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Woman said she went into sepsis before she could get life-saving abortion care in Texas

By Nadine El-Bawab, ABC News May 15, 2023 | 6:34 AM
Kevin Le

(NEW YORK) — A Texas woman said she had to wait until she developed sepsis before physicians could provide her with life-saving abortion care.

Texas has several abortion bans in place that prohibit nearly all abortions, except when a mother’s life is at risk or there is a risk of serious bodily harm. The state has civil and criminal penalties for performing banned abortions.

One of the bans prohibits abortions after fetal cardiac activity has been detected, which meant that doctors couldn’t provide her immediate emergency care, which she would have had access to in states where abortion is not banned or restricted.

Kristen Anaya’s medical records, obtained by ABC News, show she waited 22 hours between when she was admitted to the hospital to when she delivered her baby, despite her spiking a fever and shaking uncontrollably within an hour of arriving.

Anaya said she and her husband Stephen went to see a specialist two years into their marriage, hoping to get pregnant.

After her husband underwent a medical procedure and she went through two rounds of egg retrials for in vitro fertilization, doctors told them they had one embryo, she said.

Anaya said she had the embryo implanted in January and found out she was pregnant nine days later. The couple was elated. Anaya has one 20-year-old son, but this would be her husband’s first child.

Four months later, Anaya said her water broke and she began leaking amniotic fluid — which is essential to keep a fetus alive.

After consulting with her OB/GYN, the couple drove to the hospital and Anaya lost a significant amount of amniotic fluid within the next hour.

An ultrasound confirmed that she had lost nearly all her amniotic fluid, but the baby’s heart was still beating, according to Anaya’s medical records. As she was being examined by a doctor, Anaya began having rigors — shaking uncontrollably — and spiked a fever, both an indication of an infection which could lead to sepsis, the medical records show.

“The pregnant patient has a life-threatening physical condition aggravated by, caused by, or arising from a pregnancy, That condition places the pregnant patient at ‘risk of death;’ That condition poses a ‘serious risk of substantial impairment of a major bodily function’,” doctors wrote in her admission medical records.

It was only a few hours later, when they spoke with Anaya’s OB/GYN, that the couple said they realized their baby girl — who they named Tylee — would not survive.

But the couple had no time to process the devastating news — Anaya’s OB/GYN told her she would “get very sick,” before doctors could help her, she told ABC News.

“So it would have been avoidable — me going into sepsis — if they were able to induce labor. The quicker they could get Tylee delivered, the better chance they had at me not going into sepsis. However, Tylee still had a heartbeat,” Anaya said.

“My husband and I are being told that ‘not only did we lose Tylee, but now you’re gonna go into sepsis and there’s nothing we can do about it other than watch you because of the abortion laws in Texas,'” Anaya said doctors told them.

According to her medical records, Anaya’s physician “initiated contact with the termination committee” — a committee of physicians who must approve any abortion care at the hospital — upon her admission to the hospital, a step which is not required of physicians in states where abortion is legal, according to Dr. Aileen Gariepy, an OB/GYN and assistant professor at Weill Cornell Medical College. Gariepy was not involved in treating Anaya.

If Anaya was a patient in New York, she would have been able to get abortion care immediately. The fever and chills were an indication of an infection and left untreated, sepsis is fatal, Gariepy told ABC News.

“That would be an indication to proceed immediately to start some kind of intervention to end the pregnancy. We can give antibiotics, but the cure is to deliver the pregnancy,” Gariepy said.

“There would be no state laws prohibiting us from giving her the highest level of medical care,” she said.

An ethics committee also had to approve the abortion, Anaya and her husband said.

“As a husband, now I’ve lost my daughter and now I could potentially lose my wife and the doctors kind of have to let it happen. That doesn’t make sense,” Stephen Anaya said.

Kristen Anaya said she then began to get sicker, with a high fever, shaking uncontrollably for hours and vomiting at least 8 times.

“They were going to be monitoring me, doing bloodwork every three hours, monitoring my vitals and ‘building a case’ to prove that my life was in great danger and they needed to induce labor,” she said.

Medical records show that Anaya’s lactic acid reached 2.8 mmol/L before she was induced — the normal range is between 0.4 to 2.0 mmol/L. Her white blood cell count went up to 17.6 k/uL, while the healthy range is between 4.5 to 11 k/uL.

When she was admitted to the hospital, her lactic acid was 1.5 mmol/L and her white blood cell count was 12.3 k/uL, according to her medical records.

“I was crying, asking for help. And I remember them literally not saying anything. [The doctors and nurses] would just literally look at me and look at Stephen and they’re just blank. There’s literally nothing they could do,” Anaya said.

She added, “I’m freezing, shaking so hard that I had body aches for a week after getting discharged from the hospital because my body was so tense and just shaking uncontrollably.”

Once Anaya’s test results met the threshold doctors had set, the hospital approved the abortion. She still had to wait from 30 minutes to an hour until the paperwork was in the system before her labor could be induced, according to her.

Despite a dilation and evacuation procedure being more effective at removing all the fetal tissue and the placenta, according to Gariepy, Anaya said she was only offered a labor induction.

The placenta usually detaches itself once a pregnancy is full term. By inducing labor and not performing the surgical procedure there is a risk the placenta will not be delivered, Gariepy said.

“There’s a 25% chance of still needing surgery [after induction] because the placenta get stuck,” Gariepy said.

Even after receiving four rounds of induction medication, Anaya’s placenta was not delivered, according to her medical records.

She has since needed two dilation and curettage procedures to remove the placenta and stop her bleeding. The first was during her 5-day hospital stay.

Then, Anaya began bleeding heavily in early May and needed a second procedure to remove placenta tissue, her medical records show.

The hospital where Anaya received care, and her physician did not immediately respond to ABC News’ request for comment.

She said she is still having pain and complications and her cervix was still dilated at an appointment last week, despite delivering on April 16. Doctors said her uterus still does not look normal, Anaya said.

“I’m kind of in a gray area, I’m not taking the path of recovery that they would expect. Because I’m still having some complications,” Anaya said. “They’re really unsure as to why I’m still feeling the way that I’m feeling and so we’re kind of gonna wait and see.”

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