INDIANAPOLIS — As Indiana lawmakers plan to pass abortion restrictions with few to no exceptions, doctors worry about health complications that could threaten the lives of Hoosier women.
With a week-and-a-half to go until a special session, doctors say pregnancy complications like ectopic pregnancies need to be considered in any legislation so they can provide health care to women before it threatens their lives.
"It is a life-threatening diagnosis," said Dr. Caroline Rouse, a maternal fetal medicine physician with IU Health.
Rouse works with pregnant women every day, some dealing with health challenges to themselves or to the fetus.
Ectopic pregnancies, where the fetus implants somewhere other than the lining of the uterus make up around 1 to 2 percent of pregnancies, according to the CDC, can be fatal to the mother.
"An ectopic pregnancy is very concerning. The risk if the pregnancy continues to develop in an abnormal location is that it will rupture which could cause significant bleeding, even hemorrhage which can be life-threatening," Rouse said. “It is a very serious diagnosis. Ectopic pregnancy continues to be a cause of maternal mortality even in the United States and even in our own state."
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These pregnancies are not able to be safely carried to term, Rouse said it's important that ectopic pregnancies be managed before it can threaten the life of the mother.
“An ectopic pregnancy is a medical diagnosis. It’s a medical emergency, and the decision for management, medical or surgical should be left between the physician and the patient," Rouse said. "When that pregnancy is wanted and desired and hoped for by that family, having to talk about ending the pregnancy can be really, really devastating. But when the alternative is that pregnant mom could potentially hemorrhage and die as a result of that pregnancy, that's where those conversations go."
These kinds of pregnancies and health challenges surrounding them aren't simple, according to Rouse, and healthcare decisions surrounding them should be made by families and their doctors, not lawmakers.
“Medical conditions including ectopic pregnancy can be complicated. And it can be really challenging and I would say impossible to know in many cases, when someone is getting really, really sick - sick enough that they cannot survive. Our job as medical providers is really to prevent that type of health deterioration, to act before somebody gets so sick that they may die,” said Rouse.
Indiana lawmakers meet in less than two weeks, with the expectation they'll ban abortions with few exceptions.
Rouse said they need to listen to medical advice for pregnancy complications, to understand that simply writing an exception for "the health of the mother" are not always black-and-white when it comes to doctors being allowed to offer lifesaving medical care.
“I’m concerned that the wording in the legislation could be concerning for providers who are really trying to do the best thing medical for their patient. And if the laws do not clearly exclude ectopic pregnancy as an indication for definitive management which would be ending the pregnancy through medical or surgical means, people are going to get hurt because physicians are afraid to act,” Rouse said.
Without that clarity, Rouse said she worries both doctors and their patients could pay the price.
“I think a lot of medical providers, myself included, are concerned that we are going to be potentially criminalized for providing evidence-based medical care that the patient needs,” she said.
Lawmakers are supposed to have 40 days in a special session to get legislation through.
Gov. Eric Holcomb originally called for it to start on July 6. But Democratic leaders tell us since the session was pushed to the 25, they only have 21 days to hear testimony, debate and vote.
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