Lauren Miller: “It’s like a baby waiting for a new baby,” she wrote in a journal on Aug. 20, 2022
On Aug. 20, 2022, she wrote in her journal: “I started throwing up at five yesterday morning and it won’t stop. It is now the afternoon, over a full day later. I can’t even keep down crackers, water, tea.”
She went to the E.R. because she was worried about dehydration. She received a bag of IV fluid and medication for the nausea and was told she had hyperemesis gravidarum – severe morning sickness. A doctor did an X-ray. “That’s when we found out about the twins,” she says.
She says she was completely shocked because they had no history of twins on either side of the family. Miller, 35, and her husband, Jason, already have a 1-year-old son. But it explained her intense morning sickness; that’s a typical side effect in twin pregnancies.
At first, she felt overwhelmed, thinking through all they would need to do to get ready for twins: a bigger car, another crib, more baby gear. She says that it was kind of like getting a two-for-one special, since she always wanted three kids.
Lauren Miller of Dallas received horrible news when she was 13 weeks pregnant with twins. One of the twins had trisomy 18, a genetic abnormality that causes about 90% of fetuses to die before birth. The other twin was healthy.
A few hours later, a genetic counselor called her. “It just gets worse,” she wrote after that conversation. Baby B is putting myself and his twin at a higher risk of birth-related issues, because he continues to grow. But she can’t say much – she was careful about what she even said.”
That’s what she did. Miller traveled to Colorado at 15-weeks pregnant to undergo a “selective reduction” procedure in order to ensure her child’s health and longevity.
Miller felt like she knew why the genetic counselor was being so cryptic. There is a procedure calledselective reduction for pregnancies with more than one fetus. Doctors can kill one fetus, while another fetus continues to grow. Babies can be born with a live birth or births, and there’s a chance that the chances will increase due to multiple pregnancies.
The Texas Freedom Caucus and a Secret Mission: How Laura and Jason Miller left the State after announcing Baby B’s heart stopped
There are some lawmakers in the state who would like to go further. The list of priorities released by the Texas Freedom Caucus included stopping those who aid or abetting abortion in other states from doing so. A spokesperson for the caucus did not respond to NPR’s interview request.
She wrote that they need to make plans since they don’t know what they’re doing. I feel confused and scared and I hate all of this.
Miller was able to see an OB- GYN with expertise in high risk pregnancies the day after, who could help confirm the diagnosis of trisomy 18.
She had another baby shower there. Baby A looked fine, but the scan of Baby B was “heartbreaking,” she says. There were more concerning signs: an incomplete abdominal wall, indications of heart abnormalities, and the cystic hygromas had grown larger. The doctor had trouble getting the tissue sample for the diagnostic test. Miller says he threw his gloves in the trash.
Miller said she had a fear of the abortion laws in Texas after she returned home. At her next prenatal appointment, as she got her ultrasound and it was clear that Baby B’s heart had stopped, she wondered — could the ultrasound tech report her?
Lauren and Jason Miller flew to Colorado the night before their appointment. It was one week after the doctor in Texas told her to leave. She was 15 weeks pregnant at the time.
“It was so weird packing, kind of like this secret mission,” she says. It was so strange. I’m from Texas – I’m an 8th generation Texan – and to be feeling like I need to escape the state was just a bizarre sensation.”
An abortion technician in a Dallas woman: “I was sobbing,” Lauren Miller recounts of a journey she had to get an abortion
“They did the ultrasound – we saw him one last time, took one last photo of the twins together so that we would have that,” Miller remembers. It was a single needle. They injected it directly [into Baby B] and then they were done.
That was it – the whole thing took a few minutes. There’s no removal process in a case like hers, where one twin is healthy – both fetuses stay in her uterus for the rest of her pregnancy. One grows, and one doesn’t.
“As soon as they left, I was sobbing,” she says. “It was just so many emotions. This was very much a wanted pregnancy. That was, I think, the first time that we were really confronted fully with the loss.”
When she came back to Dallas she found that she didn’t know anything about abortion. She wondered if the technician would report her if he knew she traveled out of state for an abortion. “You don’t know where everybody is, so it feels like we’re talking in code,” Miller says.
Lauren Miller, a patient from Dallas who traveled 800 miles for an abortion, said her doctors could have done more to help her if Texas had not placed restrictions on abortion.
She says she’s been overwhelmed by how much stress she’s had to go through. Additional costs were also a factor. She knows most people can’t afford to pay that much for an abortion at a moment’s notice.
