December 19,2024

Wyden Investigation Highlights Dangers of Post-Dobbs Emergency Medical Care for Pregnant Women

Ahead of Republicans controlling the White House and both houses of Congress, Wyden calls on hospitals, medical societies, and states to take action to protect patients and providers

Washington, D.C. – Senate Finance Committee Chair Ron Wyden, D-Ore., today released the findings of the Committee’s investigation into eight hospitals that reportedly delayed and denied women emergency reproductive health care in potential violation of the Emergency Medical Treatment and Active Labor Act (EMTALA) post-Dobbs.

The Committee’s report, “Practicing Amid ‘a Minefield’: Emergency Reproductive Health Care Post-Dobbs,” reveals that, faced with the challenges presented by state abortion bans, most of the hospitals surveyed have not provided physicians with clear and comprehensive guidance on protocols for providing the emergency reproductive health care that is guaranteed under EMTALA. Committee discussions with emergency room physicians, family medicine physicians, and obstetrician and gynecologists (OBGYNs) from across the country make clear this lack of guidance from hospitals is pervasive, and doctors say they are scared to provide the emergency care they swore an oath to provide, even in the most dire of circumstances. Women continue to pay a deadly price for the chaos and confusion Republican lawmakers have created by passing state abortion bans.

“As a second Trump regime begins and MAGA Republicans take control of Congress, it’s going to be all-hands-on-deck to make sure women can get the reproductive health care they need, no matter where they live,” Wyden said. “Because of MAGA Republican abortion bans, women are suffering and dying. Make no mistake: as long as these bans are on the books, women will continue to die. Hospitals can and must do more to protect patients and providers amid Republican-created chaos and control.”

In the report, Chairman Wyden outlined the steps hospitals, provider groups, hospital associations, and other organizations should take to protect women and providers as MAGA Republicans take back full control of the White House and Congress:

  • Hospital associations, provider groups, and hospitals should work together to provide training, guidance, and resources to doctors on the interplay between EMTALA and abortion bans. Content should include state-specific information, a “decision tree” adapted to the requirements of state laws, protocols for assessing a pregnant patient, and information on how to navigate exceptions to abortion bans.
  • Professional medical organizations should issue guidance and publish standards that clearly define appropriate clinical care in obstetric emergencies. Professional medical organizations should ensure that all clinicians receive appropriate education and training on these standards. In states with abortion restrictions, there should be additional education on how to stabilize pregnant patients, including when to pursue a surgical intervention.
  • Hospitals should support the full-spectrum of providers – OBGYNs, primary care physicians, and family medicine physicians – in becoming certified to prescribe mifepristone. As reproductive health care access continues to be eroded across the country, providers must step up to be an access point for mifepristone and safeguard their patients’ reproductive autonomy.
  • OBGYNs, primary care physicians, and family medicine physicians should proactively counsel pregnant patients on their EMTALA rights and how to report potential violations to CMS. To support this effort, provider groups should develop patient-facing information and training for their members on how to discuss patients’ rights under EMTALA.

The Committee also recommends the following priority actions to restore comprehensive emergency reproductive health:

  • The protections guaranteed by Roe v. Wade should be established in all states. States should enact laws that use the protections enshrined in Roe as the standard to protect access to abortion and comprehensive reproductive health care. Democrats will continue to champion the urgent need to restore Roe and codify a federal right to abortion.
  • EMTALA should be enforced to the fullest extent of the law. Democrats and the Committee will demand strong enforcement by CMS as a leading watchdog and closely monitor the agency’s enforcement efforts.
  • CMS and the independent HHS Office of the Inspector General (HHS-OIG) should receive the full resources needed to carry out comprehensive EMTALA enforcement activities. Democrats will continue to advocate for this essential funding and closely monitor enforcement efforts.

The report follows a Finance Committee hearing in September, where members heard directly from Kaitlyn Joshua of Baton Rouge, La., a state that implemented a near-total abortion ban following Dobbs, who testified to experiencing care delays during her second pregnancy. The Committee also heard from Dr. Amelia Huntsberger, a generalist OBGYN, who was forced to move from Idaho to Oregon due to Idaho’s strict abortion laws.

The full report can be found here.

Supporting documents for the report can be found here.

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