A 3rd Texas Woman Died Amid Confusion, Inaction Over Abortion Ban

On Monday, we learned of a fifth woman who died after experiencing pregnancy complications and being denied a life-saving emergency abortion procedure. Of these stories, all reported by ProPublica, Porsha Ngumezi is the third from Texas, which imposes a total abortion ban that threatens doctors with life in prison. A committee of medical experts told ProPublica that Ngumezi’s death was preventable if she had received a dilation and curettage or D&C procedure.

Ngumezi, a mother of two young sons she shared with her husband Hope, was approximately 11 weeks pregnant in the spring of 2023 when she began experiencing bleeding consistent with miscarriage. She drove herself to the emergency room at Houston Methodist Sugar Land, where Hope later joined her after finding childcare. 

At the hospital, an ultrasound all but confirmed she was in the middle of a miscarriage, which carried greater risk due to a blood-clotting disorder she suffered from. But Ngumezi hadn’t received prior prenatal care because her OB/GYN told her it was too early to come in. Consequently, there was no documentation of how far along she was, which could be a legal vulnerability for the hospital. Over the next six hours, Ngumezi passed out and needed two blood transfusions. A nurse’s note reveals Ngumezi was also passing blood clots “the size of grapefruit.” Hope called his mother, a former physician, who told him she needed a D&C. Doctors who received medical notes also told ProPublica that since she was clearly hemorrhaging, the D&C was the only way to vacuum all remaining fetal tissue from her uterus and stop the bleeding.

Finally, seven hours after she arrived at the hospital, the OBGYN, Dr. Andrew Ryan Davis, arrived to see her. He gave her misoprostol, a common pill involved in medication abortions or to induce labor and stop postpartum hemorrhage. But, experts told ProPublica, it’s unsafe to give misoprostol to someone who’s bleeding heavily, especially one with a blood clotting disorder like Ngumezi. Dr. Elliott Main, the former medical director for the California Maternal Quality Care Collaborative and an expert in hemorrhage, told the outlet that Ngumezi “needed to go to the operating room.” Instead, Texas’ laws seemed to influence the Methodist hospital’s decision-making.

Dr. Gabrielle Taper, who recently worked as an OB-GYN resident in Austin, explained to ProPublica that Texas’ abortion ban has made doctors across the state hesitant to offer D&C procedures; giving misoprostol pills seems less legally risky. Thanks to the ban, Taper said, “there was much more hesitation about: When can we intervene, do we have enough evidence to say this is a miscarriage, how long are we going to wait, what will we use to feel definitive?”

As the night progressed, Ngumezi complained of chest pain and said she didn’t feel right. Nurse notes indicate her vitals looked fine, but medical experts told ProPublica that when healthy pregnant patients are hemorrhaging, they can appear stable until they crash, at which point, they could deteriorate too quickly for hospitals to save their lives. This appears to be what happened to Ngumezi, who died nearly 10 hours after arriving at the emergency room. 

I burst into tears when I got here. The speaker is a bereaved husband.
“We all know pregnancies can come out beautifully or horribly,” Hope told ProPublica. “Instead of putting laws in place to make pregnancies safer, we created laws that put them back in danger.”

www.propublica.org/article/pors…

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— Irin Carmon (@irincarmon.bsky.social) November 25, 2024 at 9:15 AM

Medical experts told the outlet they were confused as to why the hospital didn’t perform additional tests after Ngumezi complained of chest pain. “At every point, it’s kind of shocking,” Dr. Daniel Grossman, a professor of obstetrics and gynecology at the University of California, San Francisco who reviewed Porsha’s case, told ProPublica. “She is having significant blood loss and the physician didn’t move toward aspiration.”

In October and earlier this month, the outlet reported on the deaths of Josseli Barnica and Nevaeh Crain, who died from sepsis in 2021 after being denied emergency abortion care for their pregnancy losses. They died shortly after Texas began enforcing its six-week ban, SB 8. In September, the Gender Equity Policy Institute reported that maternal deaths in Texas increased by 56% between 2019 and 2022, compared to an 11% increase nationwide during the same time period. “There’s only one explanation for this staggering difference in maternal mortality. All the research points to Texas’ abortion ban [SB 8] as the primary driver of this alarming increase,” the organization said. 

In the Monday report about Ngumezi, ProPublica referenced other cases similar to hers, including one woman who was sent home by another hospital in the same Houston Methodist system and told to “let the miscarriage take its course.” The woman lived, but experts told the outlet that the doctors had all but gambled with her life: “She got lucky—she could have died,” one said. 

Here is what @lizrplatt.bsky.social & the Columbia team & I found about Houston Methodist in our major report on religious hospitals BEFORE Dobbs, when the hospital system already heavily restricted abortion procedures.

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lawrightsreligion.law.columbia.edu/sites/defaul…

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— Amy Littlefield (@amylittlefield.bsky.social) November 25, 2024 at 9:43 AM

Journalist Amy Littlefield stressed that in addition to Texas’ abortion laws, stories like Ngumezi’s are complicated by the status of Houston Methodist hospitals as religious institutions, which have a history of refusing to offer any services resembling abortion to the detriment of their patients. “Obviously, as [ProPublica] rightly points out, the strict anti-abortion laws in Texas have made doctors all the more hesitant to perform procedures that hasten the end of a pregnancy. But it’s crucial to note that restrictions existed before these laws, too,” Littlefield wrote on social media.

Over a year after Ngumezi’s death, Hope told the outlet that his young children sometimes mistake women they see in public for their mother. “We all know pregnancies can come out beautifully or horribly,” Hope said. “Instead of putting laws in place to make pregnancies safer, we created laws that put them back in danger.”