The molar pregnancy Jaci Statton had would never become a baby. It was cancerous, though.
At the last hospital in Oklahoma she went to during her ordeal last month, Statton says staff told her and her husband that she could not get a surgical abortion until she became much sicker.
"They were very sincere; they weren't trying to be mean," Statton, 25, says. "They said, 'The best we can tell you to do is sit in the parking lot, and if anything else happens, we will be ready to help you. But we cannot touch you unless you are crashing in front of us or your blood pressure goes so high that you are fixing to have a heart attack.'"
Oklahoma has three overlapping abortion bans, with different and sometimes contradictory definitions and exceptions. A study published Tuesday along with a commentary in the Lancet medical journal shows hospitals all over Oklahoma are struggling to interpret the laws and create policies that comply with the state's abortion bans. The resulting confusion is having dangerous consequences for women like Statton.
"Simulated patient" survey
In the study, the Center for Reproductive Rights, Oklahoma Call for Reproductive Justice and Physicians for Human Rights surveyed 34 hospitals around the state. Researchers found that most hospitals could not provide any information about their policies or procedures or explain what support would be provided to doctors who determine that an abortion is necessary to save a patient's life.
To conduct the research, several young women called 34 hospitals in the state with a script, saying they were pregnant for the first time, trying to decide which Oklahoma hospital to go to for care, and wanting to understand the hospital's policies and processes for providing abortions if pregnancy complications arose. "It's called the 'secret shopper' methodology – we called it a 'simulated patient' methodology," says Dr. Michele Heisler, professor at the University of Michigan and medical director of Physicians for Human Rights, who is one of the study's authors.
"What we hadn't anticipated is what we found – the confusion, the contradictory statements, the misinformation," Heisler says. "Three of the 34 hospitals said they'd just never provide abortions," for example, even though there are exceptions written into the laws. Four hospitals said doctors needed to go through an approval process to be able to provide a medically necessary abortion, and 14 hospitals provided unclear answers about whether there was such an approval process.
The Oklahoma State Board of Medical Licensure provided guidance in September for doctors in the state on how to navigate the abortion bans, but declined NPR's interview request, citing ongoing litigation. Oklahomans for Life, an anti-abortion rights advocacy group, did not respond to a request for comment by publication time.
"The woman's body as an incubator"
Heisler warns that it can't be said that this research shows definitively that Oklahoma hospitals do not have clear policies or guidance on how to apply these abortion laws, only that those policies were not available to the simulated patients who tried to get that information.
"I think one of the most frightening statements, which was at one of the hospitals, the person was trying to be reassuring and she said, 'Oh, well, you know, in the case of a medical emergency, we would try to use the woman's body as an incubator to just try to keep the pregnancy going as long as possible,'" Heisler says.
"Nobody should blame the hospitals," she adds. "They've been put in an untenable situation."
High health stakes, political potency
Oklahoma Governor Kevin Stitt pledged to sign "every piece of pro-life legislation that came across my desk." He has kept that promise. One of the three Oklahoma abortion bans comes with criminal penalties including felony charges and up to five years in prison for anyone who administers, prescribes, or "advises" a woman on an abortion. The stakes for interpreting the laws correctly are high for doctors and hospitals.
One big issue is how to understand the exception for when someone's life is in danger. The state Supreme Court ruled in late March that abortions must be allowed when a patient's life is in danger even if there is no medical emergency. The state legislature is also considering new exceptions to the abortion ban, and more court challenges are underway.
The incident where the Stattons were told to wait in the parking lot until Jaci's condition became life threatening happened two weeks before Oklahoma's state Supreme Court weighed in to clarify exceptions to the state's bans.
"This needs to change"
Jaci Statton's pregnancy ordeal began in late February. She's a stay-at-home mom living near Shawnee in central Oklahoma. She and her husband, Dustin Statton, have three kids – two seven year olds and an eight year old. Dustin is an oil field technician, and they have a fishing guide business – she says she and her family go fishing every day.
After weeks of feeling terrible – nauseous and dizzy and weak – Statton had a sudden episode of heavy bleeding that sent her to the emergency room. At her OB-GYN the next day, she learned she had a type of molar pregnancy, in which some of the tissue is cancerous. Molar pregnancy happens when a fertilized egg has too many chromosomes. It does not develop into a viable fetus. It is usually a benign condition, but in about 15% of cases, like Jaci's, it is cancerous. Her doctor told her she was at risk of hemorrhage and even death, but that she couldn't get treated there.
The treatment for a patient in her condition is a dilation and curettage or D&C – an abortion procedure that clears pregnancy tissue from the uterus. Over the course of a week, again and again, she says doctors told her they could not care for her.
After a week of being transferred to three different Oklahoma hospitals, Statton says her doctors actually suggested she leave the state and go to a place where an abortion is legal.
She and Dustin ended up driving three hours to an abortion clinic in Kansas where she was able to get a D&C. She's now facing another surgery to remove more cancerous tissue, and she may need chemotherapy. Mentally, she says, it's been rough.
"I think something needs to be done" about Oklahoma's abortion laws, Statton says. That feeling has prompted her to speak publicly about what she went through. "I don't know how else to get attention, but this needs to change."
Statton wants to try and ensure no one else has the same experience.
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