Federal complaint blames pro-life Texas law for hospitals' response to miscarriage

A new federal complaint filed against two Texas hospitals alleges that they failed to provide necessary emergency medical care to a woman experiencing a miscarriage in October 2025.

The complaint states that Baylor Scott & White Medical Center in Round Rock and St. David’s Round Rock Medical Center both violated the federal Emergency Medical Treatment and Active Labor Act (EMTALA).

However, based on the details of the complaint, it is unclear if there was a true medical emergency; if there was, then the hospitals could be negligent.

Key Takeaways:

• A woman suspecting a miscarriage has alleged that she was denied necessary medical care at two Texas hospitals.

• At her first emergency room visit, it was confirmed that her preborn baby did not have a heartbeat.

• She was discharged, but scared about horror stories in the media, she went to a second emergency room, where she was given pain medication and antibiotics, though she had not yet developed an infection.

• Her OB/GYN then saw she had not completed the miscarriage, and gave her medication to complete the process.

• The case is being used to argue that pro-life laws put women's lives at risk.

The Backstory:

According to The Texas Tribune, Lynn Callaway and her husband, Mario, were expecting their second child and awaiting the first prenatal appointment when she began experiencing pain and spotting. She went to the OB/GYN, and a nurse practitioner thought Callaway might be having an ectopic pregnancy or a miscarriage because she didn't see an embryonic sac on the ultrasound.

"I hadn't heard of any good situations from this. It sounded like an emergency," said Callaway, who began to panic.

An ectopic pregnancy is an emergency, but the office noted a "threatened abortion" in her charts ( which indicates the pregnancy was likely still considered viable), and ordered bloodwork to check her human chorionic gonadotropin (hCG) levels, which should double every 48 to 72 hours during early pregnancy.

The bloodwork showed that her hCG pregnancy hormone had dropped, and it ultimately continued to drop over 10 days.

Callaway's pain was increasing, and she felt lethargic. She called her OB/GYN and was told her hCG was still too high for any intervention. It is unclear why, other than that they thought her pregnancy may still be viable. She was told that if her condition worsened, she should go to the emergency room (ER). Emergency departments don't typically provide miscarriage management unless it's an emergency.

"I was just totally confused," said Callaway. Her confusion was admittedly in part due to what she had "read about Kyleigh Thurman." Thurman and the media had blamed Texas' pro-life law for the delayed treatment she received for an ectopic pregnancy.

An investigation found that medical staff had actually failed to follow proper protocol, and the law was not to blame.

First trip to ER

Callaway's symptoms worsened, so she went to the ER at Baylor Scott & White, and for an unknown reason was given an STD test. The doctor found that she was miscarrying, and there was no embryonic heartbeat.

The Texas Tribune reported that Callaway expected to receive meds like misoprostol and mifepristone (the two drugs that make up the abortion pill regimen), calling it the "standard procedure" for treating early miscarriage. However, the standard of care is typically expectant management, which involves managing symptoms and preventing infection. Women aren't normally administered drugs or provided surgery at first during miscarriage, especially at an ER, where doctors work to stabilize patients, not perform surgeries without an emergency.

Furthermore, only certified prescribers can dispense mifepristone, and it is possible that the ER doctor may not have been certified.

Callaway was told to go home and wait, taking Tylenol for the pain. At home, she had chills and increased pain, and she began to think she might die.

Her husband said, "I just felt helpless in a way that I’ve never felt in this relationship, in this marriage. It did something to me where I felt like I had to still be present for my son and be level-headed, but then on the inside I’m freaking out.”

It's clear that Callaway and her husband were both scared, and that the stories they had seen in the media may have helped to fuel that fear. Miscarriage is emotional and frightening, and doctors often dismiss women's emotional and medical concerns. Research shows that up to 93% of women who seek medical help for any reason feel dismissed, and that this readiness to dismiss exists within pregnancy and miscarriage care.

