US doctors embroiled in sudden legal uncertainty over abortions

Days after the US state of Ohio banned abortions once a fetal heartbeat is detected, doctor Mae Winchester had a patient who needed to terminate her pregnancy to save her life.

Her patient, who was 19 weeks pregnant, asked if "legally she was going to be OK and if legally I was going to be OK," Winchester told AFP.

It wouldn't have been a question when the nationwide right to abortion was still protected under the US constitution.

But the Supreme Court overturned the 1973 Roe v. Wade ruling on June 24 -- and some states, including Ohio, moved quickly to restrict the procedure, sometimes only with exceptions for medical necessity.

Doctors across the country were thrust into an ambiguous legal landscape that they say threatens both their ability to do their jobs and their patients' health.

While her patient had a clear medical emergency, with the rug pulled out from under the nearly 50-year-old right, that night Winchester made a call to the hospital's lawyers.

"I know what I need to do medically. But from a legal standpoint, how do I protect her? How do I protect myself? How do I protect our institution? Our nurses and anaesthesiologist that are going to be involved with this case? It affects everybody," she said.

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Such concerns echoed by doctors from varying specialities caught in the crosshairs of new laws, as well as health care lawyers working to help providers navigate the shifting ground.

"It's a bizarre situation where doctors have to be nervous even when they're providing legitimate care for potentially life-threatening conditions," said Harry Nelson, managing partner at health care law firm Nelson Hardiman, which advises physicians.

The penalties in new legislation can be severe and not limited to losing one's medical license, but also possible felony charges, years in jail and thousands of dollars in fines.

Even the threat of litigation will take a toll, said Nelson, noting that few organisations and individuals can withstand the financial, logistical and mental cost "without a significant level of stress."

Some authorities in states with tight abortion restrictions have said the concern is misplaced because of laws' exceptions for medical endangerment, with anti-abortion advocates accusing opponents of "fear mongering."

But the risk is taken seriously by the Department of Health and Human Services.

It has said the Emergency Medical Treatment and Labor Act (EMTALA) supersedes state abortion laws if the procedure is needed to stabilize a pregnant patient -- a move praised by abortion rights supporters, who have pressured President Joe Biden's administration to preserve access to the procedure.

But the guidance has come under fire, with Texas Attorney General Ken Paxton suing the administration, saying it "seeks to transform every emergency room in the country into a walk-in abortion clinic."

It's unclear how zealous prosecutors will be, and a group of some 90 elected prosecutors from across the country as of July 14 have already said they will not pursue abortion cases.