After several hemorrhages, Avery Davis Bell suffered a miscarriage at 18 weeks. The state of Georgia, where she was, limits abortions to the first six weeks of pregnancy and this fact prevented her from receiving the necessary treatment as soon as possible. During the endless wait, Bell reached a dangerously low oxygen level and guarantees: “No one should have to go through that”
In early October, Avery Davis Bell learned she was about to lose the baby she and her husband wanted so much.
The 34-year-old geneticist had been hospitalized in Georgia after repeated episodes of bleeding, and both she and her doctors knew exactly what was needed to treat the miscarriage and prevent a potentially fatal infection. They also knew why I wasn’t receiving that care right away.
In an instant, the impacts of her state’s restrictive laws on abortion care became clear: If Bell was bleeding from a car accident or a ruptured appendix, doctors could help her immediately. If she had suffered a miscarriage in Boston, where she lived until 2020, doctors might have taken action. But because she was having a miscarriage at a hospital in Georgia, the surgery had to wait.
Since the U.S. Supreme Court’s 2022 Dobbs decision eliminated the federal right to abortion, the management of abortions has become more complicated and, in some cases, more deadly.
Many miscarriages occur at home without medical intervention, but cases like Bell’s can be treated with the same medications or surgical techniques used for miscarriages.
have total or near-total bans on abortion. Several others restrict it to certain periods of pregnancy, including Georgia, which limits abortion to the first six weeks of pregnancy. Bell’s pregnancy was 18 weeks — too early for her fetus to survive outside the womb, but far beyond the Georgia limit.
Doctors told Bell she would have to wait unless her condition worsened: the condition forces people to wait 24 hours before they can have an abortion, except in cases of medical emergency.
Having lost so much blood, Bell needed two iron infusions and received a blood transfusion during surgery. (Courtesy of Avery Davis Bell)
Bell went into crisis mode.
“I was breathing, registering everything that was going on in my mind and thinking, ‘I just need to get over this,’” explains Bell. “I even told my wonderful husband, who was obviously devastated when we got this news, ‘I love you. Let’s be sad, but right now I have to overcome this medical emergency, and I’m sorry to ask you, but I need you to pull yourself together until I get to surgery. ”
Bell doesn’t blame his doctors at Emory University Hospital in Atlanta. Instead, he says he blames the law itself.
When Georgia’s six-week abortion ban went into effect in 2022, Republican Governor Brian Kemp promised that the state was “ready to provide the resources they need to be safe, healthy and informed.” But Georgia, which has long had one of the worst maternal mortality rates in the country, has also had at least two pregnant women unable to access timely medical care or legal abortions.
You are not the only state facing these problems. Texas enacted an abortion ban in 2021, and the rate of maternal deaths increased 56% from 2019 to 2022, according to the Gender Equity Policy Institutes’ analysis of U.S. Centers for Disease Control and Prevention data. , a woman died after being told it would be a “crime” to intervene in her miscarriage at a Texas hospital, and a pregnant teenager died after trying to get care for pregnancy complications in three Texas hospital visits.
In states with abortion restrictions, the maternal death rate rose twice as fast between 2018 and 2020 as in states without such restrictions, according to a 2022 report from . Inequities have deepened racial and ethnic gaps in health outcomes, as women of color — particularly black and Hispanic women — often have higher maternal mortality rates.
A troubled pregnancy
Bell and her husband, Julian, could have stayed in Boston, where she earned a doctorate in genetics and genomics at Harvard University and he graduated from MIT. But Bell grew up in Georgia and they wanted to be closer to family as they grew their own.
They were excited to have their first child, a son, in 2021.
In July of this year, I found out I was pregnant again. When he was 12 weeks pregnant, he told his son that he would soon have a brother. He was ecstatic.
“I talked to the baby and hugged him every day in my belly,” she says.
In September, Bell began having problems with her pregnancy. His health status was stable, but he was bleeding. Doctors diagnosed a subchorionic hematoma, a condition that causes bleeding between the uterine wall and the amniotic sac. A for herself, but Bell said she had one of those rare cases where she kept bleeding.
Doctors ended up advising Bell to stay on bed rest. She guarantees that she only left the house to vote early and to go to the doctor regularly.
But in early October, Bell’s bleeding worsened and he had to go to the hospital three times in two weeks.
At first, doctors told Bell the baby was still doing well. On the second visit, they warned her that if the bleeding didn’t stop, it could be too heavy for the fetus and dangerous to her own health.
At one point, a clot the size of a dinner plate passed through her. He took it out of the toilet and placed it in a food container to show the doctors.
“It was very scary,” recalls Bell.
