Two hospitals may have violated federal law in denying a woman an emergency abortion, health officials say.

The Department of Health and Human Services (HHS) has launched official investigations into two hospitals which are accused of depriving Mylissa Farmer, 41, of the life-saving procedure in November last year, months after Roe v Wade was overturned.

Ms Farmer was twice refused an emergency abortion in her home state of Missouri and Kansas after her waters broke at 18 weeks pregnant and she was told the fetus was no longer viable. Doctors said they could not treat her to prevent infection, bleeding, and potentially death because a fetal heartbeat could still be detected.

Healthcare providers are trying to navigate the mishmash of state termination laws that have sprung up after the Supreme Court overthrew Roe last year, which stood as a constitutional right to abortion for almost half a century.

Abortion is illegal in Missouri, except to save the pregnant person’s life or prevent serious health outcomes. 

Mylissa Farmer talks with the News-Leader on September 28, 2022, at her home in Joplin, Missouri

More than a dozen states have restricted access to abortions following the overturning of Roe V Wade

In Kansas, abortions are generally allowed up to 22 weeks, but pro-abortion campaigners feel there is widespread confusion and fear among physicians about giving abortion care. 

HHS would not reveal which hospitals were being investigated, but the NWLC said it filed the original complaint against Freeman Health System in Joplin, Missouri, and University of Kansas Hospital in Kansas City, Kansas.

Missouri’s Department of Health and Senior Services previously confirmed they were investigating Freeman Hospital West in Joplin, Missouri, over the claims.

HHS did not say if it would be taking action against the hospitals.

If the hospitals are found guilty, they or their Medicare Provider Agreement can be terminated.

Hospitals can also be fined up to $100,000 per violation. They may also be liable for civil lawsuits from patients. 

It is HHS’s first investigation into violations of the Emergency Medical Treatment and Labor Act (EMTALA) — passed by Congress in 1986 to ensure public access to emergency services — for hospitals that will not give abortions. 

After Roe v Wade was overthrown, the White House told hospitals and doctors they had to offer abortions in the event of a medical emergency or if the health or life of the patient is in danger, even if this would violate state law.

But in practice, critics argue that doctors have been left hesitant to give abortions and with different opinions on what constitutes a medical emergency.

A study published last week alongside commentary in the Lancet demonstrated that hospitals in Oklahoma are finding it difficult to interpret the laws and enact policies which comply. 

In some states, physicians are threatened with criminal or civil penalties for performing abortions.

HHS would not reveal which hospitals were being investigated, but the National Women’s Law Center (NWLC) said it filed the original complaint against Freeman Health System in Joplin, Missouri, and University of Kansas Hospital in Kansas City, Kansas

In early August, Ms Farmer had to travel to Illinois to terminate her pregnancy when her water broke at 17 weeks and five days and put her life in danger

The government can investigate hospitals that get federal funding for breaking the law. 

Mylissa Farmer, from Missouri, was 18 weeks pregnant in November 2022 when her waters broke. She lost all of her amniotic fluid and was told by doctors the fetus would not make it.

But she was denied an emergency abortion because they could still detect fetal heartbeat activity.

Abortion is outlawed in Missouri, except to save the pregnant person’s life or prevent serious health outcomes. In Kansas, abortions are generally allowed up to 22 weeks.

Some fifteen states have banned abortion, including Georgia which prevents the procedure at six weeks of pregnancy.

Ms Farmer was forced to trek to an abortion clinic in Illinois to get emergency treatment. 

The complaint, which was filed by the National Women’s Law Center (NWLC), claimed: ‘This was a medical emergency, putting her at risk of severe blood loss, sepsis, or death. But she was denied the emergency care she needed.’

HHS Secretary Xavier Becerra said in a statement: ‘Fortunately, this patient survived. But she never should have gone through the terrifying ordeal she experienced in the first place.

‘We want her, and every patient out there like her, to know that we will do everything we can to protect their lives and health, and to investigate and enforce the law to the fullest extent of our legal authority, in accordance with orders from the courts.’

The statement said: ‘During her visits to two different hospitals, the patient was not offered the care that her doctors determined was necessary to stabilize those emergency medical conditions — not because of the clinical judgment of her providers, but because the hospital policies would not allow an abortion to be performed.

‘This was a violation of the EMTALA protections that were designed to protect patients like her.’

Ms Becerra sent a letter on Monday to hospitals and provider associations across America notifying them of the probes and reminding them of their duty under federal law to offer abortions in certain circumstances.

Last year, a federal judge in Texas stopped HHS from imposing its guidelines in the state.