Mylissa Farmer, 41, from Missouri, United States, a high-risk patient due to her medical history, experienced alarming symptoms when her water broke less than 18 weeks into her pregnancy last August and was in dire need of an abortion.
But doctors told her she might die as she couldn’t have an abortion under state law until she got sicker.
ProPublica, a non-profit journalistic organisation known for uncovering abuses of power, reported that Farmer had a history of blood clots, irregular heartbeats, polycystic ovary syndrome, past abdominal surgeries, and a prior miscarriage.
Doctors at Freeman Health System, a Level II trauma centre, determined she had suffered a pre-viable pre-labour rupture of membranes, or PPROM – her water ruptured too early, and she lost amniotic fluid.
PPROM stands for Pre-term Premature Rupture of Membranes. It is a medical condition where the amniotic sac surrounding the foetus breaks open before the 37th week of gestation. This often leads to the leakage of amniotic fluid from the mother's vagina, which can cause an infection in both the mother and the baby.
PPROM is one of the leading causes of pre-term birth, making it a significant concern for obstetricians and gynaecologists.
According to records, Farmer’s OB-GYN at Freeman Health System and a maternal-foetal medicine specialist described in detail the severe risks Farmer faced if she continued the pregnancy: clotting, sepsis, severe blood loss, loss of her uterus, and death. At the doctors’ request, ProPublica is not naming them after they expressed concerns for their safety.
The maternal-foetal medicine specialist explained to Farmer that typical treatment options usually include abortion care, according to the documents. But when Farmer requested that labour be induced, the specialist told her it was not possible in Missouri.
Missouri’s abortion ban is one of the strictest in the country. It bans all abortions except those that are necessary to save a pregnant patient’s life.
The maternal-foetal medicine specialist further advised Farmer she could travel to another state for care or stay at the hospital for observation.
According to the American Pregnancy Association, the incidence rate of PPROM occurs in about 3% of all pregnancies, and it is responsible for about 30% of pre-term births.
PPROM can be diagnosed based on clinical symptoms, such as vaginal discharge, and confirmed through diagnostic tests, such as an amniocentesis or a nitrazine test. The chances of the pregnant patient developing a life-threatening infection are high.
Official documents filed on behalf of Farmer suing the state for denial of care, during three emergency room visits over two days in Missouri and Kansas, doctors repeatedly gave Farmer the same chilling message: “There was virtually no chance her foetus would survive, and the pregnancy was putting her at high risk for life-threatening complications, there was nothing they could do for her” as their hands are tied by the Roe vs Wade State law.
Dr Chloe Zera, an expert in maternal-foetal medicine in Massachusetts, said that if Farmer had entered her hospital in Boston, where access to abortion has increased since Roe was reversed, she would have been able to get the surgery done right soon if she preferred.
“That’s not what happened in Missouri or Kansas.”
Farmer faced a difficult and frustrating search for adequate medical care during her high-risk pregnancy, according to a complaint filed by the National Women's Law Centre on her behalf.
The complaint reports that Farmer reached out to multiple hospitals in states where abortion is legal, specifically Illinois and Kansas, but was unable to get through to some of them. The few that did respond were either not equipped to handle her medical needs or could only provide services for miscarriages later in pregnancy.
Farmer's attempts to secure the necessary care led her to try contacting two abortion clinics in the area, but she did not receive a response from either.
Her search finally ended after one hospital recommended the University of Kansas Health System in Kansas City, Kansas, where she arrived at 11.35 pm.
Upon examination, medical personnel confirmed that Farmer no longer had any amniotic fluid and presented her with two options - inducing labour or a dilation and evacuation procedure.
Farmer opted for induction to meet her goal of holding her newborn daughter, whom she had already named Maeve; she consented to the latter at the medical team's recommendation.
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