However, early miscarriages can take weeks to complete, and may include cramping, pain, and the passage of clots for two weeks or longer.

• Sometimes, a woman experiences a "threatened miscarriage," as doctors initially believed Callaway was; in these cases, the cervix doesn't dilate, but there is bleeding, and the baby's heartbeat may or may not be detected. This is still considered a viable pregnancy. If the cervix is dilated, this is considered an inevitable miscarriage.

• A missed miscarriage means the baby has died, but the body has not recognized this yet. An incomplete miscarriage is when the miscarriage does not complete, and it requires intervention.

The next morning, bloodwork came back abnormal but "not necessarily life or limb threatening." Callaway was told to follow up with her OB/GYN.

“No one’s here to help me,” Callaway remembers thinking. “I just felt like I was on my own, and that these people didn’t care. And if the hospital isn’t going to treat you, what are you going to do?”

Second trip to ER

On Sunday, Callaway visited the ER at St. David's Round Rock. Her hCG had dropped further, and she had an infection, according to the complaint. She was given pain meds and antibiotics, but was told that the ER didn't offer mifepristone or misoprostol and did not do surgical treatments for miscarriages. The complaint states:

A physician assistant arrived and told Ms. Callaway she was suffering from a miscarriage and had developed an infection, so they would be discharging her with pain medication and antibiotics to take home. Ms. Callaway asked why they were not offering her a procedure or medication to terminate the pregnancy, and the physician said this was not something the ER provided and Ms. Callaway would need to follow up with her OB/GYN.

However, later in the complaint, it states (emphasis added):

St. David's acknowledged the potential for infection as they prescribed Ms. Callaway antibiotics but offered nothing more.

She was again told to follow up with her OB/GYN. According to the St. David's Round Rock website, "Our emergency medicine physicians stabilize your condition as quickly as possible to prepare you for the next step of care or discharge."

If Callaway was indeed dealing with an infection at this point, it would have warranted an immediate dilation and curettage (D&C). However, the complaint is unclear whether it was an active infection or, as with any miscarriage, the potential for infection.

On Monday, she saw her OB/GYN, who found the miscarriage had not completed, and gave her medication to help pass the retained tissue, indicating that Callaway almost certainly did not have an active infection.

According to the ObG Project, "Surgical intervention is management of choice" when there is an infection. It also notes that doctors should "ensure patient does not have" an "infection" before giving misoprostol or mifepristone.

The Details:

The complaint against the hospitals states that they "failed to offer procedural or medical treatment to terminate Ms. Callaway's pregnancy during a dangerous miscarriage." It further states:

In October 2025, Ms. Callaway, while experiencing a miscarriage, was repeatedly denied care at multiple medical facilities in Texas. It would take seven days, three hospital emergency rooms (“ERs”), and countless calls to her OB/GYN before anyone would agree to give her proper medical care. Ms. Callaway’s pain was dismissed, her signs of infection ignored, and she was forced to pass the pregnancy without medical assistance from Texas physicians. Yet at the same time she was denied miscarriage care, she was subjected to unnecessary STD testing.

What Ms. Callaway experienced has now become standard in states with abortion bans: When ERs are unable to conclusively identify a continuing intrauterine embryo in the early weeks of pregnancy, they send patients home.

It is inaccurate to claim that it is only hospitals in pro-life states that send women home during miscarriages.

Natural miscarriage, without medical intervention, is the most common way a miscarriage is handled. A follow-up exam will determine if the uterus has completely cleared. The standard of care is typically expectant management, which involves managing symptoms and preventing infection.

However, women are sometimes given the choice of expectant management, medication, or a surgical D&C. When it comes to mifepristone, as mentioned, the ER doctors may not have been certified to dispense it.

Emergency rooms exist to stabilize patients before they can get the appropriate, specific help they need. As reported by NPR in 2023, a resident in emergency medicine, Dr. Andreia Alexander, said that she had never performed a D&C for a miscarriage at Indiana University School of Medicine's emergency department.

