Warning: this article discusses miscarriages and still birth which some readers may find distressing.
Two women have died after waiting for emergency care following miscarriage, leading to experts to weigh in.
Brenda Yolani Arzu Ramirez and Porsha Ngumezi sat for hours as their both began to experience catastrophic complications, leading to their deaths.
As Roe v Wade was overturned in the wake of presidency controversy, experts and family have contributed their thoughts as to how this occurred, and the impact.
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The women both needed urgent procedures to clear their uteruses at the time but never received the help they needed.
In the wake of Texas’ abortion ban, medical experts were worried women like Porsha and Brenda would die without care.
In the end, experts agree both women died as a result of hospitals choosing not to provide abortion procedures.
Online, their deaths caused a debate about the importance of women’s health.
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One person said on Reddit: “To them, women are livestock.”
Another wrote: “It's a war against women.”
Brenda’s story
Brenda Yolani Arzu Ramirez’s baby died when she was 22 weeks pregnant, triggering a life-threatening infection in the form of sepsis, which worsened as she waited hours at Austin hospital.
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Brenda had been waiting to deliver her baby stillborn, vaginally in November 2021.
While the OB-GYN who assessed her suspected she needed urgent care, she was unable to receive it when she rushed to the hospital.
The soon-to-be mom-of-three had two little boys at home and had a history of preeclampsia in her previous pregnancies.
Preeclampsia can cause dangerously high blood pressure during and after pregnancy, and it can be fatal.
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However, Brenda was able to deliver her children via caesarean section as she was far along in her pregnancies.
However, this time was different, and Brenda was suffering the dangerous symptoms such as a fever, vomiting and shortness of breath.
Both times, she was far enough along that her babies could be successfully delivered by caesarean section.
This time was different. Brenda was only 22 ½ weeks into her pregnancy. She was feverish, vomiting and short of breath. Her head ached.
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In the emergency room, medical staff noted she had a temperature of 103 degrees, as per The Dallas Morning News, and her lab tests found she had a low white blood cell count.
Having carried out an ultrasound of the fetus, they discovered there wasn’t one.
But this was November 2021, three months after Roe v Wade was overturned and physicians could face civil litigation if they provided abortions for any reason.
Even though the hospital’s OB-GYN thought Brenda may need a dilation and evacuation to clear her uterus and put in an order for Brenda to be transferred to St. David’s North Austin Medical Center, the orders were not carried out.
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Brenda did not receive the immediate procedure and was instead given a large dose of pitocin to bring on contractions for delivery.
Hours later, she delivered the baby vaginally and became critically ill due to the bacterial infection of her baby’s death, leading to sepsis.
She sadly suffered multiple organ failure and died two weeks later after suffering a seizure before her heart stopped, as per the outlet.
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Dr Deborah Bartz, an associate professor of medicine at Harvard Medical School and a reproductive medicine specialist in Boston said Brenda needed a D&E, Bartz said, not to have been induced for vaginal delivery.
Brenda was just one of two women who needed urgent care and allegedly didn’t receive it.
Porsha’s story
Porsha Ngumezi sat for hours in an emergency room as she passed grapefruit-sized blood clots, while miscarrying in the first trimester.
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It was April 2023, the 35-year-old and her husband found out they were having another baby after already having two boys, ages 3 and 5.
However, Porsha began spotting early in her pregnancy and she was told to keep an eye on it or seek help if things worsened.
Porsha had underlying conditions such as chronic idiopathic thrombocytopenic purpura, a condition that causes low platelet counts, as well as sickle cell trait and iron deficiency anemia.
In June, when Portia was 11 weeks pregnant, the bleeding worsened and she headed to Houston Methodist Sugar Land Hospital.
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But after two hours later, she began to pass numerous clots into the toilet, as well as what she believed was the fetus, before the toilet flushed automatically.
“I just had a miscarriage in their restroom,” Porsha allegedly texted her husband, Hope. “I haven’t stopped bleeding.”
“Omg,” he responded. “Are they doing something about the bleeding.”
“I have to stay. They have to make sure it all passes,” she wrote back.
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When Hope arrived, Porsha had been at the hospital for four hours.
It was then that she became flushed, and her blood pressure dropped.
She was given fluids and two red blood cell transfusions, but she was still passing large clots half an hour later.
An emergency room staff member then expressed concern over transferring Porsha to a bed in the less urgent medical-surgical unit, as she was still bleeding.
Hope told The News that the OB-GYN advised he could give Porsha misoprostol to help with the abortion, or to perform a dilation and curettage (D&C) to stop the haemorrhaging.
They opted for the misoprostol, which The Dallas Morning News says Porsha’s mom disagreed with, urging that she needed the D&C.
Porsha began to complain her chest hurt, and hours later she started gasping for air before her heart stopped.
Porsha was intubated and chest compressions were delivered, but she was pronounced dead an hour later.
“Delay in care, delay in care, delay in care,” said Dr Deborah Bartz, an associate professor of obstetrics, gynecology and reproductive biology at Harvard's Brigham and Women's Hospital in Boston. “Not offering the care that was needed, and ultimately, not listening to the patient, and then the patient’s husband, as it related to what her symptoms were.”
What have experts said?
Many experts have voiced their concerns over the documents detailing the women’s treatment plans, revealing the lack of urgency.
For Brenda Bartz said: "As soon as she hit the door for the second hospital,' Bartz said. "She should have had a D&E."
Dr Rebecca Cohen, an OB-GYN practicing in Denver, explained how Porsha’s underlying blood disorders could have exacerbated her bleeding, and the large blood clots signalled an urgent need for a D&C.
Cohen went on to say that ‘if she had come to the hospital that I work at, she would have been alive still.’
Bartz said that the time lost was crucial, and for Brenda, it allowed the bacteria to spread throughout her body, while Dr Nancy Binford, a OB-GYN, said once sepsis is identified, time is critical.
“Do I think the law could have contributed to this? Yes, because I think doctors are terrified,” said Dr Karen Swenson, an OB-GYN said to the outlet.
What have the hospitals said?
In a statement to The Dallas Morning News, St. David’s HealthCare, the owner of both of the hospitals where Brenda was treated, said it couldn’t comment on Brenda’s case due to privacy laws.
But it did detail that St. David’s North Austin Medical Center is a Level IV Maternal Facility, with the capability to provide comprehensive care for pregnant and postpartum patients.
It had the ability to treat via medication and D&C and induction methods too.
However, it said there were limitations based on different circumstances per pregnancy.
“Similar to any highly specialized medical field, access to D&E and/or induction may be limited in many settings, especially at later gestational ages, adding further complexity to the decision process,” the statement said.
In a statement, Houston Methodist said it follows all applicable Texas law, as well as abortion laws.
“As a faith-based system, we have had a long-standing policy regarding appropriate treatment for pregnant women,” the statement said, “including a termination only being performed for the health and safety of the patient.”
As a result of Porsha’s death, her husband contacted an attorney to investigate her death and a medical malpractice lawsuit was filed in June against the hospital, two doctors and two physician groups.
It is currently being litigated.
UNILAD reached out to Houston Methodist and St. David’s North Austin Medical Center for comment.
Britt Jones