Louisiana miscarriage patient who had to cross state lines for critical care wants answers
Editor’s Note: This is the sixth installment of an occasional States Newsroom series called When and Where: Abortion Access in America, profiling individuals who have needed abortion care in the U.S. before and after Dobbs. Read previous installments:
Tabitha Crowe said she woke up around 4 a.m. one Thursday in August covered in blood. She was visiting her parents in south Louisiana when she started miscarrying her first pregnancy. She said her mom and dad drove her to a nearby hospital while she fought dizziness from the blood loss in their back seat.
“I didn’t even know I could bleed that much,” Crowe told States Newsroom.
Over the course of the next few days, Crowe said she passed baseball-sized blood clots and experienced extreme pain and dizziness in two different hospitals, while never being offered a common miscarriage procedure, even after she requested it.
An estimated 10% to 20% of known pregnancies in the U.S. end in miscarriage. In about 80% of miscarriages, women are able to expel the pregnancy tissue naturally over a period of one to eight weeks, according to the American College of Obstetricians and Gynecologists.
When intervention is necessary in the first trimester, ACOG recommends abortion medications or procedures such as vacuum aspiration or dilation and curettage (D&C). Later in pregnancy, recommended termination procedures include dilation and evacuation (D&E), which has a high safety record but is condemned by anti-abortion groups and banned in some states.
But increasingly, women say they are being denied routine miscarriage care in states like Louisiana, where doctors face imprisonment if they perform an abortion unless a woman is at risk of dying, and where common miscarriage drugs are now more difficult to access.
Doctors in Louisiana and Texas have also reported a rise in patients whose pregnancies are no longer viable receiving more risky and invasive terminations, such as Cesarean sections and inductions, in lieu of abortion procedures. It’s a change in practice some doctors involved in the anti-abortion movement endorse.
And in cases like Crowe’s — where death might not be imminent but failing to intervene could increase the risk for infection or other issues — some doctors are telling patients to finish their miscarriages at home.
“I think they were waiting for me to get in bad enough health,” said Crowe, who attributes her experience to Louisiana’s abortion ban, though she said no medical staff mentioned the law or responded to her requests for a D&C.
But waiting for patients’ conditions to worsen can sometimes be fatal, according to an ongoing investigation by ProPublica, which has reported on five deaths linked to abortion bans, most recently a young mom in Texas who spent hours in the ER but was never offered a D&C that could have saved her life.
As stories emerge linking abortion bans to adverse health effects, some state health departments are working to make these stories harder to learn about.
In Georgia, officials recently dismissed all 32 members of the state’s Maternal Mortality Review Committee following ProPublica’s reporting that the committee linked two women’s deaths to Georgia’s six-week abortion ban. The state said it would reset the committee through a new application process and is considering measures to ensure patient confidentiality.
In Texas, ProPublica reported that at least three women have died because of delays in care caused by the state’s abortion bans. Despite these reported deaths, Texas’ Maternal Mortality and Morbidity Review Committee said it wouldn’t examine any pregnancy-related deaths from 2022 and 2023, the first two years after the state’s near-total abortion ban took effect, according to the Washington Post.
Idaho, shortly after banning abortion, disbanded its Maternal Mortality Review Committee in 2023after members recommended expanding Medicaid. The recently re-established committee is now backlogged and focused on publishing 2023 data in January before tackling 2022 data. The committee’s last report, based on 2021 data, showed the state’s maternal mortality rate had doubled in recent years and most of the deaths were preventable.
Crowe said her experience has moved her to speak out for better reproductive health care.
“For me to have a miscarriage for the first time, it’s already a very scary process,” said Crowe, who said she eventually got the care she needed outside of Louisiana. “You go to a hospital, you expect care, you expect some type of answers on what’s going on. And I didn’t get that.”
‘I had a sense it was because of the abortion laws’
Crowe and her husband, Noah Holesha, live on the Eglin Air Force Base in the Florida Panhandle. Crowe said her husband is in the Army and she was medically discharged from the military in 2023 and now works as a caretaker. The two married in 2022 and were expecting their first baby in February.
But on the way to LSU Health Lallie Kemp Medical Center in Independence, on Aug. 8, Crowe said she felt she would never get to meet this baby. Two weeks earlier, her 10-week-old fetus only measured 6 weeks. Now in the emergency room, Crowe said medical staff gave her pain medicine, cleared her blood clots, and discharged her to finish miscarrying naturally.
Two days later at her parents’ house, Crowe said she woke up with 10 out of 10 pain.
“I was in excruciating pain again, like screaming and crying pain,” she said.
She said her parents took her back to Lallie Kemp, where they transferred her to St. Tammany Parish Hospital Emergency Department in Covington, about a 45-minute drive, because it was the nearest hospital with a dedicated OB-GYN unit.
