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Conflicting federal, state abortion guidance leaving some providers confused about treatment

CDC: Most pregnancy-related deaths avoidable, could come up to year after labor
Posted at 10:44 PM, Jul 13, 2022
and last updated 2022-07-14 09:19:06-04

TAMPA, Fla. — When it comes to pregnancy, Dr. Rachel Rapkin says things can change in the blink of an eye.

"Yesterday morning I was on call and somebody came in that we took to the OR at 7 in the morning after I had been working 24 hours, who had a ruptured ectopic [pregnancy] and lost her entire blood volume," she said.

And when seconds matter Dr. Rapkin said doctors spring into action—but she added that lately, many are thinking twice about what treatments they use for pregnant patients.

"Doctors are really scared of getting prosecuted. Doctors are scared of going to jail, of losing our licenses," Dr. Rapkin said.

She says the fear stems from vague guidance from the state's 15-week abortion ban, which says that an abortion after 15 weeks can only happen under a few conditions—including if the the fetus has a fatal abnormality or if it saves the pregnant person's life. The state also asks that in certain cases at least two doctors sign off on the abortion.

Dr. Rapkin said doctors are now left to determine where to draw that line.

"We have patients coming in with all kinds of medical conditions that are very dangerous in pregnancy or pregnancy can make them more dangerous or bring them one," Dr. Rapkin said.

Adding to the layer of confusion is an executive order from President Biden, which among other things, reminds hospitals that get Medicare funding to provide emergency care to folks—in accordance with the Emergency Medical Treatment & Labor Act.

And emergency care technically includes an abortion.

The question now is which guidance should doctors follow? Well, civil rights attorney Gretchen Cothron said in this case, it's the federal government.

"If a woman is in a hospital in an emergency situation and an abortion is necessary to save her life then that federal law preempts the state law, so doctors are supposed to then perform the abortion," said Dr. Rapkin.

Cothron also tells ABC Action News that due to the confusion she's advising people to have important conversations in case of an emergency situation.

"Be very communicative with your doctors, you might want to reach out to an attorney or reach out to an abortion fund," Dr. Rapkin said.

Confusion about the rules is also on the minds of some state leaders, who contacted the federal government for guidance on how to protect "abortion rights." Last week, State Representative Fentrice Driskell spoke with Vice President Kamala Harris about the issue.

Now, Vice President Harris will be holding a roundtable discussion about reproductive rights Thursday, during a visit to our state.