Analysis

4 things to know about the letter 111 OB/GYNs wrote to condemn Texas’ pro-life law

pro-life, American Medical Association, Alaska

This week, a group of 111 Texas OB/GYNs sent a letter “to elected officials and policymakers in Texas,” claiming that the recent ProPublica stories about two pregnant women who died in Texas are proof that the state’s pro-life law is harmful to women.

The doctors claim in their letter that ProPublica’s “evidence is clear” that pro-life laws were what caused the deaths of Josseli Barnica and Nevaeh Crain, that it was pro-life laws that harmed these women. And yet, Live Action News has debunked these claims, as have other groups, showing that these reports are blaming pro-life laws while ignoring nearly identical cases of negligence and injury in states without pro-life laws.

And in fact, laying the blame on pro-life laws is ProPublica’s stated goal, though even the Associated Press admitted earlier this year that its own analysis revealed that “[s]erious violations that jeopardized a mother or her fetus’ heath occurred in states with and without abortion bans…” (emphasis added).

Four questions:

  • Who are these doctors, and do some have pro-abortion affiliations?
  • Are these doctors speaking consistently about whom they view as patients?
  • Is this letter exploiting the women who died, and does it mislead the public?
  • Who is largely responsible for the false narratives and failure to guide doctors?

Secular Pro-Life effectively summed up the first reason why this doctors’ letter should be highly suspect:

The doctors stated, “The nature of the strict abortion ban in Texas does not allow us as medical professionals to do our jobs… We know firsthand how much these laws restrict our ability to provide our patients with quality, evidence-based care.”

As of 2023, there were a reported 910 OB/GYNs employed in Texas. So, who are some of the 111 (12%) that signed this letter?

Doctors’ associations with abortion 

The first signer’s name on the letter is Dr. Damla Karsan, one of the plaintiffs who sued Texas in the case Zurawski v. Texas. Karsan had planned to commit an abortion on Kate Cox’s preborn daughter in Texas, who was diagnosed with Trisomy 18. The pro-abortion media claimed that Cox’s life was put at risk by her pregnancy. Cox eventually went out of state, specifically to obtain a D&E abortion on her daughter, Chloe, in the second trimester. (A D&E, or dilation and evacuation, removes the pain-capable, still-living preborn child from the mother’s uterus piece by piece, by dismemberment.) Not long after the abortion, Cox happily announced another pregnancy, without apparent concern for her safety, though this pregnancy carries the same risk to Cox as her pregnancy with Chloe. Yet, Cox does not intend to abort this new child unless he or she is also diagnosed with a disability. Cox is willing to endure the potential risks to herself, as long as her baby is free of disability. Dr. Karsan was the only plaintiff whom the Court recognized had proper standing to sue; however, the Court also noted that the state of Texas allows lifesaving abortions under the law, which has not changed since the case and which was also further clarified by the Texas Medical Board.

Another signer, Dr. Allison Gilbert, is an abortionist who at one time worked for Southwestern Women’s Options (SWO) in Dallas and may currently work at the late-term abortion facility that formerly operated as SWO in Albuquerque, New Mexico (once owned by Curtis Boyd, who reportedly committed more than 250,000 abortions). This was the facility responsible for the death of Keisha Atkins, who sought a second-trimester abortion there at six months gestation. New Mexico is one of nine states which has no limits on abortion.

Another of the signers of the letter is Dallas OB/GYN Dr. Austin Dennard, a mother who sought an abortion in Texas after her preborn child was diagnosed with anencephaly, a human being to whom she referred only as “a lethal anomaly.” Dennard claimed in an ad promoting the Biden-Harris campaign that her own life was at risk with this pregnancy; in fact, her life was no more at risk than any other mother carrying a child without a disability. In her words, she sought to end her baby’s life by abortion so that she would not have to “watch him die.” The claim that her health was somehow at risk due to her son’s diagnosis is false — and extremely troubling, given that Dennard is a practicing OB/GYN.

Signer Dr. Todd Ivey, who reportedly “spearheaded” the doctors’ letter, is a district officer for the pro-abortion American College of Obstetricians and Gynecologists (ACOG) who, in 2023, said he “fully expected” to see increased maternal mortality due to pro-life laws — without any evidence (and despite evidence to the contrary). Ivey is also reportedly associated with Texas Children’s Hospital. The false narrative portraying intentionally killing preborn children as ‘health care’ — advanced by pro-abortion groups like ACOG (which has, for decades, wholeheartedly endorsed abortion and population control), and by misleading pro-abortion media like ProPublica — work in tandem.

Signer G. Sealy-Massingill has worked as an abortionist in Texas; he was named chief medical officer of Planned Parenthood of Greater Texas in 2017, and also served as Section 2 chair for District XI for ACOG.

Dr. Ann Schutt-Aine, another of the signers, is an abortionist who was caught on undercover video by pro-life investigator David Daleiden. In the footage, she described how (as Chief Medical Officer of Planned Parenthood Gulf Coast at the time) she would “pull off a leg or two” from the body of a child she was killing before fully removing the baby from the vaginal canal in an effort to alter her abortion procedures so she couldn’t be accused of committing a federally illegal D&X “partial-birth” abortion.

