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Fri Aug 5, 2022, 12:25 PM

Opinion: The coming state-federal showdown over abortion

A woman turned away with an ectopic pregnancy. A miscarrying mother sent home, where she develops an infection. People with severe pregnancy complications left untreated. Within a month of the Supreme Court’s decision overturning Roe v. Wade, abortion bans have thrown emergency care into disarray and put doctors in an impossible bind.

Federal law requires physicians to treat pregnant patients in emergencies, providing abortions when necessary, while the law in some states prohibits emergency abortions. A showdown between the federal government and the states is now brewing. The state of Texas is suing the Biden administration to block federal guidance that protects access to emergency abortion care, even in states where abortion is a crime. And on Tuesday, the administration went on the offensive, suing Idaho over its abortion restrictions.

At the heart of both lawsuits is a nearly 40-year-old federal statute, the Emergency Medical Treatment and Labor Act, known as EMTALA. The law assures that everyone who shows up at the emergency room gets checked out. And if the hospital finds the patient has an “emergency medical condition,” it has to stabilize them – meaning the patient’s condition won’t worsen when they’re discharged. That includes laboring patients, for whom EMTALA guarantees protection.

After the Supreme Court overturned Roe in Dobbs v. Jackson’s Women’s Health Organization, the federal government reminded hospitals that emergency care of pregnant people sometimes requires abortion. Stabilizing treatment may call for dilation and curettage (D&C), a common abortion procedure, or methotrexate, a drug used for conditions like pain and inflammation that’s also commonly used to end ectopic pregnancy and miscarriage.


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