What Florida’s Abortion Law Says about Protecting the Life and Health of the Mother
The state’s 15-week abortion ban allows for the termination of a pregnancy when necessary to ‘avert a serious risk’ to the physical health of the mother.
Florida’s 15-week limit on abortion, a law that has been in effect since July 2022, includes an exception to protect the life and physical health of the mother. Specifically, the text of the law says that the exception applies whenever two physicians certify in their reasonable medical judgment that terminating a pregnancy is necessary to save the life of the pregnant woman or to “avert a serious risk” of “substantial and irreversible physical impairment of a major bodily function of the pregnant woman other than a psychological condition.” If the threat is imminent, a second physician’s certification is not necessary.
This exception should obviously protect women experiencing a life-threatening condition known as pre-viability preterm prelabor rupture of the membranes (PPROM) — when a pregnant mother’s water breaks before viability. As National Review recently reported:
A pregnant woman’s water breaking before viability is a life-threatening condition because “it’s very, very hard to predict who’s going to get really sick really fast,” Dr. Ingrid Skop, a pro-life obstetrician-gynecologist based in Texas, told National Review in a phone interview. An infection is often present before it can be detected. As Skop, who also serves as director of medical affairs for the Charlotte Lozier Institute, the research affiliate of the largest national pro-life group (Susan B. Anthony Pro-Life America), told NR back in July 2022: “I say this as a pro-life physician: It is appropriate to deliver at that point. Because we know that likelihood that four days, six days [later], she’s going to be clinically infected. We know that the likelihood this child was going to make it to be born alive, to stay alive, not die in the neonatal period, is super low.” Despite the very low odds of the baby’s surviving, sometimes a mother will choose “expectant management” — watchful waiting — but as Skop said: “If [the mother] wants delivery at the time of initial diagnosis, it is the standard of care to do so and is allowed by all state pro-life laws.”
But the Washington Post published a gut-wrenching report on Monday about two separate cases in which hospitals dangerously delayed care for women experiencing this condition in Broward County, Fla., in December 2022.
After Anya Cook’s water broke nearly 16 weeks into her pregnancy, Broward Health Hospital in Coral Springs did not offer to induce delivery and instead sent Cook home, the Post reports:
When the doctor finally saw [Cook], he delivered the distressing news, they said: Anya was experiencing PPROM — and because of the state’s abortion law, he could not induce labor. She could not stay at the hospital, either, she said she was told.
Because she was so early in her pregnancy, she recalled the doctor saying, there was no chance her baby would survive. . . .
The Post, with Cook’s consent, read relevant portions of the records to four physicians, all of whom agreed that Cook had a clear case of pre-viability PPROM, making her high-risk for infection and hemorrhage.
A spokeswoman for Broward Health, Jennifer Smith, did not directly address PPROM, and declined to make the doctor who treated Cook available for an interview. But she said in an interview that Cook was “not at risk” when she left the hospital after her water broke.
“There was no indication she needed any interventional care,” said Smith, the hospital’s vice president for corporate communications and marketing.
Broward’s policy on pregnancy termination, obtained through a public records request to the public hospital, mirrors the language in Florida’s abortion law.
Cook “did not necessitate an abortion in the emergency department,” Smith wrote in a statement. “Had her condition failed to improve or worsened to result in a threat to her life or irreversible physical impairment of a major bodily function, Ms. Cook would have been admitted for further care and treatment.”
So the Broward Health spokeswoman flatly claims that Cook was “not at risk” when she left the hospital, while four physicians told the Post “that Cook had a clear case of pre-viability PPROM, making her high-risk for infection and hemorrhage.”
In a separate case of PPROM, Shanae Smith-Cunningham was sent home from Broward hospital HCA Florida Northwest:
HCA Florida Northwest provides abortions in cases where a physician believes that “a medical emergency exists or the fetus exhibits a fatal anomaly,” Jennifer Guerrieri, the hospital’s vice president of strategic communications, said in a statement.
“Our focus is on providing the best possible care for our patients. Our hospital policies and procedures align with state and federal regulatory requirements.”
Again, Florida’s abortion law does not require waiting until a threat to the mother’s life becomes imminent. It specifically permits terminating a pregnancy to “avert” — a synonym for prevent or avoid — a “serious risk” to the physical health of the mother. PPROM places the mother at risk of life-threatening sepsis or hemorrhaging, and it places the mother at risk of permanent damage to a major bodily function.
As the Post notes, Florida state senator Erin Grall, sponsor of the six-week abortion limit now working its way through the legislature, specifically said at a committee hearing in March that doctors are legally allowed to immediately treat women with PPROM under existing law.
Last Wednesday, I spoke to Grall about her six-week ban, which just passed the state senate, and I asked whether she was aware of any cases in Florida of hospitals delaying care in life-threatening circumstances. She said that while Democratic state senator Lauren Book relayed anonymous stories of two women in Broward County being sent home while in the process of suffering miscarriages, she had not been provided any confirmation. (The two women’s stories were confirmed in the Post’s report on Monday. Grall did not respond on Monday to a request from National Review for an interview about the Post story.)
Grall told NR on April 5 that “there are ways to hold all of our medical professionals accountable to practicing within the standard of care,” including “an administrative complaint through [the Florida Agency for Health Care Administration], or the Department of Health, or a potential lawsuit because there were actual damages as a result of withholding medical care.” She also said it’s possible that a state hospital could submit a request to the attorney general requesting guidance, and that guidance can be provided through various state agencies, including the Board of Medicine.
While guidance all around is helpful, Grall noted that it is important that any list of conditions covered by the law be non-exhaustive. The whole point of deferring to “reasonable medical judgment” was to make sure the law doesn’t tie doctors’ hands when they’re trying to avoid threats to the life or physical health of the mother.
It is not clear how widespread the problem of hospitals’ misinterpreting the law and dangerously delaying care in these cases is in Florida, but it should not be happening at all. And whether complaints are filed against the hospitals in question or action is taken by the legislature, the attorney general, the governor, executive-branch agencies, or the Board of Medicine, what matters most is that this crisis gets solved.