Cheyenne Roche: Women's access to emergency treatment under fire

May 2—If you or someone you know is capable of becoming pregnant, you need to know about the case the Supreme Court is hearing this week. Let me be perfectly clear. Women will die if the Supreme Court rules with Idaho and Texas.

To understand the case, we first need to rewind to 1986 when the Emergency Medical Treatment and Active Labor Act (EMTALA) was first enacted.

The law requires hospitals to ensure patient access to emergency medical care and to prevent the practice of patient dumping, in which uninsured patients were transferred, solely for financial reasons, from private to public hospitals without consideration of their medical condition or stability for the transfer.

Basically, it ensures if you go into a hospital in medical distress, they must treat you regardless of your financial status.

Over the course of the last 38 years, it is now considered one of the most comprehensive laws guaranteeing nondiscriminatory access to emergency medical care and thus to the health care system.

And now, it's under fire.

Idaho and Moyle, et al. v. United States was appealed to the Supreme Court by Idaho politicians seeking to disregard EMTALA and put doctors in jail for providing pregnant patients necessary emergency medical care.

It began after the Supreme Court overturned Roe v. Wade, ruling abortion was no longer a federal constitutional right. By August 2022, Idaho's Defense of Life Act was set to take effect, making it a felony for any abortion to be performed in the state unless to save the life of a pregnant person or if a pregnant person reported themselves as a victim of rape and/or incest to the police and provided a copy of the police report to the physician performing the abortion.

Before the policy was enacted, the Biden administration filed a federal lawsuit in the United States District Court for the District of Idaho, asserting the Defense of Life Act's ban on abortion directly conflicted with EMTALA's mandate to provide stabilizing and lifesaving medical care during pregnancy complications.

Over the last two years, it has been a legal battle, finally making its way to the Supreme Court this week.

Texas also has stake in the game. The Biden administration issued guidance to hospitals after the overturning of Roe v. Wade, reminding them that if a doctor believes an abortion is necessary to stabilize a patient's emergency medical condition, "the physician must provide that treatment."

Well Texas wasn't a big fan of that oversight. So they sued the Biden administration, saying it was an effort to "force hospitals and doctors to commit crimes" and "transform every emergency room in the country into a walk-in abortion clinic."

As it stands, medical providers have found themselves having to decide between providing necessary emergency care to a pregnant patient and facing criminal prosecution from the state, or declining medical care and leaving a patient in crisis while facing federal sanctions for violating EMTALA.

Let's put this into a real world situation. I have been trying to get pregnant. I would love to have a baby. I would not have an abortion under any circumstance other than necessity.

So in this scenario, I live in Texas or Idaho and I get pregnant. At seven weeks pregnant, I begin to experience shoulder pain, vaginal bleeding and lightheadedness. It gets to the point where I feel I need to go to the emergency room.

After conducting tests, it's determined my pregnancy is ectopic. In a healthy pregnancy, the fertilized egg attaches itself to the lining of the uterus. In an ectopic pregnancy, the egg attaches itself somewhere outside the uterus, usually to the inside of a fallopian tube.

The pregnancy will always result in loss, and the ectopic tissue must be removed to prevent life-threatening complications.

But in this moment, my life is not at risk. Idaho and Texas would say their providers are not legally allowed to perform an abortion in this scenario because I'm not actively dying.

So they send me home. The structure containing the ectopic pregnancy typically ruptures before 16 weeks. When an ectopic pregnancy ruptures, bleeding may be severe and even threaten the life of the woman. The later the structure ruptures, the worse the blood loss, and the higher the risk of death for the pregnant woman.

If I'm not able to leave the state to find care, it may be too late for doctors to save me by the time they are actually allowed to.

As EMTALA stands, the language for when care is provided is much more vague. "Acute symptoms . . . such that the absence of immediate medical attention could reasonably be expected to jeopardize an individual's health or result in serious impairment to bodily functions or dysfunction to bodily organs or parts."

It is vital the Supreme Court rule with EMTALA so women can continue to have life-saving medical care.

On June 24, the two year anniversary of Roe being overturned, women around the country will strike for women's rights. Activists are calling for women to not attend work and not spend any money to show the economic impact of women. For those not able to participate in those activities, simply wear red to support the fight for medical care.