Death after late-term abortion at Germantown clinic resulted from natural causes

May 29, 2013

A 29-year-old woman who died after a late-term abortion at a controversial Montgomery County clinic suffered a rare condition in which amniotic fluid was pushed into her blood system, according to an autopsy report released Wednesday by Maryland’s Office of the Chief Medical Examiner.

Although the report says the complications arose after the procedure, it doesn’t suggest errant treatment at the clinic and specifically states that the woman had no signs of injury to her uterus. The first cause of death listed — disseminated intravascular coagulation — can occur during otherwise routine deliveries. “The manner of death is natural,” the office concluded.

Amniotic fluid protects a baby inside the womb. When it enters a woman’s blood system, it can impede her ability to clot blood, said David Fowler, Maryland’s chief medical examiner. In this case, the condition caused damage to the woman’s heart, lungs, liver and other areas. The condition caused “dysfunction of multiple organs,” the report stated.

The findings affirm earlier information released by the medical examiner that described the woman’s cause and manner of death in briefer terms.

The woman’s death, on Feb. 7, has become a flash point of the nationwide abortion debate, just as the clinic has been since it opened more than two years ago in a nondescript office park in Germantown. At the center of the controversy is the clinic’s leader, LeRoy Carhart, one the few doctors nationwide who publicly acknowledges performing late-term abortions. Antiabortion activists regularly demonstrate outside Carhart’s clinic and try to persuade his patients not to go through with procedures.

In this case, a woman from New York who was 33 weeks into her pregnancy went to Carhart’s clinic Feb. 3, according to abortion opponents who saw her arrive and tried to speak with her. She stayed in town for the multi-day procedure, developed complications and went to Shady Grove Adventist Hospital, where she died, according to state and local officials.

Abortion opponents quickly described the death as just the kind of tragedy they predicted would happen when Carhart opened his clinic. Some antiabortion activists said that Carhart had “killed” the woman.

Family members could not be reached for comment Wednesday.

The woman’s mother-in-law earlier told the Journal News in New York that relatives wanted privacy and were upset with rhetoric surrounding the case.

The recent autopsy report does not provide an account of what happened to the woman at Carhart’s clinic. The goal of the autopsy is to find the cause and manner of death, Fowler said.

Amniotic fluid can escape to the bloodstream during childbirth, Fowler said, because two things are often present: contractions, which create pressure, and natural trauma, such as the placenta separating from the uterine wall. Fowler declined to comment on what might have happened at the clinic. But he said that in many late-term abortions, doctors try to create a process similar to natural childbirth.

Abortion opponents who tracked the woman’s movements outside Carhart’s clinic in February said she underwent a procedure designed to kill the fetus and induce labor. The medical examiner’s report said there were “fetal anomalies.”

Carhart has declined to discuss the case. But earlier this year, an antiabortion group made secret videotapes of Carhart at his clinic in Nebraska during which he discussed the woman’s death. He said she had an “allergic reaction,” which experts said may have been his effort to describe disseminated intravascular coagulation in layman’s terms.

This month, Maryland health officials released findings of their evaluation of Carhart’s clinic as part of a broader survey of 16 surgical abortion facilities in Maryland. Officials said nurses were not properly trained to give sedation medication. The officials said they investigated a complaint about the woman’s death but “identified no deficiencies” linked to her care.

Dan Morse covers courts and crime in Montgomery County. He arrived at the paper in 2005, after reporting stops at the Wall Street Journal, Baltimore Sun and Montgomery (Ala.) Advertiser, where he was a Pulitzer Prize finalist. He is the author of The Yoga Store Murder.
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