Schutt-Aine also told Daleiden, “[Y]ou told me about the proposition, and so now every time a do a D&E [dilation and evacuation abortion], I’m like, ‘Oh there’s some lungs, there’s some kidneys.”

At the time, Daleiden was posing undercover as a harvester of fetal organs, which his ‘business’ would purchase from Planned Parenthood and then sell to researchers. She told Daleiden that if anyone outside the abortion industry were to hear her talking about having a “leg” to sell, the reaction would be horror. “I’m like, oh sh**, if other people were to hear me, they’d be like, you are f***ing evil,” she said.

 

Is the preborn child a patient?

About a dozen of the signers, like Ivey, appear to be associated with Texas Children’s Hospital, which is equipped with a Level IV NICU (to provide the highest level of medical care for babies born prematurely, before 32 weeks). Among those physicians are Dr. Nina Ali, Dr. Diana Crabtree, Dr. Bayless Drum, Dr. Brennan Lang, Dr. Tara Harris, Dr. Susan Raine, Dr. Audra Timmins, Dr. Paola Torres Ortiz, and Dr. Utsavi Shah. Some are also associated with the Texas Children’s Fetal Center, which claims on its web page (emphases added):

Our patient outcomes, breakthrough treatments, and comprehensive care for mother and baby are made possible through one of the nation’s leading teams of maternal, fetal and pediatric specialists. Here, you and your baby will be cared for by a multidisciplinary team that includes maternal-fetal medicine specialists, imaging experts, surgeons, neonatologists, geneticists, pediatric cardiologists and pulmonologists, among many others, as well as specialized support staff that make every step of your journey easier.

Through their combined expertise and unified approach, this remarkable team is delivering the highest quality care available for pregnancies involving fetal abnormalities.

Interestingly enough, unlike the description on the Fetal Center’s website, which mentions the “baby” as a patient along with the mother, the doctors’ letter does not mention “the baby” as a “patient” of concern. The letter’s signers associated with the Fetal Center’s steering committee include Ivey, Dr. Manisha Gandhi, and Dr. Christina Davidson.

If a hospital is equipped to help save even the tiniest and most fragile premature babies, shouldn’t one expect that its physicians, tasked to deliver those children and care for their mothers, would see these preborn human beings as their patients, too? Yet the letter only mentions “doing often what is medically necessary for the patient’s health and future fertility” — nothing similar to the Fetal Center’s discussion of “comprehensive care for mother and baby” (emphasis added).

Texas OB/GYN letter text (Screenshot: X)

Texas Children’s even boasts treatment for multiple high-risk conditions, including prenatal surgery for spina bifida and treatment for Twin-to-Twin Transfusion Syndrome — about which, the hospital says “the majority” who receive “appropriate treatment… will survive and… be normal and healthy. The survival of both twins is very important to us.”

If a preborn child’s survival is important in one scenario, shouldn’t it at least be worth a mention in other scenarios? Why is the preborn child disregarded as a patient in this letter from obstetricians, when the preborn babies of both Josseli Barnica and Nevaeh Crain also died along with their mothers?

Yes, “Josseli Barnica and Nevaeh Crain should be alive today.” And we would want their children to be alive, too.

Doctors do not need to ignore (or intentionally destroy) the life of a preborn child to treat his or her mother, and both deserve to be treated with dignity and respect. There can be no doubt that the Barnica and Crain families are grieving the loss of both these mothers along with the children they carried.

These cases of apparent medical malpractice, and failure to recognize the signs of sepsis, should serve as a wake-up call to medical professionals to listen to their patients and take the threat of infection seriously.

Other doctors know that direct and intentional killing isn’t necessary

Since ProPublica released its first two misleading articles in September, blaming Georgia’s pro-life laws for the deaths of two women who obtained the abortion pill, many groups have been speaking out to correct the claims. Live Action News addressed the case of Amber Thurman (Georgia) and Candi Miller (Georgia), pointing out that similar cases have occurred in states with no pro-life protections. We pointed out how the media and abortion industry’s misleading claims about these cases, and misleading of the public about miscarriage and ectopic pregnancy treatment, are doing harm to women.  We addressed the heartbreaking deaths of Josseli Barnica and Nevaeh Crain, and have shown how it is not pro-life laws which are doing harm; it is misinformation about those laws, and a lack of information about those laws, which is doing harm.

And physicians who treat pregnant women every day are stating the same.

Dr. Ingrid Skop, a Texas OB/GYN who is also the VP of Medical Affairs for the Charlotte Lozier Institute, stated that Nevaeh Crain’s death was preventable and that she “received substandard medical care.” Sepsis, which ultimately led to Crain’s death, can take hold very quickly, and signs must be recognized and responded to quickly. In Crain’s case, they were not. Currently, the Sepsis Alliance says that 23% of in-hospital maternal deaths are related to sepsis, and this percentage has gradually increased over the years. In response to the case of Josseli Barnica, Skop stated that her death (also due to sepsis) was a case of “medical malpractice,” and “poor quality care all around.”

