Following Indiana’s near-total abortion ban, a new study shows emergency room doctors are less likely to treat pregnant women who are bleeding. Doctors often send them to overworked OB-GYNs instead.
Kathryn LaRoche, one of the study’s authors, spent time inside two Indianapolis hospitals and interviewed staff. The assistant professor, who studies public health at Purdue University, watched pregnant patients come to the ER for vaginal bleeding.
Up to 25% of pregnant women experience bleeding or spotting in the first trimester. LaRoche noted that this symptom can look the same in both miscarriages and medication abortions.
“It’s a really common complaint,” LaRoche said. “Once, the ER could deal with it completely. Now, because this could be associated with abortion, they refer out.”
In 2022, Indiana passed an abortion ban with narrow exceptions for rape, lethal fetal anomalies and saving the mother’s life. The legal risks fall on doctors, who can be arrested and prosecuted for providing an abortion outside of these situations. In one high profile case, Indiana’s attorney general went after Dr. Caitlin Bernard’s medical license after the OB-GYN provided an abortion to a 10-year-old rape victim.
And, according to the study, Indianapolis physicians have become more wary about treating pregnant patients in general.
“This has created a chilling effect,” LaRoche said. “It’s very concerning that emergency room doctors are afraid of providing routine care.”
At the same time, Indiana has a shortage of OB-GYNs who can see these patients. About 1 in 4 Indiana counties are considered maternal care deserts; these areas do not have hospitals with labor and delivery services, birthing centers or practicing obstetricians. Marion County does not have a desert, and pregnant people from across the state travel here to receive care.
The study’s authors are worried about potential delays in care and the growing number of patients OB-GYNs must see now. In Texas, a woman died from a miscarriage after doctors said it would be a “crime” to intervene due to the state’s abortion ban. In another case, a teenage girl died from sepsis after waiting 20 hours for doctors to treat her miscarriage.
While Indiana’s ban was written to target abortions, LaRoche said, there’s been an impact beyond that: “It’s altered the standard of care for people experiencing routine complications during pregnancy.”
Medication abortions increase after bans
Indiana has limited exceptions for getting an abortion.
In cases of rape or incest, a pregnant person has up to 12 weeks since their last period to get an abortion. For the fetal anomaly exception, it must be a condition that will result in the death of a child up to three months after birth; the window to get an abortion is within 22 weeks of the patient’s last period.
Providing an abortion to save the mother’s life requires a doctor to certify in writing that the procedure is medically necessary.
The year before the ban went into effect in 2023, the Indiana Department of Health tracked about 9,500 abortions. By 2025, that annual number dropped to 126 abortions, which met the criteria for the exceptions.
These statistics don’t account for people who use telehealth services, order abortion pills in the mail, or travel out of state. Studies show in the years following state bans, the number of abortions have actually increased. About 28% of these cases are medication abortions from telehealth.
While it is illegal for Indiana doctors to prescribe medication for an abortion, patients cannot be charged for taking them. Some people use out-of-state doctors or online services. The pills, mifepristone and misoprostol, have had FDA approval for decades.
Experts say the legal risks are complicated. Authorities generally cannot go through a person’s mail, and doctors from other states can be protected by shield laws.
LaRoche said the Indianapolis study looked for cases where women showed up at local emergency rooms after taking abortion pills at home, but it’s hard to track.
“People can show up bleeding and say they had a miscarriage, but they’ve taken medication,” she said. “There’s no way to clinically distinguish between that.”
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Mirror Indy reporter Mary Claire Molloy covers health. Reach her at 317-721-7648 or email maryclaire.molloy@mirrorindy.org. Follow her on X @mcmolloy7.
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