Washington state law requires hospitals to provide emergency abortions, Inslee says

Preterm rupture of membranes and an infected uterus that could easily lead to sepsis. A complicated ectopic pregnancy about to burst and cause hemorrhaging. Bleeding from an incomplete miscarriage.

These are scenes documented by emergency room doctors in Washington after treating women who fled states with strict abortion bans to seek life-saving reproductive health care in Washington hospitals.

Two years after the U.S. Supreme Court’s overturning of Roe v. Wade, Washington Gov. Jay Inslee has ordered hospitals in the state to continue providing emergency abortions for patients.

The U.S. Supreme Court will soon rule on another reproductive rights case out of Idaho, a dispute that could change whether emergency abortions are protected under a federal law that requires hospitals to evaluate and treat patients with emergent conditions.

Washington state will be unaffected by whatever the justices rule in that case, Inslee announced this week. The governor issued a directive to the state Department of Health ordering the agency to clarify requirements under state law that grant patients the right to emergency abortions.

Inslee’s directive also ordered the health department to take enforcement action upon any hospitals in Washington that do not offer emergency abortion services.

“A woman’s right of choice is still under attack in the state of Washington, a reality we simply have to face,” Inslee said Tuesday at a news conference in downtown Seattle. “We have been locked in this battle to protect a women’s right of choice.”

Inslee spoke behind a podium next to a sign that read, “KEEP POLITICIANS OUT OF EMERGENCY ROOMS.”

State law already requires Washington hospitals to provide emergency health care to all patients based on nationally recognized standards of care, including emergency abortion care. Inslee’s directive mandates the state Department of Health to issue policy guidance that clarifies that law and ensures it remains unchanged regardless of the U.S. Supreme Court ruling in the Idaho case.

“We’re making it clear so that everybody will understand the rules. We’re understanding how draconian this has been in women’s rights across the state of Washington,” Inslee said, noting that droves of women from across the country now travel to Washington for abortion services they cannot receive in their states of residence.

A University of Washington study published last month found a 50% increase in out-of-state patients going to one of the main abortion-providing clinic networks in Washington since the fall of Roe v. Wade. Cedar River Clinics currently offers reproductive and sexual health care in Seattle, Tacoma, Renton and Yakima.

Since the overturn of Roe v. Wade, 20 states in the country – including Idaho – have put in place laws that make abortion mostly, or completely, illegal.

Across the United States, stories continue to pile up about women who are denied abortion care in states with strict bans even when complications with a pregnancy pose life-threatening danger.

Pregnancy can be dangerous. But in the United States today, four in five pregnancy-related deaths are preventable with medical intervention, according to the Centers for Disease Control and Prevention.

In its ruling on the pending abortion case out of Idaho, Idaho and Moyle, et. al. v. United States, the U.S. Supreme Court will decide whether Idaho’s abortion ban supersedes a federal law called the Emergency Medical Treatment and Labor Act, which requires hospitals to evaluate and treat patients with emergency conditions, including “necessary stabilizing treatment” to pregnant people.

“Abortion care is health care,” reads Inslee’s directive. “For decades, practicing health care providers and other medical experts have determined abortion care to be the safe and effective standard of care for people who exercise their right to choose or need to end their pregnancy to avoid adverse health outcomes.”

After Inslee spoke at Tuesday’s news conference, Dr. Sarah Prager took the podium. Prager, a professor of gynecology at the University of Washington School of Medicine, said the U.S. Supreme Court’s overturning of Roe v. Wade two years ago put at risk the ability of doctors to safely care for patients.

“How close to death must somebody be before a doctor is able to step in and provide care? The fact that laws now exist limiting a doctor’s ability to save a life is simply mind-boggling to me,” Prager said. “When I, or any doctor, has a sick patient in front of me, I shouldn’t have to pause and consult with the hospital’s legal team to figure out if I’m able to act.”

Within a matter of seconds wasted, a patient’s health, future fertility and life are put on the line, Prager added.

In a statement sent to The Spokesman-Review Wednesday, a representative from Providence Inland Northwest Washington said the hospital network will “continue to offer emergency services in accordance with state and federal law and affirm the importance of reproductive health to women’s wellness.”

“Providence facilities do not deny emergency care, including for complex pregnancies or situations in which a pregnant person’s life is at risk,” reads the statement. “Our clinicians exercise their best medical judgment and provide all necessary interventions to protect and save the life of the mother.”

Also on Wednesday, a representative from MultiCare Health System sent a statement to The Spokesman-Review in support of Inslee’s directive.

“Everyone should have full access to the health care services they need, including reproductive medicine,” reads the statement. “We believe that the decision to have an abortion – whether that be an in-person surgical procedure or an oral medication prescription – should be one made by the pregnant individual and their provider. This is not a new position for MultiCare, but one that we have been committed to for decades as a community-based, secular, not-for-profit health system.”

After Tuesday’s news conference, the Washington State Hospital Association released a public statement in support of Inslee’s directive.

“Hospitals’ commitment to emergency care includes a commitment to providing a whole host of services to which some people might apply a moral character,” association CEO Cassie Sauer said. “This includes not just emergency pregnancy-related services, but also drug overdoses, injuries sustained in fights, sexual-related emergencies, services to undocumented immigrants, and many other services that some people have said hospitals should not provide.”