Texas has the strictest abortion ban in the nation, forcing many women to travel out of state for medical care. Josseli Barnica was among those unable to seek care in states with minimal or no abortion restrictions. She died in September 2021 due to Texas’s ban on abortions after six weeks of pregnancy. Doctors delayed treatment for her miscarriage for 40 hours, according to a recent report from ProPublica.

Impacts of abortion legislation on maternal health

Barnica, 28, was married, the mother of a 1-year-old daughter, and eagerly anticipating a new addition to her growing family. However, those hopes were shattered when she visited the hospital for cramps on Sept. 2, 2021. At that time, she was just over 17 weeks pregnant, which was past the newly enacted abortion ban that took effect the previous day. The law went into effect almost a year before the U.S. Supreme Court overturned Roe v. Wade in 2022; it also bans abortion at conception.

Barnica returned to the hospital the following day, Sept. 3, after reporting that her bleeding had worsened. An ultrasound revealed “bulging membranes in the vagina with the fetal head in the open cervix,” along with low amniotic fluid, according to medical records obtained by ProPublica. A miscarriage was “in progress,” but she was unable to receive the help she needed.

Barnica’s husband told ProPublica in Spanish that doctors told her “they had to wait until there was no heartbeat” and “it would be a crime to give her an abortion.” Barnica died of an infection three days after she delivered. According to autopsy records, she had “sepsis due to acute bacterial endometritis and cervicitis following spontaneous abortion,” Newsweek reported.

Medical perspectives on abortion legislation and Barnica’s case

ProPublica consulted several medical experts (OB-GYNs and maternal-fetal medicine specialists) about Barnica’s situation, who stated that her death was “preventable” had she received life-saving measures much earlier and been in a state with supportive health care options.

“If this was Massachusetts or Ohio, she would have had that delivery within a couple hours,” Dr. Susan Mann, a national patient safety expert in obstetric care who teaches at Harvard University, said, per ProPublica.

Doctors in Barnica’s case told ProPublica that they use independent judgment with the patient and “our responsibility is to be in compliance with applicable state and federal laws and regulations”.

According to Section 170A.002, “A person may not knowingly perform, induce, or attempt an abortion.” However, doctors have to intervene if “the pregnant female on whom the abortion is performed, induced, or attempted has a life-threatening physical condition aggravated by, caused by, or arising from a pregnancy that places the female at risk of death or poses a serious risk of substantial impairment of a major bodily function.”

Republican officials remain silent on the issue

Republican officials like Gov. Greg Abbott, Sen. Ted Cruz, and state Attorney General Ken Paxton have championed pro-life rights and praised the overturning of Roe v. Wade and the state’s abortion ban. However, they have remained quiet after the controversial law affected Barnica and other women.

Rep. Colin Allred, D-Dallas, took to X, formerly known as Twitter, and spoke out on Barnica’s death while calling out Cruz for his silence on the matter.

“My heart breaks for the Barnica family,” he posted on X on Wednesday. “Josseli Barnica should be alive today but because of Ted Cruz’s cruel abortion ban, Texas women have been denied the life-saving health care they need. We can’t afford six more years of Ted Cruz.”

Barnica is one of at least two women who have died in Texas following the abortion ban, according to ProPublica. In Georgia, another state with a strict abortion ban, two Black women — Amber Nicole Thurman and Candi Miller — also lost their lives.

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