| Many of the 13 so-called "trigger laws," that went into effect in the wake of the Supreme Court's decision to overturn Roe v. Wade include language that allows for an abortion to save the life of the mother. The problem is, few states have clarified what constitutes a "medical emergency." States' attorneys general haven't released language around what counts as a medical emergency when terminating pregnancies, leaving obstetricians and hospital attorneys unsure of how to proceed in the new legal landscape. Raising the stakes, many of the trigger laws include provisions that threaten doctors who violate the law with criminal felonies that could lead to years-long prison sentences.
"Me, a lawyer, has to help a trained physician make the decision of whether their patient is near enough to death (under the law) for them to take action that is agreed to by the patient," Lisa Larson-Bunnell, an associate counsel and compliance director for a hospital in Missouri, a state that has banned abortion, recently wrote on Twitter. A commonly used definition of a medical emergency is a situation in which absence of medical attention will result in the immediate death or impairment of a patient. But the laws' vague language doesn't explain what "immediate" means. Larson-Bunnell said doctors were calling her to find out if they could legally treat patients whose fetuses have died from natural causes before they develop sepsis, or if they have to wait for their patients to start actively dying before they intervene.
That sounds like an extreme, nightmare scenario, but it's exactly what happened in 2012 to Savita Halappanavar in Ireland, who died of sepsis when doctors were legally barred from removing a fetus she miscarried but that her body hadn't expelled on its own. Louise King, an assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School, said she worries a similar situation might arise in the US under these new laws. "Someone is going to have a near miss or pass away because of confusion over what is possible and not possible under these laws," said King, who is also the director of reproductive bioethics at Harvard Medical School's Center for Bioethics. King points to the common issue of ectopic pregnancies, which occurs in 1 out of 50 pregnancies. When the fertilized egg implants somewhere other than in the uterus — a fallopian tube, ovary, or even scar tissue from a previous cesarean section — the fetus won't be able to grow full-term. And if it's not aborted, it will eventually rupture (usually between six and 16 weeks) and cause internal bleeding, from which a woman may die. King says ectopic pregnancy is something every obstetrician knows how to treat but the post-Roe trigger bans have created a legal gray area. Before a fetus ruptures, a woman is technically healthy. "If you're sitting happily in front of me with an ectopic pregnancy that hasn't ruptured, your vitals are fine. You are not in any danger of losing your life at that moment," she says. "Legally, that's not an 'emergency.' So how am I supposed to act under that law?" On June 24, six minutes after the Supreme Court overturned Roe, Missouri's attorney general Eric Schmitt posted a photo of himself signing a legal opinion to trigger the state's abortion ban, along with a promise to actively enforce the new law. The same day, Tennessee's attorney general Herbert Slatery filed an emergency motion asking a federal appeals court to waive the 30 day waiting period that was supposed to occur before the state's abortion ban took effect. But neither of them have explained what constitutes a "medical emergency" and how doctors should proceed. Schmitt and Slatery's offices didn't respond to a request for comment. The Texas Republican Party wrote a message about the subject on Twitter, citing a previous law that carved out ectopic pregnancies and miscarriages from the definition of what constitutes an abortion. Without formal guidance, King says doctors, clinics and hospitals will be left to take risks that could not only endanger the health of pregnant people but create uneven care based on decisions that are made on a case-by-case basis. "I promise you, these laws are going to result in effects you didn't intend," King said. | 
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