WASHINGTON鈥擠ays after the US state of Ohio banned abortions once a fetal heartbeat is detected, doctor Mae Winchester had a patient who needed to terminate her pregnancy to save her life.
Her patient, who was 19 weeks pregnant, asked if 鈥渓egally she was going to be OK and if legally I was going to be OK,鈥 Winchester told AFP.
It wouldn鈥檛 have been a question when the nationwide right to abortion was still protected under the US constitution.
But the Supreme Court overturned the 1973 Roe v. Wade ruling on June 24 鈥 and some states, including Ohio, moved quickly to restrict the procedure, sometimes only with exceptions for medical necessity.
Doctors across the country were thrust into an ambiguous legal landscape that they say threatens both their ability to do their jobs and their patients鈥 health.
While her patient had a clear medical emergency, with the rug pulled out from under the nearly 50-year-old right, that night Winchester made a call to the hospital鈥檚 lawyers.
鈥淚 know what I need to do medically. But from a legal standpoint, how do I protect her? How do I protect myself? How do I protect our institution? Our nurses and anesthesiologist that are going to be involved with this case? It affects everybody,鈥 she said.
Such concerns echoed by doctors from varying specialities caught in the crosshairs of new laws, as well as health care lawyers working to help providers navigate the shifting ground.
鈥淚t鈥檚 a bizarre situation where doctors have to be nervous even when they鈥檙e providing legitimate care for potentially life-threatening conditions,鈥 said Harry Nelson, managing partner at health care law firm Nelson Hardiman, which advises physicians.
Lose license? Face jail?
The penalties in new legislation can be severe and not limited to losing one鈥檚 medical license, but also possible felony charges, years in jail and thousands of dollars in fines.
Even the threat of litigation will take a toll, said Nelson, noting that few organisations and individuals can withstand the financial, logistical and mental cost 鈥渨ithout a significant level of stress.鈥
Some authorities in states with tight abortion restrictions have said the concern is misplaced because of laws鈥 exceptions for medical endangerment, with anti-abortion advocates accusing opponents of 鈥渇ear mongering.鈥
But the risk is taken seriously by the Department of Health and Human Services.
It has said the Emergency Medical Treatment and Labor Act (EMTALA) supersedes state abortion laws if the procedure is needed to stabilize a pregnant patient 鈥 a move praised by abortion rights supporters, who have pressured President Joe Biden鈥檚 administration to preserve access to the procedure.
But the guidance has come under fire, with Texas Attorney General Ken Paxton suing the administration, saying it 鈥渟eeks to transform every emergency room in the country into a walk-in abortion clinic.鈥
It鈥檚 unclear how zealous prosecutors will be, and a group of some 90 elected prosecutors from across the country as of July 14 have already said they will not pursue abortion cases.
But in Indiana, where abortion is still legal up to 22 weeks and the Republican-dominated legislature is considering tighter abortion restrictions, a doctor has already been threatened with investigation over performing the procedure for a 10-year-old rape victim who had to cross from neighboring Ohio.
The obstetrician-gynecologist (OB-GYN) was accused of not reporting the case, as state law requires in case of sex crimes involving minors 鈥 an accusation has been disproved.
Nelson and other lawyers said much of the rhetoric amounts to 鈥渟care tactics鈥 and political capitalization to garner support around one of the most hot-button issues in the country.
But he underscored that in states like Texas, Idaho and Oklahoma, which allow for civil lawsuits against anyone who knowingly 鈥渁ids or abets鈥 an abortion, there is real risk from 鈥渟ingle issue agitated people who are鈥 looking to make examples.鈥
鈥楻ock and a hard place鈥
It鈥檚 not only OB-GYNs who may be caught in the net, with doctors voicing fear over the impact on care for pregnant patients with diseases such as cancer, the treatment for which could harm a pregnancy.
Health care providers in states where abortion access is still available also are seeking advice, Nelson said, as anti-abortion leaders eye cross-border care as their next battleground.
鈥淏ecause every situation is so different it鈥檚 really hard for us to write guidelines, and everybody is asking for guidelines,鈥 said Wisconsin-based OB-GYN Kristin Lyerly, a legislative chair for the American College of Obstetricians and Gynaecologists (ACOG).
ACOG has joined some 75 other health care organizations in condemning legislative interference in the patient-doctor relationship after the Supreme Court ruling.
鈥淧regnancy management is complicated but doctors have to do it, not politicians,鈥 Lyerly told AFP.
Since Roe v Wade was overturned she鈥檚 heard from colleagues feeling 鈥渟tuck between a rock and hard place.鈥
鈥淲hat are you supposed to do? Commit malpractice or go to jail for being a criminal for performing an abortion?鈥
RELATED STORIES
Abortion pills to become next battleground in US reproductive fight
US abortion reversal spurs online data fears
U.S. Supreme Court overturns Roe v. Wade, curtailing abortion rights
Fresh protests as new US abortion reality takes shape