Exemptions: Conditions where it is necessary to avoid serious risk for death or a serious risk of a life-threatening physical impairment of a major body function (not including psychological or emotional conditions). Excludes procedures aimed at live birth, treating ectopic pregnancies, or removing a deceased fetus.
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ACEP Now: Vol 44 – No 01 – January 2025Suggestions: Document treatment for ectopic pregnancy as exempt. For spontaneous abortion cases like sepsis or severe bleeding, document health or reproductive risks.
South Dakota
Statute: S.D. Codified Laws § 22-17-5.1, et seq.
Exemptions: Treatment necessary to preserve the pregnant person’s life.
Suggestions: Document the life threat. For ectopic pregnancy, mention the life threat and evidence supporting that medical treatment may prevent surgery and enhance future fertility.
Tennessee
Statute: Tenn. Code Ann. § 39-15-213, et seq.
Exemptions: Ectopic pregnancy, molar pregnancy, deceased fetus, and substantial risk for death or serious risk of an irreversible impairment of a bodily function to the pregnant person.
Suggestions: Document that ectopic pregnancy treatment is exempt. For spontaneous miscarriage posing health risks, document the life/health threat and when continuation is more likely to harm the pregnant person.
Texas
Statute: Tex. Health and Safety Code § 170A.001, et seq.; § 245.002
Exemptions: Excludes procedures for removing a deceased fetus caused by spontaneous abortion, ectopic pregnancies, and life-threatening physical condition or serious risk for an irreversible impairment of a bodily function to the pregnant person.
Suggestions: Document ectopic pregnancies and nonviable miscarriages as exempt, explicitly noting any life/reproductive health threats.
West Virginia
Statute: W. VA Code § 16-2R-1, et seq.
Exemptions: Nonviable embryo/fetus, ectopic pregnancy, or medical emergencies where it is necessary to avoid serious risk for death or a serious risk for a life-threatening physical impairment of a major body function (not including psychological or emotional conditions).
Suggestions: Document fetal nonviability, ectopic pregnancy, or the need for emergency treatment potentially ending the pregnancy.
Dr. Bedolla is assistant professor at the University of Texas Dell Medical School and national director of risk science at US Acute Care Solutions.
References
- Davis MF. The state of abortion rights in the US. Int J Gynaecol Obstet. 2022;159(1):324-329.
- Gostin LO, Wetter S, Reingold RB. One year after Dobbs-Vast changes to the abortion legal landscape. JAMA Health Forum. 2023;4(8):e233091.
- Manninen BA. A critical analysis of Dobbs v. Jackson Women’s Health Organization and the consequences of fetal personhood. Camb Q Healthc Ethics. 2023;32(3):357-367.
- Fox D. The abortion double bind. Am J Public Health. 2023;113(10):1068-1073.
- Lilly AG, Newman IP, Bjork-James S. Our hands are tied: abortion bans and hesitant medicine. Soc Sci Med. 2024;350:116912.
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One Response to “Navigating Strict State Abortion Laws”
January 26, 2025
Antony Hsu, MDThanks for moving this forward! For your fellow ED docs at your shop, please share this article and a copy/paste-able smart phrase that can be shared. Note that the following phrase is not vetted but your site medical director and you could consider reviewing with legal counsel to be triple-sure about the appropriateness.
“I am concerned about the life-threatening risks to the patient due to delays in treatment for *** (e.g. PPROM, impending sepsis, ectopic pregnancy resulting in hemorrhagic shock) and so am initiating *** (e.g.medication, a specialist consult, transfer to nearest capable facility). Patient (***and their family) states that they understand the risks, benefits and alternatives and agrees with the plan.