A case study of talking about abortion in the Texas legislature: What do doctors really need to know about abortion? The case of Lauren Miller’s OB-GYN
Diane edited the audio version of the story. There is a visual designer and developer by the name of Meredith Berggruen. Elena was the audio producer.
Elizabeth Sepper is professor of law at the University of Texas at Austin and she says the first amendment protects free speech. “Physicians have free speech to speak to their patients openly,” she says. “Physicians should be free to say the a-word.”
Lauren Miller’s OB-GYN asked thatNPR not use her name, as she was not authorized by her employer to speak with the media.
Many doctors are hesitant to speak about this issue. A half dozen Texas OB- GYNs didn’t respond or refuse to speak to NPR.
There is an exception in Texas law that allows abortion when a woman’s life or a “major bodily function” is in imminent danger. But it’s not uncommon for there to be pregnancy complications — like Lauren Miller’s — where many doctors would consider it to be the standard of care to offer abortion as an option. Those are the kind of circumstances where physicians feel like they can’t be fully truthful about a patient’s options without risking a lawsuit.
The doctor doesn’t want her patients to know anything in writing, and having candid conversations with her patients about abortion options out-of-state makes her feel vulnerable. “I am putting myself out there,” she says. I don’t know if a patient’s grandmother or partner or sister would find out that I’m talking to them about an abortion, but the only thing they need to do is find a lawyer.
Still, whether doctors can openly counsel their patients without violating SB8 is a bit more complicated, and hasn’t been tested in court. The law is very vague and probably written on purpose, says Palmer.
Texas abortion bans bans as leave doctors talk about abortion code to pregnant patients in the early stage stages of pregnancy, Dr. Amy Palmer tells NPR
“Those restrictive laws are increasing complex abortion care because people come later, and abortions later in gestation are more complicated,” Espey explains. She says that people don’t know that there are options outside-of-state.
She recalls one Texas patient whose fetus had acrania, where the fetus has no skull. It’s a serious problem for the fetus. Espey says that the doctor didn’t tell her to get care out-of-state. “She was an immigrant. She had to figure out how she could travel to New Mexico for an abortion in six weeks.
The patient ended up hemorrhaging and needing a hysterectomy. If she had the chance to have the pregnancy terminated at 11 or 12 weeks, she would not have had her uterus ripped out.
There are many genetic testing options for pregnant women as early as 10 weeks of birth in Texas but they don’t have much ability to act on that information.
Palmer, the doctor in Fort Worth, agrees. “We are asking questions that we can only provide limited resources for the answer,” she says. “And it is really frustrating as a physician to not be able to provide full care for patients.”
NPR contacted Republican Texas lawmakers to ask about their state’s abortion laws and to get comment, but they didn’t reply. Attorney General Ken Paxton’s office also did not respond to NPR’s request to explain how the state plans to enforce Texas’s abortion laws, especially in relation to doctors and counseling.
Pro-Life and Abortion: What Do Republicans Really Want to do in the State of Texas, and Why Do They Aren’t?
“I don’t hear a lot about it in the capital,” Steinhauser says. I think there will be no significant change in the session this year.
He sees very little political appetite for bringing abortion up again among Republicans lawmakers in the state, because Texas Republicans did well in the last election even after Roe v. Wade was overturned and the state’s abortion restrictions took effect. “I think Republican legislators realize, ‘We passed these bills into law, we weren’t punished at the ballot box,'” he says. “What are the rewards for doing anything different?”
O’Donnell is from Texas Alliance for Life, a group that lobbies for abortion restrictions. , says her group is not currently advocating for more restrictions. “What we’re working for in this session is maintaining our pro-life gains,” she says, adding that the medical emergency exception currently in the law is “adequate.” She said the goal is to make abortion not only illegal in our state, but also unthinkable, when asked if doctors are afraid to talk to their patients about abortion.
How would Congress have handled this agonizing process?” a one-year-old mother of two children says she doesn’t plan to visit Washington, D.C.
“They would have been able to give information and schedule it,” she says. “It wouldn’t become this whole agonizing process of just trying to get information of — what do we actually need? Where do we go?”
She has a one-year-old and is preparing for the arrival of her baby at the end of March. She says she’s also civically engaged. “I have no qualms, when something’s going on, calling a member of Congress, writing an email, staying informed, [sending] the letter to council.”