Thread by @txnewsprincess

This morning, in a FB group I’m in, a woman told us she is having a miscarriage. Her doctor prescribed misoprostol to help her complete the miscarriage. The doctor had to spend 30 minutes explaining to a Walgreens pharmacist that she wasn’t having an abortion. 🧵

The first round of misoprostol didn’t work. The doctor calls in another round, and she heads to the pharmacy to pick it up. After waiting 20 minutes, she is told by the pharmacist that they’ve talked to colleagues and the corporate office, and have decided not to fill it,

… because they don’t know for sure she isn’t using it for an abortion.
This is what happens when you don’t actually consider women’s health when making policy.

This is only going to get worse if Roe is overturned by SCOTUS.

I have a couple seconds for a bit of a follow up.

Her doctor actually told them they wouldn't send the prescription to CVS because it likely wouldn't get filled.

But this isn't totally the pharmacy's fault. The legal liability is so murky and so up in the air,

that some pharmacies just don't want to risk the litigation.

If you want to lay the blame somewhere, I would blame the laws that have created this scenario.

Another update: I don’t want to say too much, but the woman was able to get her prescription filled at another pharmacy.
I thought I would answer a few questions/comments from today. (bonus 🧵)

1) This is Texas. There is a law on the books that allows anyone to sue anyone suspected of helping someone get an abortion or getting an abortion. 19thnews.org/2022/03/senate…

This means that, potentially, a pharmacist could be sued individually, as well as their drugstore, for filling a prescription meant to assist in an abortion, and it would be up to the patient and the pharmacist to prove it was for something else.

My strong advice if you’re a woman in Texas picking this prescription up (or a pharmacist filling it) is to make sure the counseling the pharmacist typically does when handing over a prescription be done with even more privacy than usual.

2) Consider asking your doctor to send you to Planned Parenthood for the rest of your miscarriage care, and follow up with your doctor after. This will allow you to skip some of the interactions with people that are going to be the worst about this.

3) It’s more invasive, but if your doctor offers a D&C consider taking it. The recovery time was better (I’ve done both kinds), and you have more control over how the situation plays out in this political climate.

4) Find someone who will advocate on your behalf, and let them do it. Your partner, your best friend, your parent, whatever. This is a REALLY hard time, and you need to conserve your strength for it. Let someone else argue with the pharmacist.

5) And finally, because of the way things are, you may find more scrutiny on your actions, and this is sad and stupid and the worst time for it. Find a trusted third party that can help you work through the this. Self-care doesn’t end when you stop bleeding. Find mental supports.

Good morning! I'm up waiting for my first interview of the day (on a completely unrelated subject) but I did want to talk about how the Texas law will change the landscape (clearly) for medical professionals.

For the most part, doctors have always prescribed, and pharmacists have always filled. That's been the natural order of things for some time.
But with the new abortion law, every layer of standard care for a miscarriage is also fraught with a fair amount of peril.

Peril for the doctor, peril for the patient, peril for the pharmacist.

So the standard of care will likely have to change as well. Doctors may have to begin stocking misoprostol in clinic to help their patients avoid conflict at a vulnerable time.

That's not ideal either, because now you've put your entire staff at risk of being named in a suit, too.

There really is no good way to mitigate harm, that I can see.

It will most certainly mean that doctors will have to be even more careful about how they chart, and create an airtight paper trail for every single miscarriage, in the event a suit is filed.

I would also encourage OB/GYNs to compile a referral list for grief counselors and therapists, and encourage patients who have experienced a miscarriage to seek them out.
Miscarrying a wanted baby is awful, and the new law is going to make it even worse.

I know a lot of people have commented about how awful the pharmacists were for not helping.

But it's not as black and white as "evil corporate pharmacy chain takes anti-abortion stance and punishes customer."

Because it's Texas, it's way more complicated.

I've also had people tell me to move out of Texas.

I can't tell you how unhelpful that is. I'm a white cis-het woman with a job I can do from anywhere. That's a lot of privilege for me to take to another state's voting booth if I move.

I don't fault people who do leave, but

imagine what all of us privileged people could do if we didn't move, and instead actually voted as conscientiously as we tweet?

Oh my damn, this thing has really grown some legs.

I want to make something clear: I'm a journalist. But I'm also a woman, and having been through three miscarriages myself, I can't imagine having to explain myself repeatedly.

I don't have to imagine it, because I did.

For my last two miscarriages, I was with a new doctor. On paper he seemed great, and he came recommended by friends.

But I guess those friends had never had a miscarriage, because by the end of #3 (I had #2 and #3 within about six months of each other), my husband and I were calling him Dr. Asshole.

We came in the day after an ultrasound found no heartbeat on what was roughly a 9 w/o embryo

We were back in his office because I was in a lot of pain, and bleeding heavily. The literature he handed me said to come in if you were bleeding over a certain amount, but he treated me as if I was just being hysterical.

I begged him to put me on his schedule for a D&C. He finally agreed -- almost 48 hours later.

By then I was running a low-grade fever, still bleeding, and still in a lot of pain.

We didn't make it to the first available time he had (which was the next week). I ended up in the ER that afternoon, where they gave me misoprostol, pain medication, and observed me.

I finally completed the miscarriage while I was there.

That was not quite 8 years ago. But I think about this doctor a lot, and have thought about him a lot over the past 48 hours.

Because what if I had him (I forgot to mention that he sat me in a room full of happy pregnant women while I waited for his scheduler), and

(on top of having to deal with his eye rolling and having to beg for care), I then had to go to several pharmacies to try to fill my prescription?
Would he even be helpful enough to advocate for me with a pharmacist?
My guess is that would’ve inconvenienced him a lot.

We cannot have an honest discussion about reproductive health without acknowledging that many pregnancies end in miscarriage, and that there is a standard of care for them that mirrors the standard of care for abortion.

And we can’t just hope it all works out for women who are miscarrying. That ship has (judging from my OP and the litany of comments from women who have also dealt with this) sailed. It’s not working out.

I also know that several of my fellow journalists are interested in where this woman posted. She did so anonymously, and in a private group. I don’t feel comfortable divulging more than that.

I have heard a lot since I started this thread that I honestly thought maybe 50 people would see, and several women have shared their own stories about difficulties in getting appropriate healthcare.
It shouldn’t matter why someone is picking up a prescription for misoprostol

I believe that with my whole heart. In a perfect world, my doctor could prescribe me something and (unless it’s contraindicated with another drug I’m taking) the pharmacist would fill it without needing to double check my intentions.

It’s worth noting that in the thousands of responses to this thread, not once have I heard about a urologist or PCP spending 30 minutes on the phone explaining what their patient intends to do with the erection they achieve with their Viagra script.

“Is this to do some raping? Will your patient be sure to get the full consent for each sexual act performed with the aid of this medication? Do they promise to only display the erection to consenting parties who wish to view it? Are you sure?”
No. That isn’t happening.

Women are already being warned by their doctors (saw one instance just this morning) to come in and get their IUDs soon, because they don’t know if that’s next. They are even warning that they may not be able to offer misoprostol to soften the cervix prior to insertion

All of this is only pro-life if we actually support life. But we don’t. Maternal mortality rates are awful in this country. We can’t commit to a living wage. We have no paid parental leave.
This is pro-birth, and there is a vast difference between that and being pro-life.