A group of pro-life OB-GYN doctors are pushing back on campaign-trail rhetoric, saying that a Georgia woman, Amber Thurman, who died after taking abortion drugs from a North Carolina clinic, was given improper treatment for chemical abortion side effects. Recent comments from Vice President Kamala Harris called her death the result of a “Trump abortion ban.”

Thurman received the chemical abortion drugs in a North Carolina clinic but did not receive the follow-up care that would have been required in the state’s Senate Bill 20, the “Care for Women, Children and Families Act,” passed by the state legislature in 2023. The aftercare requirement in SB 20 was ultimately overridden by less-stringent regulations imposed at the federal level by the Food and Drug Administration, a division of the US Department of Health and Human Services.

Removal of the after-care requirements can be traced to lawsuits filed immediately after SB 20 was passed, which argued that the state law was inconsistent with those federal regulations.

“This woman was failed by the abortion and medical industries, and three people are dead because of it,” said Chelsey Youman, national director of public policy with Human Coalition, in an interview with the Carolina Journal. “Who at the abortion facilities oversaw her health and well-being? Was she told about the side effects and risks of abortion pills? Where did the drugs come from? Why did the FDA eight years ago stop requiring a follow-up visit after taking abortion pills?”

fear on the campaign trail

In a list of top election concerns, Carolina Journal’s August poll found abortion ranked as a top issue behind inflation, immigration, and the economy, but ahead of education, taxes, and public safety.

Source: Carolina Journal

During a speech in Atlanta last week, Harris highlighted Thurman and another Georgia woman, blaming their deaths on a “Trump abortion ban,” a campaign message she uses often on the stump in these closing days of the election. Thurman traveled to North Carolina for an abortion after learning she was pregnant with twins.

“Now we know that at least two women — and those are only the stories we know here in the state of Georgia — died because of a Trump abortion ban,” Harris said. “The reality is, for every story we hear of the suffering under Trump abortion bans, there are so many of the stories we’re not hearing, but where suffering is happening every day in our country.”

The Trump campaign responded in a statement to USA Today: “President Trump has always supported exceptions for rape, incest, and the life of the mother, which Georgia’s law provides. With those exceptions in place, it’s unclear why doctors did not swiftly act to protect Amber Thurman’s life.”

Georgia’s six-week abortion ban went into effect on July 20, 2022. Thurman passed away in August of 2022 due to complications from taking abortion drugs.

how was post-care removed from state law?

North Carolina’s Care for Women, Children and Families Act initially required the patient to see the provider in person for pre- and post-abortion appointments. The state law from SB 20 continues to restrict abortion after 12 weeks (1st trimester), with certain exceptions. The law also bans medication abortion (medical abortion) after 70 days (10 weeks).

Following the passage of SB 20, Planned Parenthood and Dr. Beverly Gray of Duke Health filed lawsuits against House Speaker Tim Moore, R-Cleveland, and Senate Leader Phil Berger, R-Rockingham, disputing specific provisions in SB 20 and alleging that they interfered with federal law. US District Court Judge Catherine Eagles issued an injunction targeting the “hospitalization requirement” and the “IUP documentation requirement” within the bill.

The “IUP documentation requirement” mandates that doctors document the intrauterine location of a pregnancy before administering abortion drugs. The second requires hospitalization for all abortions performed after 12 weeks. Eagles issued a 34-page order, which leaves the rest of SB 20 intact and restricts most abortions after 12 weeks. 

In addition to the legal wrangling in North Carolina over medical care following a chemical abortion care, earlier this year the US Supreme Court failed to tighten these FDA regulations regarding the use of mifepristone in a 9-0 decision led by Justice Brett Kavanaugh.

investigative report details what went wrong

Last week, ProPublica issued an investigative report into the circumstances surrounding Thurman’s death. 

