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today we're diving into discussions
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about some of the incredibly tragic but
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very predictable consequences of the
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overturn of Roy Wade these are four
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lives that we have now known to have
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been lost having been deemed probably
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preventable in the absence of the now
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quite restrictive abortion access
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legislation in many states these are not
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hypothetical they're real stories and
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they come from maternal mortality review
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committees in Georgia and Texas meaning
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these aren't biased although again
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everybody has bias they aren't made
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political a maternal mortality Review
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Committee reviews every maternal death
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in the US and makes an assessment as to
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where things potentially went wrong and
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this is a standard that's happening with
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all maternal deaths not just those that
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have happened since the overturn or
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those thought to be related to it they
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aren't generally released to the public
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but prua has managed to release four of
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these reviews and we're going to talk
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about what happened in their situation
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where the laws created the environment
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for these things to happen and why it's
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important for us to continue to review
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these and discuss them you will
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inevitably start hearing about this more
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because these committees are reviewing
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cases from a couple of years ago at this
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point because it takes a lot of time to
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get to the point of having all the
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information to review and actually
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reviewing it you will notice if you are
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familiar with this topic or any of the
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discussions around it that the cases
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will be early similar to Savita halap
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panavar who was a 31-year-old dentist in
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Ireland who died after their abortion
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laws became quite restrictive and her
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story ended up being the push that they
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needed to overturn their very
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restrictive laws unfortunately we
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haven't seen quite that same response to
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these quite the opposite in a lot of
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circles actually but I think it's
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important for us to go through them
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understand them and most importantly not
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to forget these women who should be here
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and are mothers who left behind children
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and daughters who left behind families
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who have loved ones that are mourning
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and are victims of blanket abortion
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legislation first person we're going to
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talk about today is Amber Thurman Amber
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was a mother in Georgia who had a
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six-year-old and her death has been
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reviewed by the Georgia maternal
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mortality Review Committee they look at
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all the deaths in Georgia that happen
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pregnancy related or during pregnancy
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and they try to go over them basically
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any death that occurs during pregnancy
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or I think it's within a year of the
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pregnancy ending so the Georgia maternal
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mortality Review Committee determines
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pregnancy relatedness causes of death
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contributing factors and then they make
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recommendations on how to improve
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maternal outcomes this is a very
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important review process and we do it
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for a lot of things in medicine and I
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think the fact that Most states have
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these review committees particularly for
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maternal mortality is important both in
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General Health understanding but also to
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understand that when we're talking about
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these this isn't just oh someone picked
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apart this medical situation it's a
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standardized process with a lot of
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expert involvement and a always
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similarly structured process to go back
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and decide this is definitely
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preventable not preventable probably
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preventable Etc so the Review Committee
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assigns a factor of preventability to
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every matal death that's their whole job
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in the summer of 2022 Amber Thurman was
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28 years old she's a single mother and
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she had a six-year-old little boy she
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was a medical assistant and she really
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wanted to go to nursing school she had
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recently moved out of her family's home
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and into her own apartment was getting
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on her feet and really getting her
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footing as a single mom anybody who's
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been a young mother especially a single
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mother knows it is very hard to get your
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footing and it's just adds another layer
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of tragic to me that she was finally
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doing that and starting to be able to
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follow her dreams because of that and
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how hard it had been for her to get back
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on her feet move out get her own
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apartment be the single mother that she
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wanted to be and by all accounts her
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friends and family have said she was a
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wonderful mother she found out she was
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pregnant and when she found out she was
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pregnant she decided to prioritize her
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current life and her young son I think
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it's important that we stop here and
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talk about the turnover way study just
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quickly that says people who are seeking
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abortion and this is based on lots of
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data this isn't something I'm just
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making up its database people seeking
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abortion who are turned away have an
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increased risk of poor outcomes for
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their currently living children poorer
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socioeconomic status for them and their
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children moving forward more likely to
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stay in abusive relationships and are
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just overall going to experience
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children who are less healthy and less
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well off when compared to people in
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their similar situations who were
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seeking abortion and weren't turned away
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so she made a decision that was
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prioritizing for her her life and the
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life of her young son unfortunately
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Georgia's 6-e abortion ban had gone into
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effect on July 20th which was right
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around the time that she found out that
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she was pregnant I also think it's
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important to add in here that six we
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abortion bands are effectively complete
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bands incredibly difficult to find out
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your pregnant make a decision get in
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with someone and access abortion care
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and that 6 week time frame nearly
