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In this article, ProPublica reports on a decision by the Texas Medical Board to sanction three doctors who withheld treatment from pregnant women who needed medical intervention and died because they didn’t get it. The doctors were following the state’s strict abortion ban, which harshly punishes any doctor who aids an abortion unless the fetus is dead.

ProPublica reports:

Two of the doctors failed to properly intervene as a pregnant teenager repeatedly sought care for life-threatening complications, the board found. The third did not provide a dilation and curettage procedure to empty a miscarrying patient’s uterus, and she ultimately bled to death.

As ProPublica investigated those preventable deaths and five others across three states in the past few years, reporters found that abortion bans have influenced how doctors and hospitals respond to pregnancy complications. Facing risks of prison time and professional ruin, doctors have delayed key interventions until they can document that a fetus’ heart is no longer beating or that a case meets a narrow legal exception. Some physicians say their colleagues are discharging or transferring pregnant patients instead of taking responsibility for their care.

Doctors and lawyers have questioned why medical boards, which oversee physician licensing and investigate substandard care, have not played a more active role in guiding doctors on how to uphold medical standards within the constraints of the law. When asked by ProPublica in 2024 what recourse miscarrying patients had when a doctor denied them necessary treatment, the president of the Texas Medical Board said it had no say over criminal law but that patients could file a complaint and “vote with their feet” to seek care from another doctor.

Since then, the Texas board has taken more steps than those in other states, publishing guidance this year that provides case studies on how doctors can legally provide abortions to patients with certain medical complications. The state Legislature ordered the board to create the training materials as part of the Life of the Mother Act, which was passed after ProPublica’s reporting and made modest adjustments to the state’s abortion restrictions in an attempt to prevent additional maternal deaths.

Georgia, where Amber Thurman died after doctors did not try to empty her septic uterus for 20 hours, has not revisited its ban or disciplined key doctors involved.

Maternal care experts say health care providers will continue to hesitate to offer standard care as long as bans carry serious criminal consequences — Texas’ law can put a physician behind bars for 99 years. But those who spoke to ProPublica say that medical board sanctions are one of the few levers that can provide a counterweight, pushing hospitals and doctors to provide standard care despite uncertainty over vaguely written laws.

Michelle Maloney, who is representing the families of both Texas patients in malpractice lawsuits, said she was pleasantly surprised by the board’s recent actions. “Over the course of my career, I’ve had many horrific, horrific death cases. For someone to get disciplined by the medical board, especially while there’s ongoing litigation, is just extraordinarily rare,” she said.

In 2024, ProPublica reported on the case of 18-year-old Nevaeh Crain, who began experiencing severe pregnancy complications when she was six months pregnant in 2023. Although she exhibited clear signs of an infection, doctors at two hospitals sent her home. On her third visit, as Crain’s condition deteriorated, a doctor did not send Crain to the intensive care unit until he could confirm fetal demise with two ultrasounds. Texas law requires doctors to create extra documentation before performing procedures that could end a pregnancy. By the time the doctor had logged there was no fetal heartbeat, the medical record shows, Crain was too unstable for surgery. She died with her fetus still in her womb.