A Tennessee Woman Had to Take a 6-Hour Ambulance Ride to Get an Abortion

A pregnant Tennessee woman with high and rising blood pressure had to take a roughly six-hour ambulance ride to get an abortion in North Carolina, according to a report in the Wall Street Journal. When she got to the second hospital several hundred miles away, her blood pressure was dangerously high and she was showing signs of kidney failure.

The woman’s doctor in Tennessee, Leilah Zahedi-Spung, is a high-risk obstetrician who spoke to the WSJ for a story about how abortion bans impact medical emergencies. Zahedi-Spung said the patient was in her second trimester when her blood pressure began rising; the fetus had been diagnosed with genetic abnormalities and wasn’t expected to survive. Zahedi-Spung worried the woman could develop life-threatening preeclampsia and thought she needed an abortion, but the procedure has been banned in Tennessee since late August. Eight states border Tennessee and abortion is banned in all but two of them.

“She kept asking if she was going to die,” Zahedi-Spung told the WSJ. “I kept saying, ‘I’m trying, I’m trying, we’re going to make it happen. We just need to get you to the right place where you can be taken care of.’” She said she was relieved to see the patient alive a few weeks later.

The Tennessee law, which makes providing abortions a felony, doesn’t contain explicit exceptions for abortions “necessary to prevent death or serious and permanent bodily injury”—instead, doctors have to prove the procedure was necessary via what’s known as an “affirmative defense.” The Associated Press described affirmative defense this way: “Instead of the state having to prove that the procedure was not medically necessary, the law shifts the burden to the doctor to convince a court that it was.” (Bans in North Dakota and Idaho—both of which are currently blocked—also use affirmative defense language.)

Given these realities, Zahedi-Spung said she feared if she performed the medically necessary abortion, the state would still charge her with a crime that would lead to a long legal fight and upend her ability to practice medicine.

Even bans that don’t require an affirmative defense and have more standard exceptions for the “life of the pregnant person”—like, for instance, treating ectopic pregnancies—are often meaningless in practice. Perhaps the hospital lawyers don’t want to risk a lawsuit, or the doctors themselves may fear legal action (and many have hundreds of thousands of dollars in student debt and their own families to provide for). But it’s easy enough for a part-time state lawmaker to throw some words into a bill.

Zahedi-Spung spoke to the WSJ in her personal capacity and didn’t name her employer. Multiple OB/GYNs recently told CNN that their employers are muzzling them from talking about the impacts of abortion bans—whether they work in states where their patients can’t access the procedure, or in places where people are traveling to get care.

Zahedi-Spung decided it’s too risky for her to practice in Tennessee and recently accepted a job in Colorado where abortion is legal. It’s a predictable loss of a medical provider thanks to a hostile environment. Per the WSJ:

Chloe Akers, a criminal defense attorney based in Knoxville, Tenn., read the law after Roe fell and was surprised to see it contained no exceptions, only defenses that doctors could use after the fact. She founded a nonprofit Standing Together Tennessee and began giving seminars to doctors and others about the law.

Ms. Akers tells healthcare providers there are ways to manage risk, such as keeping robust records of their decision making. But if a doctor asks how to take that risk to zero, she answers, “You stop providing obstetric care in the state.”

Let this story be a reminder that abortion bans harm everyone who can get pregnant.