Amanda Zurawski tells a harrowing story of medical trauma in a post-Roe world.
The Supreme Court’s decision to overturn Roe v. Wade has had far-reaching consequences. About 30 million women live in a state where abortions are now banned in some form. Since the ban, 66 clinics across 15 states have stopped offering abortion services.
Abortion bans are reshaping healthcare for people undergoing a variety of experiences. Unfortunately, Amanda and Josh Zurawski learned about the dangers of abortion bans when they sought miscarriage management in Texas. The loss of the Zurawskis’ daughter, Willow, nearly ended Amanda’s life as well. This incredibly tragic video, produced by our friends at the online media platform Meteor, and Amanda’s accompanying essay illustrate how these bans have dangerous and far-reaching effects on people in all types of scenarios.
After initially struggling to get pregnant, Amanda Zurawski underwent fertility treatments. The time and money paid off, and she was in her second trimester in August of 2022. At 18 weeks, however, Amanda began to feel off. Her pelvis “felt…abnormally ‘open,’” she wrote in her essay. Plus, her body began discharging thick, yellow fluid.
After seeing her OB-GYN for a quick exam, Amanda learned she had an “incompetent cervix” — that is, a cervix that has dilated prematurely. As a result, the Zurawksis’ daughter would inevitably die before birth.
Heather Irobunda, MD, of Obstetricians for Reproductive Justice explains in Meteor’s video that cervical incompetency (or insufficiency) only happens “in about 1 percent of all pregnancies.” However, it’s comparatively common among people who miscarry: “it happens in about 20 percent of people who end up having miscarriages [in the second trimester].”
This upsetting news can come on fast, too: “You can evaluate a patient a week or a few days before and everything looks fine. And then…your patient comes back in and is like, ‘I feel…a lot of pressure…Can you check me out?’ And then their cervix can be completely dilated and there’s no real reason,” says Dr. Irobunda.
“If a cervix is dilated prematurely in the second trimester, things get very serious, very quickly. The risk of infection is so high, especially with an exposed membrane and bag of water in the vagina,” says Jennifer Lincoln, MD, of the same clinic. “And then Amanda’s ruptured.”
While Amanda and Josh reeled from the loss of their daughter, they were also shocked to hear that Amanda’s healthcare team would be unable to treat her immediately. Typically, Dr. Irobunda says that doctors would quickly perform a dilation and evacuation to remove the pregnancy. Or, patients might receive medication to induce the miscarriage under observation.
After the abortion ban, however, these standard methods of care suddenly constituted an illegal abortion; to receive care legally, Amanda would need to face death. Amanda explains that “this was August 23, 2022, in the state of Texas, where abortion is illegal unless the pregnant person is facing “a life-threatening physical condition aggravated by, caused by, or arising from a pregnancy.” Amanda would need to wait to either go into labor naturally or develop a life-threatening infection.
Traveling to a sanctuary state was out of the question because there was a fairly high chance she could develop sepsis in-flight or on the road — a prospect that Amanda calls “a death sentence.” Dr. Lincoln agrees that “patients can go from being healthy and fine to being septic in a matter of an hour.” Unable to leave the state, Amanda was forced to wait. It took three days for her hospital’s ethicist board to deem her “sick enough” for treatment.
This wait — which was completely avoidable and unnecessary — left Amanda gravely ill: “I developed a raging fever and dangerously low blood pressure and was rushed to the ICU with sepsis. Tests found both my blood and my placenta teeming with bacteria that had developed as a result of the wait. I would stay in the ICU for three more days as medical professionals battled to save my life.” It’s still unclear what long-term effects the infection may have caused.
Dr. Lincoln says that while Amanda underwent a devastating experience, she is also very lucky to have survived: “These laws…eventually will end up killing patients…the bottom line is that when somebody can go from being healthy to dead in 30 minutes, how are we supposed to wade through all of that with lawyers who have no clue?” Obstetricians for Reproductive Justice’s Jenn Conti, MD, adds that the burgeoning culture of fear in hospitals will prevent providers from taking action as patients suffer: “[The] paralyzing fear amongst healthcare providers that, if anything goes wrong involving pregnancy, someone somewhere could accuse them of illegal activity. And that’s all that matters in states like Texas: an accusation of guilt.” Meteor produced this video to illustrate that any American might find themselves in such dire circumstances; across the country, healthcare workers’ hands are tied.
Amanda admits that she didn’t initially expect abortion bans to affect her, since she was so excited to become pregnant: “When the six-week abortion ban in Texas passed last year and Roe v. Wade was overturned this year, I was furious. But as someone who was then desperately trying everything I could to have a child, I never imagined it would impact me personally. I didn’t realize then the extent to which these laws would truly restrict a woman’s right to make the right decisions for herself, her body, and her future children. I didn’t realize the laws I was angry about would soon prevent me from safe access to healthcare. I didn’t realize these laws would directly prevent doctors from being able to protect their patients.”
Watch the video and read Amanda’s essay to learn more about the couple’s newfound mission to fight these dangerous bans. If you’re a patient or provider who has experienced harm post-Roe and are moved to help, the Obstetricians for Reproductive Justice invite you to visit their website and use their contact form to share your story. You can remain anonymous or participate in their future storytelling events.
