A Tennessee woman who was denied an emergency abortion for her life-threatening ectopic pregnancy ultimately became infertile and was forced to have an emergency hysterectomy to save her life, ABC reported on Wednesday. The woman, Mayron Hollis, gave birth prematurely through a cesarean delivery, but for the last several months now, her infant has been in and out of the hospital as Hollis’ staggering medical bills continue to pile up.
Last summer, Hollis and her husband learned she was pregnant shortly after she’d just given birth to their first child in February 2022. The pregnancy concerned doctors, as she’d had a cesarean delivery and become pregnant again in a short amount of time, increasing the risk of a cesarean scar pregnancy—a type of ectopic pregnancy in which the embryo implants in the cesarean scar from a previous C-section.
By August, Hollis learned she did have a cesarean scar pregnancy, that her pregnancy was already bulging out of her uterus, and that she had a placenta accreta—a life-threatening pregnancy complication that occurs when the placenta grows too deeply inside the uterine wall, and part or all of the placenta remains attached to the uterine wall even during delivery. According to the Mayo Clinic, the condition can result in severe blood loss after delivery as well as infertility, as there’s only a narrow window for pregnancies with placenta accreta to be terminated without requiring a hysterectomy.
It was a crushing diagnosis for Hollis and her husband, who had wanted to have another child, prompting them to take time to determine their next step. By the time the couple determined that the risk to Hollis’ life was too significant, Tennessee’s trigger abortion ban had taken effect after the fall of Roe v. Wade last summer. Hollis would need a complex procedure requiring multiple physicians from varying specialties to terminate her placenta accreta without removing her uterus. But as a result of the state’s abortion laws, which at the time featured no exceptions, not enough physicians were willing to provide the care Hollis needed, fearing criminalization. (ABC notes that at the time, an exception to save the life of the pregnant person or prevent permanent bodily injury “only [came] into play when a physician is defending themselves in court,” after they’ve already been charged with a felony for providing abortion care.)
Doctors recommended that Hollis travel to Pittsburgh to get the procedure she needed, but she wasn’t able to, citing her husband’s and her demanding work schedules and inability to afford to take time off. Ultimately, because of Tennessee’s laws, Hollis learned she simply had to continue with her pregnancy, as it didn’t pose an immediate threat to her life. “Because of everything that was going on, they didn’t know what was the right thing to do was. So the only way to save me was for something bad to happen to me,” Hollis told ABC.
As Hollis’ pregnancy progressed, it eventually attached to her bladder, and her accreta progressed to placenta percreta, growing beyond her uterine wall and attaching to surrounding organs, creating the risk that her uterus could rupture. By December, around the 25th week of Hollis’ pregnancy, she experienced severe bleeding and was hospitalized for four days before being released. Hollis told ABC that some doctors she’d spoken to feared “they were gonna have to reconstruct my bladder.” She explained, “They didn’t know if it was gonna touch any other organs—if they could even stop the bleeding if I did start to hemorrhage.”
The following day after Hollis returned home, her severe bleeding resumed, and she returned to the hospital—this time for a cesarean delivery and emergency hysterectomy in one procedure, according to medical records obtained by ABC. “I didn’t want the hysterectomy. But they said that was the only way that they could stop the bleeding to help me, so I didn’t have a choice,” she told the outlet. Had Hollis been able to terminate the placenta accreta earlier in her pregnancy, she might have avoided the life-saving hysterectomy and continued to grow her family.
Since Hollis’ experience, Tennessee legislators added an exception to the state’s abortion laws that would allow for abortion care for ectopic pregnancies similar to Hollis’. But doctors, including one of the physicians who helped treat Hollis, fear this makes little difference in practice. “So much of medicine is gray areas,” Dr. Sarah Osmundson told ABC. “Regulating these complex decisions will result in people getting hurt and will result in people dying.”
Earlier this month, the Health and Human Services Department’s Centers for Medicare & Medicaid Services (CMS) wrapped its investigation of two hospitals that last year denied a Missouri woman life-saving abortion care, determining that these hospitals had violated EMTALA (the Emergency Medical Treatment and Labor Act). A lawyer for the Missouri woman told Jezebel that hospitals across the country—including states with ambiguous abortion bans—need to recognize that “when a patient comes to them” with a life-threatening pregnancy complication, they “do not need to—and must not—wait until the patient is on the brink of death to provide care.”
Since the delivery of Hollis’ newborn on Dec. 13, the infant, Alayna, remained hospitalized for two full months; she was so premature that she spent her first month of life in an incubator. After going home, Alayna has been in and out of the hospital. The longest she’s been at home since February, Hollis told ABC, was for two weeks.
“They really had no answer for me the whole time I was pregnant. It was the scariest thing I ever did,” Hollis said. “[Doctors were] telling me that my pregnancy wasn’t viable, but we can’t send you anywhere and we can’t do anything to help you.” All that she or those around her could do, she said, were “a lot of prayers” and “just having a lot of faith.” And now, she’s left dealing with the aftermath of her pregnancy-related struggles while going “back to work because I don’t have the means to pay for the adequate care that she needs.”