you’re going to do what’s best for your patient, but you can’t do that, that puts you in a terrible conflict. And I think many people are not going to want to continue to provide care [in Georgia]. So that’s going to specifically impact those people who already have limited access to care.”

Anti-abortion advocates dismiss these concerns as overblown. 

Cole Muzio is president of the Christian organization Frontline Policy Action. He said the law is designed to prevent abortion. 

“This does nothing to harm women who are suffering a miscarriage or having a sort of medical emergency,” he said. “This law is abundantly clear that this applies to abortion and we are making sure that lives with beating hearts, including young women, are being protected.” 

And so far there have been no reported cases of patients or providers in Georgia being accused of violating the law. But there are examples in other states, like Texas, where for legal reasons some hospitals and doctors have turned away patients with pregnancy complications, putting them at further medical risk. 

But, Fraser said it’s not just the physical toll that abortion bans can exact on pregnant patients with complications. That’s why, she said, she decided to go public with her own story — to help advocate against Georgia’s abortion restrictions. 

“I just think that once we start passing these types of laws it’s a slippery slope, and I do think that we don’t consider the mental wellbeing of women in my situation, or any situation, when we put these types of stipulations and constraints on women,” she said. “I think it just is a grave injustice.”

Fraser said she knew abortion was the only choice she could live with after her miscarriage. And she wants other people in Georgia to continue to have the same option.