FRANKFORT, Ky. — An OBGYN in Kentucky says a lot of patients have questions about the new abortion ban in the state, including how the exceptions apply.

The U.S. Supreme Court overturned Roe v. Wade last Friday. That ruling meant a 2019 trigger ban took effect in Kentucky, making abortions illegal in most instances in the state. There is an exception if the mother’s life is at risk. 

The question many have is what would constitute enough of a risk in which abortion would be allowed under the law. Attorney General Daniel Cameron said that is up to the medical professionals.

What is "life-threatening?"

Amy Kimm, an OBGYN in Kentucky who is speaking for herself and not any employer or organization, said there are several pregnancy complications that could put a mother’s life at risk including preeclampsia, changes in heart status, excessive bleeding and changes in respiratory status just to name a few.

An ectopic pregnancy is an example she brought up where current guidance on how to handle it could be unclear. An ectopic pregnancy means the fetus forms outside the uterus.

While Kimm said it’s widely accepted in the profession as being dangerous for the mother, she doesn’t know at what amount of immediate risk the mom would need to be in during one in order for an abortion to be allowed.

“Not having direction on what constitutes enough of a threat to maternal life is really difficult,” said Kimm. 

She brought up a previous instance she’s seen before in which the mother suffered trauma from a car accident. In that instance, getting rid of the placenta was a decision made to save the mother’s life.

If that same instance were to come up now, there would likely be extensive discussion, second opinions and paperwork to make sure everything is squared away legally before doctors could move forward.

“If OB has to wait for another 15 minutes and think, ‘OK, legally, what do I need to do in this situation in order to not be criminalized, be stripped of my license in order to make sure no penalty is going to fall on the institution I’m working in?’ That extra time could absolutely affect whether or not a patient has a good outcome or even survives,” said Kimm. “That’s a really scary place for us to be in.”

She said there are several common things that could arise in which a patient would be under more scrutiny now. She used the miscarriage and very pre-term ruptures of membranes as examples.

When those arise now, the protocol would be to have two attending physicians review the chart and sign off on it to cover their bases. It would mark changes in protocol when women come into the ER having miscarriages. The changes are already taking place, while doctors and health care systems try to navigate the new law.

"They are really scared"

She said there are several medical reasons women get an abortion, but she finds it has always been a tough decision for patients in the past.

“I’ve never met a patient who was excited or happy on the day we had to perform a procedure for an abortion,” said Kimm.

Since SCOTUS overturned Roe v. Wade, Kimm said she has received more questions from patients inquiring about contraceptive options. She said there have been many women who would not have normally been inquiring about tubal ligation as an option to prevent pregnancy.

“Right now they are really scared and want to know what their options are,” Kimm said.

She said more women are inquiring about long-form birth control options as opposed to the pill, which requires the women to remember to take the medication consistently for optimal effectiveness.