“Lallie Kemp Medical Center complies with federal patient privacy laws and therefore cannot discuss specific patients’ care,” Dr. Matloob Rehman, the hospital’s medical director, said in an email. “Lallie Kemp is a small, rural hospital without a full complement of specialists, including obstetrical surgery. If a patient is in need of such care, it is Lallie Kemp’s practice to refer or transfer the patient to a hospital that can provide such services.”
At St. Tammany, Crowe said she spent the day receiving pain medicine and transvaginal ultrasounds and having her vaginal canal cleared of clots. Medical records Crowe shared with States Newsroom indicate she was given misoprostol to evacuate her uterus, which Crowe said she was not aware of. She said the ultrasounds were still showing she had not completed the miscarriage. Crowe’s cousin had recently miscarried, so she and her family knew to ask for a D&C.
“They did ultrasounds and all that, but they didn’t help make sure that the miscarriage was completing,” Crowe said. “We kept telling them, ‘Hey, can y’all just do this D&C, so like we can be done with this pain?’ They wouldn’t answer.”
Crowe’s sister, a nurse in Texas, where abortion is also banned, suggested in a text that maybe it was because of Louisiana’s abortion ban that she wasn’t being offered a D&C.
“I had a sense it was because of the abortion laws, because by the time they did the canal sweep of blood clots, they didn’t even want to listen that I was in pain anymore. They were like, brushing it off, like, you’ll be fine,” Crowe said. “Even if them not doing it was wasn’t because of the abortion laws, I still didn’t get the treatment that I needed.”
Crowe said she was still dizzy and in pain when St. Tammany released her late on Aug. 10. Her St. Tammany hospital medical records say her miscarriage was completed at St. Tammany, which Crowe disputes. Medical records from the hospital in Florida, where she received the D&C, say the patient had an “incomplete miscarriage with evidence of retained POC [products of conception] on TVUS [transvaginal ultrasound], continued bleeding and anemia.”
The St. Tammany Health System communications department declined to comment on Crowe’s account, citing patient confidentiality, and said in a statement: “At St. Tammany Health System, we place our patients and their families’ wellbeing first. Patient privacy rights are established by the Federal Health Insurance Portability and Accountability Act (HIPAA). In compliance with this act, we are not at liberty to provide information or comment.”
Crowe decided to drive the four hours back to Florida. She said her pain had ebbed, but soon after she got home, her husband rushed her to Eglin Air Force Base emergency department, where she said she received a D&C the following day.
The Eglin hospital did not respond to requests for comment.
Crowe said she was still dizzy in the weeks following, and she was confused and angry, believing — without confirmation — that she was denied health care she needed because of a new abortion law. She said she started reaching out to malpractice attorneys, reproductive rights groups, even President-elect Donald Trump.
“I sent everybody emails.” Crowe said. “I reached out to Congress. I reached out to the office of Trump. I reached out to lawyers. It wasn’t anger that I’ve lost the child — because I had a feeling I was going to lose the child — but it was the anger of they didn’t give their 100% care. I was getting in bad shape, health-wise, because of it.”
Louisiana abortion laws affect miscarriage care
Louisiana was one of the first states to ban abortion after the U.S. Supreme Court overturned Roe v. Wade in 2022. And it’s the first, followed by Texas, to reclassify two abortion and miscarriage medications — mifepristone and misoprostol — as controlled substances, even though they haven’t been shown to cause addiction or dependence. In late October, health care workers sued the state, arguing that the new law is unconstitutional and has added barriers to emergency care.
One of the legal advocacy groups representing plaintiffs in that case, Lift Louisiana, co-published a report with Physicians for Human Rights with detailed interviews from patients, doctors and clinicians of how the state’s abortion ban has changed reproductive health care in Louisiana. The report found that some OB-GYN practices are now deferring prenatal care until beyond the first trimester, when miscarriage care is more common. Some clinicians reported an increase in patient referrals from rural hospitals for routine care.
“To avoid the risk of criminal penalties under the bans, nearly every clinician relayed an account in which they and/or their colleagues delayed abortion care until complications worsened to the point where the patient’s life was irrefutably at risk,” the report reads.
Crowe said she was grateful she was able to get treated, not a given in Florida, which has a six-week abortion ban and where patients have also reported being denied miscarriage treatment. But she lives on a military base, under federal jurisdiction. With a soon-to-be GOP majority in Washington, D.C., anti-abortion activists are pushing Trump to restrict pregnancy termination at military hospitals.
Though she personally disagrees with abortion after the first trimester, Crowe said she now believes in abortion rights.
“Growing up, I was always pro-life, because I always wanted to have a kid and all that,” Crowe said. “I was also the type that’s like, I’m not going to judge you if you do. Now I’m like … the choice to have an abortion is important because some women … we need this procedure done to save our lives, too. My child was already lost; it lost its life. Because of the abortion laws, you’re keeping me from having my life. … I couldn’t grieve because I was in so much pain.”
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