The names of people included in this story have been changed to protect their identities.
Melissa was thrilled when she found out she was pregnant with twins, but that joy began to unravel when her obstetrician told her to see a doctor who specializes in high-risk pregnancies.
“I found out that one of the twins' brains didn’t develop, and that it was a severe form of holoprosencephaly," the 39-year-old mother of three said. "I was in shock."
The specialist told Melissa the affected fetus had a high chance of dying in the womb or soon after birth.
With this diagnosis, she returned to her obstetrician, whom she expected to deliver the twins.
“When I came back to see him ... he just told me he had no time to see me,” Melissa said. “And I'm like, I just had this diagnosis, how can you treat me like this? He was like, 'I'm sorry,' and that’s the way it was.”
Melissa started doing her own research.
“What I found out is my life could be put in jeopardy — as well as the healthy twin — and just so many horrible things could go wrong," she said. "So I really had no choice but to terminate the one sick twin."
Terminating a fetus with an "incompatible with life" diagnosis is no longer a treatment option for families in Texas. A 2021 law prohibits abortion if a heartbeat is detected. That small window closed when Texas' "trigger law" went into effect after Roe v. Wade was overturned.
Now if doctors perform an abortion they can face up to life in prison, lose their medical license and be fined $100,000. The part of the 2021 law, in which anyone who helps a person get an abortion can be sued and fined up to $10,000 still exists. That means physicians walk a delicate line in even talking about out-of-state abortion providers.
Dr. Stewart, the maternal fetal medicine specialist Melissa saw, said before Texas' abortion ban, he would have discussed the option of terminating the fetus with the non-developing brain, especially because it also posed a risk on the healthy twin.
“I'm handcuffed; I am basically limited on what options I can talk to her about," he said. "Withholding that information seems to be completely unethical."
Ultimately, Melissa found an out-of-state provider for the procedure.
"It was scary, nerve-wracking and expensive,” she said.
Melissa was told to immediately follow up with her doctor in Texas because her pregnancy was still very fragile. Believing her previous obstetrician wanted nothing to do with her, she began looking for someone else willing to follow her care and deliver the baby.
"I was devastated for months trying to find a physician that would see me,” Melissa said. “I kept calling; I went to an office and just left [my medical] records and just hoped that somebody would see me.”
Stewart doesn’t deliver babies, but he advises obstetricians often. He said he suspects a reason some of the OB/GYNS turned Melissa down is because they didn't want to take on a risky case in today’s environment.
“Since Roe was overturned I've had consultations over and over again with doctors who are hesitating,” he said. “Obstetricians are calling that have a woman who is getting sick, septic from a pregnancy and not sure what to do. [I tell them] you need to save her life and empty the uterus because that's the only thing that will help.”
Stewart said obstetricians are also getting pushback from hospitals refusing to schedule procedures that would have been in-line with medical training before Texas’ anti-abortion laws.
"These two laws [Senate Bill 8 and the "trigger" law], I think, are severely handicapping us [doctors] and making it difficult for us to provide care to women," he said.
The legal landscape terrifies Melissa.
“If at any time from now until the delivery, if something happens and I start bleeding, I don't know what to expect,” Melissa said. “Are they just going to leave me there to suffer and possibly go into shock? It's scary.”
Melissa is now at a little over six months into the pregnancy. Last week she had a second appointment with a new obstetrician, who told her the fetus is developing well. She said the optimistic appointment offered solace for having to make the difficult decision of aborting the sick fetus with little medical guidance.
“It was very hard, but I'm going to have one healthy baby," she said. “I could have lost both."
Melissa is due in January.
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