Josseli Barnica Obituary: Josseli Barnica lamented the news as she lay in a Houston hospital bed on September 3, 2021: the sibling she had hoped to give her daughter would not survive this pregnancy.
The fetus was about to emerge, its head pressing against her dilated cervix; she was 17 weeks pregnant, and a miscarriage was “in progress,” according to medical records. More than a dozen medical professionals told ProPublica that they should have offered to speed up the delivery or empty her uterus to prevent a fatal infection.
However, when Barnica’s husband came to her side from his job on a construction site, she related what she believed the medical staff had informed her: “They had to wait until there was no heartbeat,” he explained to ProPublica in Spanish. “It would be a crime to give her an abortion.” For 40 hours, the distressed 28-year-old mother appealed to doctors to help her return home to her daughter; all the while, her uterus was exposed to infection.
Barnica died three days after giving birth due to an illness. Barnica is one of at least two Texas women who died as a result of doctors’ delays in treating miscarriages, which fall into a grey area under the state’s tight abortion regulations, which prohibit doctors from terminating a fetus’s heartbeat. Neither desired an abortion, but it didn’t matter. Though proponents argue that the laws protect both the life of the unborn and the person carrying it, in practice, doctors have been hesitant to offer care due to the risk of prosecution, prison terms, and professional ruin.
ProPublica will recount these women’s tales this week, beginning with Barnica’s. Her death was “preventable,” More than a dozen medical professionals, who reviewed a summary of her hospital and autopsy records at ProPublica’s request, described her case as “horrific,” “astonishing,” and “egregious.”
The doctors who cared for Barnica at HCA Houston Healthcare Northwest did not reply to several requests for comment on her case. In a statement, HCA Healthcare stated that “our responsibility is to comply with applicable state and federal laws and regulations” and that physicians utilize their autonomous judgment. The company did not answer a detailed questionnaire about Barnica’s care.
Texas, like all states, has a committee of maternal health specialists who analyze such deaths and recommend measures to prevent them. However, the committee’s reports on individual instances are not public, and members indicated they have not finished reviewing cases from 2021, the year Barnica died. More than a dozen OB-GYNs and maternal-fetal medicine specialists from across the country attended, including researchers from prestigious institutions, doctors who regularly handle miscarriages, and experts who have served on state maternal mortality review committees or held positions at national professional medical organizations.
After reviewing the four-page summary, which included the timeline of care as documented in hospital records, everyone agreed that requiring Barnica to wait until there was no detectable fetal heartbeat violated professional medical standards because it could allow an aggressive infection to take hold. They indicated there was a good probability she would have survived if she had received an intervention sooner.
Many people saw a strong resemblance to the case of Savita Halappavanar, a 31-year-old woman who died of septic shock in 2012 after doctors in Ireland refused to empty her uterus while she was miscarrying at 17 weeks. When she begged for help, a midwife responded, “This is a Catholic country.” The following probe and public outcry prompted the country to reconsider its severe abortion ban. However, in the wake of abortion-related deaths in the United States, officials who advocate curtailing the right have made no calls for improvements.