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impossible most would say so she
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attempted because she was already
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outside of the time frame of 6 weeks she
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decided that she would look for an
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abortion out of state importantly
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something that when all of this happened
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everybody said just go out of state
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right we're not ban an abortion just go
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out of state not something that is
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possible for a great majority of people
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but for Amber it was so she decided that
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at week 9 she would go to North Carolina
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and seek a surgical termination with the
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DNC she ended up going on the 13th of
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August she woke up at 4:00 a.m. to make
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that drive undoubtedly having to take
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off work secure child care for her very
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young son and find someone to accompany
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her unfortunately she hit serious
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traffic on the way and the clinic
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because they had been completely
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inundated with people coming from out of
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state where there are more strict
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abortion restrictions was incredibly
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busy and not going to be able to see her
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because she was going to be more than 15
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minutes late due to that traffic she was
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offered a medical termination with myth
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prone and MAA prol still a very
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acceptable manner of termination at 9
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weeks 94% of terminations in the United
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States happen below 13 weeks most of
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those being medically induced meaning
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take a pill out a miscarriage so Clinic
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employee offered her that counsel her on
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it and she decided that she would take
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the medication she took the first half
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of that pill regimen on that day the
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13th of August which would be the myth
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of pistone and she took the next
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medication which would be the
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misoprostol the following day she
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experienced what would be typical
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symptoms after she took the medication
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so she started having some cramping and
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then she started having some pain
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typically you expect the pain and
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cramping to be a range of severity for
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some people not that bad for some people
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really awful but in all cases it should
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be rather short-lived once you start
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having pretty significant cramping and
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bleeding it should go away fairly
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quickly once the now medically induced
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miscarriage has completed but she wasn't
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experiencing that she was having pain it
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was going on and on and she was bleeding
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heavily soaking through more than a pad
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an hour which is quite heavy especially
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if it's going on for many hours so the
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night of the 18th of August she has not
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sought medical care for what would I
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would imagine have been included in her
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list of things that is not normal and
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you should seek care why would she not
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do that I think we can all come up with
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a whole host of reasons that she would
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choose not to but the biggest factors
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for me in regards to this case are I
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went across state lines to get
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medication that my state says should not
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be loud and is illegal here at the
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gestational age that I'm at am I going
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to be prosecuted for doing something
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that is illegal here but was legal where
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I had it given to me am I going to be
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given treatment or treated differently
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or refuse treatment all of these things
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must be going through her head on the
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evening of August 18th she vomited blood
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and she had a snle event meaning she
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passed out or lost Consciousness at home
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luckily she was accompanied by her
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boyfriend and he called an ambulance
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which came and arrived at their house
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about 6:51 p.m. at 9:38 she was finally
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assessed by doctors at that point she
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was reporting that her abdomen was very
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tender that she had a foul smelling
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discharge and the ultrasound showed that
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there was still some retained products
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of conception or tissue in the uterus
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she also had a very low white blood cell
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count so they started started her on IV
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antibiotics and an IV drip and the
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obstetrician at that time suggested a
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DNC the next day this is absolutely the
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right answer when someone has had a
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miscarriage or an abortion that is
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incomplete and presents with fow
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smelling discharge generally being
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unwell a ultrasound showing there's
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retained products and they're very
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tender on their tummy the answer to that
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is DNC there's no other answer
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antibiotics might Bridge you to that
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point but she needs a DNC I'll pause
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here for a second because there's
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question in the chat that I think's
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relevant it took her 3 hours to be
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seeing question mark I don't think this
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is necessarily outrageous she was
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probably taken to the emergency
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department at that point she had been
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stabilized by the people in the
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ambulance so whether she was in the
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waiting room or in a room waiting to be
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seen likely what happened is she got an
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iv in the ambulance regain Consciousness
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they initiated doing some lab work and
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discussions with her they probably went
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ahead and started some IV fluids and
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then the time it takes you know get to
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the hospital settled in a room IV Place
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nurses do the intake and you're not a
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patient who's actively dying at this
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point she was sick but she wasn't on the
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edge or brink of death as we will know
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because it's quite some time before she
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gets there that is probably quite
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reasonable for someone coming in like
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this you have to think that the other
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things that the hospitals taken care of
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include major car accidents you know
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people who have lost limbs traumatically
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I don't know that that that the part
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that strikes me as unreasonable at least
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in my medical opinion from looking at
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the very limited information that I have
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in front of me so they put on
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antibiotics plan was nothing to eat or
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drink after midnight we should do a DNC
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in the morning which is using suction to
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clean out the uterus remove the probably
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infected retained tissue at 5:15 a.m.
