Porsha Ngumezi, a 35-year-old mother from Houston, was overjoyed by the news of her third pregnancy in spring 2023. The mother of two sons, ages 3 and 5, Porsha wished for a baby girl with her husband, Hope. However, at 10 weeks into the pregnancy, Porsha began experiencing bleeding which increased to the point where her OB-GYN advised Porsha to head to the emergency room. The medical staff detected via ultrasound a “pregnancy of unknown location” without fetal cardiac activity, which, in combination with her bleeding, indicated Porsha was miscarrying. Since Porsha had planned to have her first prenatal visit at 11 weeks, at the time of hospitalization, there was no concrete evidence as to how far into her pregnancy she was. Since the Texas abortion ban begins at conception, the lack of cardiac activity was not enough to allow physicians to intervene since it was possible Porsha was still so early on in her pregnancy that fetal cardiac activity was undetectable. Just after Hope arrived at the hospital, Porsha passed out from losing too much blood. The medical team provided two transfusions, but despite her significant hemorrhaging and blood-clotting disorder, they did not perform an emergency dilation and curettage (D&C). An evidence-based procedure that removes pregnancy tissue from the uterus, allowing the uterus to contract and stop bleeding, D&Cs can also be used for elective abortions. With the Texas abortion ban in place, physicians have subsequently moved away from using this procedure even for miscarriages out of fear of prosecution. Despite Hope’s mother, a former physician, urging for Porsha to receive a D&C, the medical team recommended misoprostol, a medication commonly used to induce labor, treat postpartum hemorrhage, and manage low-risk miscarriages. Porsha was bleeding too heavily (passing blood clots “the size of grapefruit”) for misoprostol to effectively treat her, but with D&Cs attracting negative attention, the hospital’s “routine” protocol was now providing misoprostol as it can be administered without the same legal scrutiny. Trusting the medical team, Hope and Porsha moved forward with this treatment plan. Porsha mourned the loss of her pregnancy throughout the hospital stay, wishing to be home with her boys. On her way to a less-intensive care unit, Porsha began experiencing chest pain – 10 hours after first arriving at the hospital, Porsha stopped breathing.
Hope returned home without his wife and the mother of his two children – for months, his three-year-old son could not comprehend that Mommy was gone. Experts who reviewed Porsha’s case have concluded her death was preventable, raising nationwide concerns that abortion bans are pressuring doctors away from established standards of care.