"Most of the time, miscarriage is not an emergency — though it can feel like one to the patient. Healthcare providers, from ob/gyns to providers in the emergency department, can all do a better job of preparing patients for this," Dr. Sarah Prager wrote in an article for MedPage Today. She added:

As an ob/gyn, I try to discuss what to do in case of bleeding in early pregnancy at a patient's first prenatal appointment. I tell patients that miscarriages are common, and if they are not bleeding to the point of feeling dizzy or lightheaded, and as long as they are not very concerned about their bleeding or pain, they likely do not need to go to an emergency room and can wait to be seen in clinic.

I also tell them, in a compassionate manner, there is unfortunately nothing anyone can do to stop a miscarriage in process. That knowledge can help patients avoid spending unnecessary time in an emergency department, only to be told to follow up with their healthcare provider in clinic.

Many ob/gyn providers likely omit the step of talking about the possibility of pregnancy loss with their newly-pregnant patients. As a result, vaginal bleeding is interpreted by too many patients as an emergency. ...

Once a patient shows up to the emergency department, the sort of care they get can vary significantly. Because most miscarriage is not an emergency (i.e., most patients are not suffering a life-threatening hemorrhage or infection), these patients are often treated as lower priority — and they can tell.

Yet, Callaway's claim, with the help of pro-abortion group Amplify Legal (the litigation and legal advocacy arm of the nonprofit organization Abortion in America), argues that this is a post-Dobbs problem.

It asserts that the penalties for intentionally killing preborn children in the womb scare doctors out of helping women whose babies have already died or who are experiencing a premature rupture of membranes and are in the early stages of preterm labor.

If that's true, it's because legal teams at hospitals have not clarified the laws with medical staff, and pro-abortion media outlets have caused mass confusion over what is and isn't an abortion — counting on the likelihood that no one will actually read the law for themselves.

Pro-life laws say that innocent humans in the womb can't be intentionally and deliberately killed. Unless a doctor is committing a procedure with the intention and goal of ending a preborn baby's life, it's not an abortion under the law.

While all efforts should be made to help both mother and child, if the mother's life is in danger, doctors should and must act, which could involve preterm delivery or a D&C to remove a baby who has already died by miscarriage.

The complaint is clear that "although Texas law bans nearly all abortions, Texas law explicitly allows termination of pregnancy in cases of miscarriage." Media coverage claiming that the pro-life laws cause negligent care for pregnant patients is misleading at best.

Callway's complaint asks the U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services (“CMS”) and Region 6 Office to investigate both hospitals' emergency departments "without referral to the Texas Department of State Health Services."

The Bottom Line:

Callaway tragically lost her baby, and doctors and medical teams clearly did not offer her the emotional support she needed or give her clarity on the process or what to expect.

Media outlets have done women a great injustice by acting as though women have historically walked into ERs with a miscarriage, and have immediately received a D&C or abortion pills. This is not how miscarriage care is typically handled.

However, medical teams could do better. As Dr. Prager wrote for MedPage Today, "Given that 3% of all emergency department visits for reproductive age pregnancy capable people are for care related to early pregnancy loss, it behooves emergency medicine and reproductive health clinicians to collaborate and make this a better experience for the many people suffering from miscarriage."

Go Deeper:

• Pro-abortion doctors use tragic case of medical negligence to promote abortion

• Woman says she was denied a ‘necessary’ abortion because of Kentucky’s pro-life law. Was she?

• ‘PREVENTABLE’: How pro-abortion media is weaponizing reporting on maternal deaths

• FACT CHECK: Tierra Walker's death was tragic, preventable, and not due to pro-life laws

• Planned Parenthood knows miscarriage care isn’t ‘restricted’ by pro-life laws. Here’s proof.

• ProPublica blames pro-life laws for miscarriage complications, but admits data can’t prove it

• Texas women blame pro-life law for delayed ectopic pregnancy treatment. But is it at fault?