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she had had 5 lers of fluid I cannot
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express to you how much fluid that is I
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it's wild to me that they gave her that
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much to me that says that she probably
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had very low blood pressure which is in
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keeping with her now being in septic
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shock and she had had quite a bit of
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bleeding I would suspect she was noted
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in the chart to have rapid breathing to
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have risk of bleeding out to have low
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blood pressure all of these things are
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alarming this person is incredibly sick
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medical staff then in the notes says
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that they are thinking she should have a
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DNC but is wary because of the newly
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criminalized DNC procedure so instead
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they increased her antibiotics did some
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testing for various infections and put
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her on something called leevo fed she
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was very very sick at this point and
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unstable at 6:45 they took her to the
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ICU reasonably so anybody on Leva fed
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should not be on the main unit or in the
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emergency department if they've been
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there for a while and she was still
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having blood pressure drops at that
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point so at 7:15 the staff then again in
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the notes appears to discuss DNC however
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by 9:15 Amber's organs started to show
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signs of failure I don't know exactly
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what this means but it likely means if I
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had to guess she was starting to go into
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some kind of renal failure or acute
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kidney injury and her kidneys probably
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were not working as well as they had
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before there can be a lot of different
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things that are end organ damage related
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to sepsis but usually the kidneys are
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the first affected by noon that day uh
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the intensive care doctor was saying to
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the OM or obig group hey uh she's still
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deteriorating what are we doing and by
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2: p.m. she was finally taken to the
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operating room in my opinion this should
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have been done way earlier but I don't
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blame the doctors and I will go over in
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just a moment why that is not the
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appropriate response to reviewing this
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by then the situation was so dire that
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doctors started with an open abdominal
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surgery they found that her Bell needed
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to be removed but it was too risky to
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continue operating because there was not
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enough blood flowing to the area a
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possible complication from the blood
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pressure medication the Obi performed a
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DNC but immediately needed to continue
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with the hysterectomy I cannot express
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you how incredibly sick they had let her
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become before going to the operating
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room during the course of this surgery
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her heart stopped she went into cardiac
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arrest and asy meaning she had no
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heartbeat and they were unable to revive
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her now let's move on to discussing how
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this relates to the six we law as with
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any attempt to legislate something that
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is a very much needed life-saving Health
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procedure for a lot of people the
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wording of the law in Georgia like many
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others in this country leaves a lot to
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be desired on top of that it is
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impossible when you are the person in
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charge of deciding when someone is sick
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enough to qualify for the exception that
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their life is in danger to distinguish
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if I do this procedure now and the
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patient is fine am I going to be sitting
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in front of a jury of my peers who is
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questioning whether I actually did an
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unnecessary abortion procedure with
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their evidence being see the patient is
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alive and she's fine or am I going to be
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in a situation that these doctors are in
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which is completely unfair for both the
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doctors and obviously more so for Amber
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and her family where the patient dies
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and now I'm in front of a jury of my
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peers going actually you let her die
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that's medical malpractice when does
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that flip happen and the answer to that
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is you can't tell me and I can't even
