Lisa Jarvis: Texas' abortion ban killed Josseli Barnica. Who will be next?

Yet another heartbreaking and infuriating story has surfaced of a woman dying because of an extreme abortion policy in the U.S.

Her name was Josseli Barnica and she was a 28-year-old mother and wife who died from sepsis in 2021 after doctors, fearful of a Texas abortion ban passed before Roe v. Wade was overturned, failed to intervene as she miscarried.

Barnica’s death was completely preventable. And it could have happened to any pregnant woman miscarrying in a state with an abortion ban.

Barnica’s story was reported this week by ProPublica, which has been chronicling the dire consequences of abortion bans in the U.S. The outlet previously identified two women in Georgia, Amber Nicole Thurman and Candi Miller, whose deaths following medication abortion were deemed preventable by a state committee of experts in maternal health. Reporters noted they had also identified a second, as yet unnamed, woman in Texas who unnecessarily died following delays in miscarriage care.

Medical reports revealed that Barnica was 17 weeks along when she arrived at a Houston hospital with a miscarriage underway. Her fetus was not going to survive, but still had a heartbeat. The usual medical response in this situation is for doctors to speed up the process to protect the woman from the risk of infection. Instead, because of the new Texas law, they did nothing. Barnica spent 40 hours struggling to deliver, contracted a devastating infection, and died.

None of that should ever have happened. When treating a woman experiencing the anguish of a pregnancy loss, physicians normally respond with compassion. They follow decades of accepted practice to ensure the woman is offered options to manage the miscarriage that match both her wishes and her health needs.

Barnica’s death occurred before the Supreme Court overturned Roe, at a time when Texas policymakers sidestepped Roe’s protections by allowing private citizens to sue anyone helping a woman get an abortion after a detectable fetal heartbeat, usually around six weeks of pregnancy. The penalty: a minimum $10,000 fine, payable to the citizen who brought the case, as well as attorneys’ fees, legal costs, and the possibility of other civil penalties.

Since Roe fell, laws around the country have become even more extreme. In Texas, doctors now risk a $100,000 fine and life in prison. Thirteen states have total abortion bans, and four more have bans that take effect at six weeks of pregnancy. Every week, more stories emerge about the way abortion bans complicate basic health care for women. The fear, always, was that someone would die from something as common as a miscarriage. And now here we are.

Barnica’s story will hit home for the millions of women in America who have experienced a pregnancy loss. Some 10% to 20% of women who know they are pregnant will miscarry, most often in the first three months of gestation.

It certainly resonated with me. The first time I lost a pregnancy, I was standing in line at a Hudson News at LaGuardia Airport when I felt a sharp pain and instantly knew something was wrong. When I called my doctor to explain what was happening, she gently walked me through my options and I hung up knowing that if anything didn’t feel right, I could head to the nearest emergency room for help.

Since the fall of Roe, I’ve thought a lot about what that experience would feel like today, if I was standing in an airport in Houston or Atlanta or Boise. I went on to have four more miscarriages. During my years-long struggle to grow my family, would I have felt safe traveling to places where I might not be offered timely care in an emergency? Would I have felt comfortable telling my boss that I didn’t want to take a work trip because I feared it might put my health at risk?

And, of course, I’ve thought most about the millions of pregnant women living in states where these aren’t hypotheticals or one-off scenarios, but their daily reality.

In a sane world, the risks of growing a family wouldn’t be so high.

Anti-abortion activists were quick to shift the blame for the deaths of Thurman and Miller. They have blamed the pills the woman took to induce abortion (ignoring decades of evidence that show they are safe) and the doctors who failed to treat them. Some even tried to argue the stories underscored the need for stricter laws on medication abortion. And in a particularly galling turn, some blamed the women themselves.

I’m not sure how anti-choice folks can explain away Barnica’s death. Maybe they’ll blame the hospital for not acting, though they should consider that the punishments in Texas for doctors have gotten even steeper since she died.

And courts and lawmakers have repeatedly declined to ease doctors’ concerns about juggling their own legal risks with patients’ medical risks. The Texas Supreme Court has refused to make exceptions in the state’s total ban for the health of the mother. And the U.S. Supreme Court has refused to weigh in on whether a federal law that guarantees emergency medical care should supersede state abortion bans. Earlier this year, the court sent a case from Idaho back to the lower courts, and earlier this month, the Supreme Court turned away a case from Texas that sought to resolve this same conflict.

These refusals have left doctors in Texas and elsewhere working in a fuzzy legal zone, unsure of when they might face criminal repercussions for providing care to women with pregnancy complications. That undoubtedly means we will hear about more women who have died from delays in care.

With each of these stories, the architects of states’ dangerous abortion policies are running out of ways to defend them. There’s no ignoring the fact that Barnica paid the ultimate price for Texas’ abortion laws — or that it could happen to any woman suffering a miscarriage in a state with an abortion ban.

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This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, health care and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News.