Thurman’s pregnancy had just passed the six-week mark on the day the law went into effect. She attempted to schedule a surgical abortion in Georgia as abortion-access advocates tried to pause the state’s six-week limit law in court. However, Thurman was well into her ninth week of pregnancy and couldn’t delay any longer, so she scheduled an abortion in North Carolina on August 13. Due to travel delays caused by traffic, Thurman missed her window for surgery. Rather than reschedule, she accepted the option of chemical abortion drugs, reported ProPublica. Despite this, she experienced complications from the drugs because not all the fetal tissue had been completely expelled from her uterus. 

According to the investigation, had she been in North Carolina, Thurman’s needed standard follow-up procedure, known as dilation and curettage, or D&C, would have been performed free of charge. But four hours away, after returning home to Georgia, she went to Piedmont Henry Hospital in Stockbridge. Doctors delayed performing the D&C until 2 pm the following day. When Thurman was finally taken to the operating room, she died on the table. 

Federal lawmakers believe Piedmont may have violated federal law by failing to provide Thurman with proper care. The Emergency Medical Treatment and Labor Act, or EMTALA this law was passed in 1986 and requires any hospital that receives Medicare funding to provide any patient with “stabilizing treatment” to any person with an “emergency medical condition,” according to the letter Sen. Ron Wyden, D-Oregon, sent to David Kent, CEO of Piedmont.

The confusion surrounds whether the Georgia “Living Infants Fairness and Equality Act”(LIFE Act) criminalizes or, at the very least, creates hesitation in healthcare providers to perform a D&C, leading to the delay in Thurman’s treatment. The ProPublica investigation blamed the law for Thurman’s death.

But the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) put out a detailed X-thread arguing what the standard of care should have been in Thurman’s case. They assert that Georgia’s LIFE Act does not criminalize a D&C in these situations and the hospital was obligated to stabilize her.

According to pro-life North Carolina lawmakers, the Harris campaign narrative on abortion policy and cases like that of Amber Thurman misrepresent the real risk to women, and the challenge that states face in post-Dobbs policy.

“What the Supreme Court did under Dobbs is return the issue to the states so the states get to decide what the limits would be for when you can get an abortion,” NC Sen. Amy Galey, R-Alamance, told the Carolina Journal. “States like Vermont have said there is no limit. You can get an abortion up through birth. So if the vice president were correct, then you wouldn’t be able to get an abortion all the way through to birth in those states like Colorado and Vermont. So obviously, since we have states now where you can get an abortion up until birth, Trump did not ban abortion.”   

Thurman’s case is noteworthy because it’s a rare case where an abortion-related death that has been deemed preventable is being brought to light, according to the report.

“Let’s be absolutely clear: Amber Thurman died after taking abortion pills,” said Youman. “Unfortunately, she had already lost her children before she arrived at the hospital, so the required standard of care was immediate removal of her children’s remains. Because removal of an already deceased child is clearly not an abortion, the state’s heartbeat law did not apply. The hospital completely failed her by not providing her basic standard of care after complications from her abortion. Tragic malpractice, resulting in multiple deaths, requires us to examine the dangers of abortion and unregulated abortion practices.”

In 2019, experts predicted that events like the death of Thurman would occur due to restrictive abortion laws pitting patients’ needs against doctors’ fear of prosecution. 

“They would feel the need to wait for a higher blood pressure, wait for a higher fever — really got to justify this one — bleed a little bit more,” said Dr. Melissa Kottke, an OB-GYN at Emory, in 2019, during a hearing over Georgia’s six-week abortion limit.

In 2016, the FDA extended the use of mifepristone from seven weeks gestation to 10 weeks gestation. Thurman was well past her ninth week when the drugs were prescribed. In 2021, the FDA removed the requirement for follow-up in-person visits.

“I think it’s really sad that this young woman died in Georgia, and people are trying to use her death to make a political statement,” said Galey. “I think it’s unfortunate that the vice president would even mention it in a big speech.”