On October 17, on his third visit to Emory, the doctor who delivered his first child was on duty. She ran tests and told Bell that her water had broken and that the pregnancy needed to end.
“She was with us for a long time and we got hugs,” Bell remembers. “When we get hugs from our doctor, it’s because it’s serious.”
Bell and her husband, Julian, endured an agonizing wait for her surgery. (Courtesy: Avery Davis Bell)
Waiting times and paperwork
Bell was devastated. I knew that, at 18 weeks of gestation, the fetus could not live outside the uterus.
The doctor called a specialist in complex family planning to help her. An intervention called dilation and evacuation would be needed to control the bleeding, clean Bell’s uterus and prevent infections.
But since the fetus still had a heartbeat, the procedure would be an abortion. Georgia law criminalizes abortions after six weeks except when “necessary to prevent the death of the pregnant woman or the substantial and irreversible physical deterioration of a major bodily function.”
The doctor “was telling me ‘because we’re in Georgia, we can’t immediately proceed to surgery,’” Bell recalls.
The 24-hour waiting period in Georgia scared and frustrated her.
“It’s very difficult, because it’s a wanted pregnancy, feeling like it’s inevitable and the waiting period I was put in made it more difficult,” explains Bell. “We couldn’t just go from an emergency situation to a successful situation. We had to stay in limbo. My fetus is dying, and I’m stable right now that I’m thinking this, but in 10 minutes I might not be, and that’s a time that no one should have to prolong, that limbo.”
The law also required Bell to fill out paperwork that she found distressing and that outlined the medical risks of abortion, the likely age of the fetus, the presence of a human heartbeat, and details about potential economic support if she were able to give birth.
“I had to sign a consent form for an abortion, which has nonsense language about heartbeat and fetal pain and other things that are clearly put in for legislative reasons and not scientific reasons,” says Bell.
The hospital transferred Bell — still bleeding and in pain — to another location that was better equipped to do the surgery, but where he would still have to wait again until doctors figured out when they could schedule the procedure.
Later that day, tests revealed that the levels of oxygen-carrying hemoglobin in his blood had reached a dangerously low level, putting his life at risk. This new sign meant doctors could finally help her.
Bell was grateful to have finally received the care she needed, but angry at her doctors, who, in her opinion, were not allowed to use their best judgment.
“My doctor had more than a decade of post-college training to be able to deal with these situations, and yet the law stopped her,” he says. “It makes doctors jump through hoops written by elderly men who have no medical knowledge and have an ideological position inconsistent with how biology works.”
Emory University declined CNN’s interview request but said in a statement: “Emory Healthcare uses the consensus of medical literature from clinical experts and legal guidance to support our providers as they make individual treatment recommendations in compliance with abortion laws. of Georgia, our top priorities continue to be the safety and well-being of the patients we serve, no matter where the patients or doctors live.”
Bell says she was fortunate to have a scientific background and a family that helped her advocate for herself, but she worries about other people who get abortions in Georgia. (Courtesy: Avery Davis Bell)
‘We are transforming the situation into something even worse with this law’
Dr. Sarah Prager, a member of , a professional organization representing more than 26,000 doctors, says abortion laws like Georgia’s are inhumane.
“You have people who are not clinicians intervening in a medical decision, which is asinine,” says Prager, who was not involved in Bell’s care. “The whole point of modern medicine is to prevent disease, so pushing people to the brink of death and making them back away because of some law is wrong, and if anything, we don’t always succeed.
“It’s cruel and devalues a person’s life and health”, he adds.
Prolonging the situation also has an emotional cost. It will take some time to heal physically and emotionally, explains Bell, who had to receive another iron infusion after surgery and is only now starting to walk again.
Eventually, he hopes to create a scrapbook with his ultrasound, the notes he received from friends and family, and a printout of the tiny footprints he received from the hospital. He still hasn’t been able to see them.
What remains is a mix of emotions. The entire family is saddened by the loss of the pregnancy. Bell and her husband still hope to have another child. And there is anger that Georgia state laws have prolonged their painful experience.
“Even if everything had gone perfectly, this would be one of the worst times of my life and the most difficult times for my entire family”, he guarantees. “And so we are turning the situation into something even worse with this law.”
Having his family around him and having a scientific background made it easier to defend his care, he notes. The doctors assured her, during her hospitalization, that they would not let her die. They treated her like a colleague, communicating clearly and going out of their way to help her. But not everyone has the same circumstances, and she worries about other people who get abortions in Georgia.
“I have overwhelming gratitude for my doctors, sadness for the child we are expecting, and anger at the ways this has been made more difficult for me and my care team because of laws and policies that are not based in biological reality,” Bell said. “Nobody should have to go through this.”
