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Elizabeth Weller had no idea her plans for a child would become entangled in the web of Texas abortion law. In late 2021, she and her husband began trying. They had purchased a home in Kingwood, a lakefront community in Houston. Elizabeth was a political science graduate student, and James was a middle-school math teacher.
When Sarah became pregnant in early 2022, the Wellers were pleasantly pleased. The Texas Tribune wishes to recognize its sponsors. Make yourself one. In retrospect, Elizabeth admits that their initial pleasure was a little naive: “If it was so easy for us to get pregnant, then it was almost like a sign that this pregnancy would be easy for us.”
Things went relatively smoothly at first. They found out they were having a girl 17 weeks into their pregnancy. Elizabeth also underwent an anatomy scan, which indicated no issues. Even if it had, the Wellers were adamant about continuing.
“We passed on the genetic tests available in the first trimester,” Elizabeth explained. “I was born with a physical handicap.” “If she had any physical problems, I would never abort her.” “I have said throughout my life that I believe that women should have access to the right to an abortion,” Elizabeth remarked of abortion rights. I, for one, would never acquire one.”
And at this point in her life, at the age of 26, she was pregnant for the first time: “I had not been put in a position where I had to consider the genuine intricacies that went into this circumstance.” I had not been placed at a crossroads in this matter.”
But, not long after the uneventful anatomy scan, the Wellers found themselves at a fork in the road. They were locked down, clinically and emotionally, as a result of a clash between normal obstetric practice and the strict new expectations of Texas law. The date was May 10, 2022. Elizabeth was 18 weeks pregnant at the time. She ate a nutritious breakfast, went for a walk outside, and returned home.
They had stashed some baby outfits and new paint cans in the nursery upstairs. Images from recent scans and ultrasounds were taped to the fridge in the kitchen. The Texas Tribune wishes to recognize its sponsors. Make yourself one.
Elizabeth stood up to go get some food. That’s when she felt something “change” in her uterus, somewhere deep inside, and then “this burst of water just comes out of my body.” And I yelled because that’s when I realized something was wrong.”
Her waters had broken, plunging her into a “dystopian nightmare” of “physical, emotional, and mental anguish.” She blames the ensuing medical trauma on Republican legislators who enacted the state’s anti-abortion law; Texas Gov. Greg Abbott, who signed it; and the inflamed political rhetoric, which Elizabeth says sees abortion “as one thing, a black-and-white issue when abortion has all of these grey areas.”
Other sorts of obstetric care are being complicated by state abortion regulations. Elizabeth’s pregnancy dilemma began – and concluded – just weeks before the U.S. In Dobbs v. Jackson Women’s Health Organization, the Supreme Court overturned the federal right to abortion.
But, since September 2021, the Wellers and 28 million other Texans have been living under a de facto abortion ban. When embryonic or fetal heart activity is detected — usually around six weeks of pregnancy — new state legislation prohibits all abortions. Thousands of women have left Texas since then to have abortions in neighboring states.
The Texas Tribune wishes to recognize its sponsors. Make yourself one. Abortion is still banned in Texas today, thanks to a 1925 legislation that the state’s attorney general, Ken Paxton, proclaimed in effect after Roe v. Wade was reversed. Another restriction, a so-called “trigger law” passed by Texas in 2021, is set to take effect in the coming weeks.
The Wellers’ crisis exemplifies the broad and possibly unforeseen medical consequences of abortion prohibition in Republican-led states. The new abortion bans, or resurrected old laws in a post-Roe environment, are strictly drafted and untested in the courts. Many states make no exceptions for rape, incest, or fetal abnormalities.
The most perplexing element, however, is the existence of exclusions for the woman’s life or health, or for a “medical emergency,” which are left ambiguous or unexplained. As a result, doctors and hospitals in numerous states are in disarray, and patients suffering from obstetric diseases such as ectopic pregnancies, incomplete miscarriages, placental difficulties, and preterm membrane rupture face severe delays and complications.
The Texas Tribune wishes to recognize its sponsors. Make yourself one. “It’s dreadful,” Dr. Alan Peaceman, a maternal-fetal medicine professor at Northwestern University’s Feinberg School of Medicine, said. “The caregivers are walking on eggshells. They don’t want to get entangled in a legal quagmire. As a result, they have no idea what the regulations are.”
“I’m counting on you to tell me the truth.” James took Elizabeth to the adjacent Woodlands Medical, which is part of the Houston Methodist hospital system. An ultrasound revealed that she had experienced premature rupture of membranes, which occurs in roughly 3% of pregnancies.
“There’s very little amniotic fluid left,” a doctor told her. That is not a good sign. All you can do now is hope and pray that everything goes well.” Elizabeth recalled that the staff was unsure what would happen next. She was admitted to the hospital, and when her obstetrician called later that night, she begged for information.
The facts were bleak. The watery, protecting cushion of amniotic fluid had vanished by 18 weeks. Although there was still a heartbeat, it may stop at any time. Both the fetus and Elizabeth were now extremely exposed to chorioamnionitis, among other concerns.
The OB-GYN, who declined to speak with a reporter for this piece, gave Elizabeth two options. The first choice was to terminate the pregnancy for medical reasons, while the second was to keep Elizabeth in the hospital and try to stay pregnant until 24 weeks, which is considered the beginning of viability outside the womb for a fetus.
The Texas Tribune wishes to recognize its sponsors. Make yourself one. Expectant treatment results vary substantially depending on when the waters breach. Doctors can try to delay delivery later in pregnancy to allow the fetus more time to develop while avoiding infection or other maternal issues such as bleeding.
When membranes break earlier in pregnancy, especially before 24 weeks, the fetus’s chances of survival fall. One reason for this is that amniotic fluid is essential for embryonic lung development. According to Peaceman, the chances of survival for a fetus at 18 weeks are nearly nonexistent: “This is probably as close to zero as you’ll ever get in medicine.”
Fetuses who survive a premature birth may die shortly after birth. If they survive, they may acquire significant lung issues or strokes, go blind, or develop cerebral palsy or other defects or illnesses. Expectant treatment after premature membrane rupture carries its own set of health hazards for women. According to one study, they were four times more likely to have an infection and 2.4 times more likely to have a postpartum hemorrhage than women who aborted the pregnancy.
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