Neither the Texas Heartbeat Act nor the state’s current pro-life law prevented physicians from providing proper care to these patients. Dr. Christina Francis, an OB/GYN and CEO of the American Association of Pro-Life Obstetricians and Gynecologists, addressed this in a video on Monday, explaining that both she and Dr. Skop find the Texas OB/GYNs’ letter “egregious” and “misleading to the public and to legislators” and “exploitative” of the women’s deaths.

Both Francis and Skop are OB/GYN hospitalists, which Francis said means that “we only work in the hospital. We take care of women that are coming in to labor and delivery units or into emergency rooms. So we are seeing women with pregnancy complications and with emergencies in pregnancy each and every day. So we speak from years and years of experience….”

The doctors took issue with the letter’s claim that Texas law “does not allow women to get the lifesaving care they need.”

Skop pointed out that the law in Texas has not prevented her from providing care for miscarriages, ectopic pregnancies, and even care in complicated situations where a pregnancy must end. “We’ve seen really just a lot of misleading of physicians in Texas and a lot of fear mongering, a lot of making doctors fear that they’re going to be prosecuted,” she said, and yet no doctor has been prosecuted since the end of Roe “for performing abortion for the life of the mother.”

“Sometimes tragically… a severe pregnancy emergency means that we do need to end a pregnancy…. Most of the time when that happens later in pregnancy, our action is to induce labor. Most of the time we can save that baby… but we all do the right thing for the mother. Quality medical care says we need to follow the standard of care and if a baby needs to be delivered to protect his mother, we are willing to do that, and Texas law does not prevent us from doing that.”

Francis discussed the cases of Crain and Barnica, describing how Crain showed signs of infection, yet was left in an ER waiting room for four hours without being seen by anyone in obstetrics. Her symptoms were, according to Francis, “all things that would raise very big red flags, for those of us who are OB/GYNs, in a pregnant patient. You don’t treat a temperature of 102.8 in a pregnant woman the same way you treat it in a non-pregnant patient. We take those fevers much more seriously…. She even screened positive for sepsis…. From my read of this, it sounds like her uterus wasn’t the source of her infection, but most likely this urinary tract infection.”

Francis then described how she once had a patient in residency who had a kidney infection that very rapidly turned septic from a urinary tract infection; this patient survived because she was in the ICU and was treated aggressively with antibiotics.

Francis pointed out that despite doctors’ actions in Barnica’s case, Texas’ law did not require a heartbeat to no longer be present in order to intervene in an emergency. “Once she did deliver, they sent her home eight hours later, which is not standard of care where I practice, and that she called in complaining of bleeding and pain and was told that was normal, so they didn’t have her come back in for evaluation — and then she tragically died. Her death certificate… showed that her death was from sepsis… but also… retained tissue… Not all of her placenta came out at the time of delivery….”

Francis added that neither case was the fault of the Texas law.

False narratives and failure to lead

Obstetricians have always understood what wording like “reasonable medical judgment” and abortion for “life of the mother” mean, according to Skop, because “even the federal Hyde Amendment, for example, prohibits payment of elective abortion, and yet it has always allowed payment and doctors to perform an abortion if it is needed to save the life of the mother. So doctors know what it means.” She added that “there is no imminency requirement in [Texas] law,” meaning that “a doctor does not need to wait until a woman is dying until he can intervene.” Yet that has been the false narrative pushed by abortion ideologues and the pro-abortion media.

So if the problem isn’t the law itself, then what is? Skop laid it out clearly:

Doctors are not attorneys. We have always relied on our professional medical associations to explain new laws that impact the practice of medicine, and this happens commonly. The Affordable Care Act, the HIPAA privacy regulations, even the opioid prescribing changes… do have also significant punishments involved. So this is not the first time that doctors have seen a significant concern from the law that they need to obey the law.

But every time what has happened is our medical organizations have explained the law to us. In fact, nearly every year, I am required to take mandatory CME [continuing medical education] to make sure I still remember how to prescribe opioids. So this is how it works in medicine.

And yet, Skop said, with these pro-life laws, things were handled very differently.

“But this time it did not work this way. None of the medical organizations voluntarily helped the doctors understand the law, and in fact, sometimes they were stirring up the confusion and fear themselves… and then when doctors did become confused and provide sub-quality care… then that’s being pointed at as demonstration that the laws are confusing,” she said, instead of placing the blame on the medical organizations for refusing to provide clarity, apparently in order to further their pro-abortion narrative.

“But the good news is, I think most doctors in Texas understand the law now,” Skop said, due to guidance from the Texas Medical Board and Texas Supreme Court which have both weighed in.

“To date since 2022, there have been 119” abortions for life of the mother, Skop noted, and no one has been prosecuted. “Most doctors do understand. So I think we need to look at the doctors who wrote this letter and recognize that there is some other agenda there. The law is not confusing.”

Because the leading professional medical organizations have been delinquent in providing additional clarity about laws protecting preborn children as well as pregnant women in emergencies, AAPLOG and other groups have joined together to promote a Women’s Healthcare Declaration, currently signed by 12 medical and health policy organizations. Read more here.

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