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Louisiana's abortion ban has doctors worried about patients — and their own careers

AILSA CHANG, HOST:

Across the country, there is fear and confusion inside some hospitals as doctors try to give the best medical care while staying within the bounds of new abortion restrictions. That is especially true in Louisiana. As Rosemary Westwood with member station WWNO reports, doctors say a new abortion ban could put their patients and themselves at risk.

ROSEMARY WESTWOOD, BYLINE: Dr. Nina Breakstone works in the emergency department of a New Orleans hospital. For the last month, she's been going to work under a cloud of uncertainty.

NINA BREAKSTONE: I'm terrified for myself, as a woman of reproductive age, and I'm terrified for my patients.

WESTWOOD: A Louisiana law now bans nearly all abortions. There is an exception to avoid a substantial risk of death to the pregnant patient or a threat of serious, permanent impairment to a life-sustaining organ. But those exceptions are left up to doctors. Get it wrong, and the risks are enormous.

BREAKSTONE: I don't want to go to jail for 10 years for doing the right thing by my patients.

WESTWOOD: Breakstone said she also doesn't want to deny them medical care. She sees a lot of miscarriages in the ER, but the law only allows abortions for miscarriages if the fetus is already dead. Breakstone said waiting for the fetus to die before she acts could be risky for her patients.

BREAKSTONE: No one has any idea how many things go wrong, how fast things can go wrong and how deadly that can be.

WESTWOOD: Dr. Tara Castellano is an oncologist specializing in cancers of reproductive organs. Castellano is worried that cancer patients with a less serious diagnosis might be denied abortions they need to start treatment, like chemotherapy. It will just depend on their doctor's interpretation of the law.

TARA CASTELLANO: If people are skittish, and if you're risk averse as a physician, you might just not want to even go down that road as an option.

WESTWOOD: Castellano said the law has fundamentally changed medicine.

CASTELLANO: You know, it's like inviting legislators and administrators and politicians into the exam room.

WESTWOOD: And potentially prosecutors. Ochsner Health, Louisiana's largest health system, has told doctors it will defend them against criminal charges. But that doesn't protect doctors from being investigated. Proponents of the state's abortion ban argue the law is clear. Angie Thomas of Louisiana Right to Life said they consulted with doctors in drafting the exception. I asked her what she'd say to doctors afraid of prosecution.

ANGIE THOMAS: I mean, I would tell them, use good-faith medical judgment. I mean, it's - don't be fearful of that if you are protecting their life.

WESTWOOD: Dr. Will Williams is a New Orleans maternal-fetal medicine specialist, meaning he sees the most severe pregnancy complications. He sometimes has to tell women that continuing their pregnancies gives them a 20- or 30-fold risk of death. Even for those patients, who should still be allowed abortions under the law, Williams worries they won't get them because they're afraid.

WILL WILLIAMS: And I do believe that there will be women who ultimately have very severe health outcomes, those including death.

WESTWOOD: Nina Breakstone, the emergency room physician, said she's going to continue to provide abortions for miscarriages.

BREAKSTONE: I think that what I will do is do what I think is best - and hope that I don't get charged - and chart defensively.

WESTWOOD: That's been a key bit of advice from hospitals to doctors in Louisiana - record everything in a patient's chart to defend your choices. And if you're still worried, call a hospital lawyer just in case. For NPR News, I'm Rosemary Westwood in New Orleans.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

Rosemary Westwood is the public and reproductive health reporter for WWNO/WRKF. She was previously a freelance writer specializing in gender and reproductive rights, a radio producer, columnist, magazine writer and podcast host.
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