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tell you and that's why this is not ever
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going to be a situation where these laws
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are effectively preventing all the
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preventable deaths because when I'm
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having to balance that and come up with
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when does it flip without the benefit of
00:14:34
knowing in foresight if the patient
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lives or dies that's an impossible
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situation so yes most people will be
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fine most young healthy people even in
00:14:43
this situation will be fine for every
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Amber Thurman there are hundreds if not
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thousands of people in her exact
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situation who don't die but how many
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people dying is acceptable when they had
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a death that is almost certainly
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preventable if not for these legislative
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efforts to control reproductive
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healthare and access DET
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termination let's go specifically
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through the Georgia House Bill though
00:15:06
the question then became is there
00:15:08
something in the wording of this bill
00:15:10
that related to this delay in care or
00:15:13
was this just medical malpractice first
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off I will say all of these bills have
00:15:18
wording that leads to delayed care but
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in this one specifically we can look at
00:15:22
it and I could tell you I could have
00:15:24
told you this would be a problem before
00:15:26
this happened so I have the bill pulled
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up here this is is House Bill 481 from
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Georgia this is where they talk about
00:15:32
what we're interested in here abortion
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means the act of using prescribing or
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administering any instrument substance
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device or other means with a purpose to
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terminate a pregnancy with knowledge
00:15:45
that termination will with reasonable
00:15:48
likelihood cause the death of an unborn
00:15:50
child provided however that any such act
00:15:52
shall not be considered an abortion if
00:15:54
the ACT is performed with the purpose of
00:15:56
so she had already taken the Myan miso
00:16:00
that she got out of state and now she's
00:16:02
in a situation where there is retained
00:16:04
tissue and she has a septic uterus
00:16:07
however they've defined here abortion as
00:16:10
being any instrument or device that
00:16:12
terminates a pregnancy she is still very
00:16:16
clearly pregnant it doesn't say there
00:16:17
has to be a heartbeat and in fact in the
00:16:20
next subsection a you can infer there
00:16:23
doesn't have to be a heartbeat so this
00:16:25
is where we see removing a dead unborn
00:16:29
child caused by spontaneous abortion do
00:16:32
we see the problem here spontaneous she
00:16:35
had admitted to having gone to North
00:16:38
Carolina taking myy and miso to
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intentionally end this pregnancy
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something that those doctors never would
00:16:43
have known if not for Amber just wanting
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to get the best care she could and be
00:16:48
honest with her healthc care team the
00:16:50
outcome might have been different but
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that's not on her she shouldn't have to
00:16:53
decide do I tell my Healthcare team the
00:16:55
whole truth or not this is ridiculous
00:16:59
they've said it can not be considered
00:17:00
abortion if it's removing a dead unborn
00:17:02
child by spontaneous abortion but this
00:17:04
is dead tissue not spontaneous abortion
00:17:07
they do have the medical emergency part
00:17:10
so technically this part would count but
00:17:13
I will again refer you to at what point
00:17:16
does it start counting and why are we
00:17:18
putting people in a position to have to
00:17:20
question whether or not it would be
00:17:22
acceptable and at what point it goes
00:17:23
from not acceptable to acceptable I
00:17:25
think it's also incredibly important to
00:17:28
consider where the doctors were in the
00:17:31
world Georgia the current volatility
00:17:34
with regards to this topic the extreme
00:17:38
views of some people on this topic and
00:17:40
what you are up against as the
00:17:42
obstetrician I don't know what went
00:17:44
through the first or second or team of
00:17:47
obstetric doctor heads or what was going
00:17:49
on behind the scenes however even if
00:17:52
they had been completely on board with
00:17:54
immediately doing a DNC knowing it might
00:17:57
risk their license if someone came back
00:17:58
and said it's it's not actually
00:18:00
something that needed to be done even if
00:18:01
that was the case which I'm not saying
00:18:02
it was you are then up against who do I
00:18:05
need to help me get this patient to the
00:18:07
operating room I need an anesthetic
00:18:10
doctor so you've got to have them on
00:18:11
board because you can't do this with no
00:18:13
anesthetic I need operating room nurses
00:18:16
so their personal beliefs or fears of
00:18:19
what will happen are then also at play
00:18:22
and maybe they don't realize how dire
00:18:25
the situation is and you just can't find
00:18:27
anybody to help you and neiz your
00:18:29
patient or be their nurse for the
00:18:31
procedure you can't just do a DNC by
00:18:34
yourself this isn't just one person
00:18:37
making one decision and the gray area of
00:18:40
when it becomes unnecessary to necessary
00:18:43
medical emergency versus not is real
00:18:45
easy in hindsight but it's not the same
00:18:48
when you are sitting there in front of a
00:18:50
patient having to make those decisions
00:18:52
and get everybody else around you on
00:18:53
board with it sadly Amber Thurman's
00:18:56
mother has been on TV and interviews and
00:19:00
all of these things talking about this
00:19:01
and I it's absolutely heartbreaking to
00:19:03
imagine what her family and her young
00:19:05
son have gone through but she has been
00:19:07
quoted as saying that her daughter's
00:19:09
Last Words as she was being wheed into
00:19:11
surgery were promise me that you will
00:19:13
take care of my son and Monday the 16th
00:19:17
of September would have been Amber's
00:19:19
31st birthday this is very heavy so
00:19:22
please look after yourself all I ask is
00:19:25
that you be aware that this is real this
00:19:27
is happening and and although it is much
00:19:30
more likely that you would be fine and
00:19:34
you would not die as a result of not
00:19:36
being able to access it does not matter
00:19:39
how low that risk was if you end up
00:19:43
being the person who dies or it affects
00:19:47
your mother or sister or daughter or
00:19:50
family member the percentage rest didn't
00:19:51
matter and I will ask you to especially
00:19:55
if you support these blanket
00:19:56
legislations really give consideration
00:19:58
to how many probably preventable deaths
00:20:01
we need before we stop saying oh well
00:20:04
here they could have done this and that
00:20:05
one or this and that one or this and
00:20:07
that one how many people have to die
00:20:09
before we go probably what we could have
00:20:11
done is not made predictably deadly
00:20:14
blanket legislation on this
