Arkansas abortion – Emily Waldorf, 38, miscarried at 17 weeks on Sept. 16, 2024, at Washington Regional Hospital in Fayetteville. Arkansas’ abortion ban required doctors to wait until infection or fetal heart stoppage—leaving her in days of medical limbo after her water broke and
On the morning of Sept. 16, 2024, Emily Waldorf’s preschooler found her curled on the bathroom floor. Waldorf had felt strange pressure during a shower—like a balloon bulging into her vagina—and then the bleeding started.
Waldorf was 17 weeks pregnant. She and her husband, Justin, dropped their daughter off at her grandparents’ and rushed to Washington Regional Hospital in Fayetteville, Arkansas, where Waldorf worked as an acute care physical therapist.
In a dark room, a doctor pointed to the hourglass-shaped image on the ultrasound screen: Waldorf’s amniotic sac was funneling into her dilated cervix, and their tiny daughter’s foot was dipping out.
“Your body is about to miscarry,” the doctor said.
Three doctors gathered and explained the stakes in plain language. The longer Waldorf’s cervix remained open and her uterus exposed to bacteria, the higher her risk of developing a life-threatening infection. The standard of care, they told the couple, was to quickly empty her womb.
But they couldn’t do it. One of the doctors. apologetic. said stopping the pregnancy while the fetus still had a detectable heartbeat would run afoul of Arkansas’ abortion ban—one that snapped into place after the Supreme Court overturned Roe v. Wade in 2022, and that carries penalties of up to $100,000 in fines and 10 years in prison. In their view. the law meant waiting until Waldorf went into labor on her own or showed signs of a dangerous infection. or until the fetal heartbeat ended.
“Our hands are tied behind our backs,” Dr. Erin Large later told Waldorf, according to a journal Waldorf began keeping on her phone and shared with ProPublica. “Tell your friends to vote differently.”
Waldorf was 38. highly educated. raised Baptist in a Republican family. and—crucially for how this felt inside the hospital—she had connections to the governor. Her father, a gastroenterologist named Kenneth Rodgers, was a doctor. This was the hospital where she had worked for six years. The OB-GYN team treating her had delivered her daughter, and some of them lived blocks from her parents.
Lying in the bed, worried that infection could enter her uterus at any moment, Waldorf finally understood what the ban meant in practice: the law could apply to anyone losing a baby.
As days passed, she began writing everything down. It wasn’t just grief. It was also the sense that the medical decision had quietly shifted away from medicine and into fear—fear of criminal exposure. fear of what a prosecutor might later call “wrong.” Her journal. her medical records. and interviews describe a system where doctors weren’t just constrained by medical uncertainty. They were constrained by legal risk.
The pattern became even more vivid when Waldorf found a headline that. by her third night in the hospital. made her realize she wasn’t alone. She had been treating critical patients in the intensive care unit for years and was used to compartmentalizing. Still, the panic arrived when she saw the story: “Abortion Bans Have Delayed Emergency Medical Care. In Georgia, Experts Say This Mother’s Death Was Preventable.”.
That was the same kind of delay that had come up before in another widely reported case. Almost exactly three years before Waldorf arrived at Washington Regional—back in Houston—a 28-year-old woman named Josseli Barnica showed up at an emergency room 17 weeks pregnant with a fetus’ head pressed against her dilated cervix. her miscarriage described in her medical record as “inevitable.” The husband later told ProPublica that inducing delivery or emptying her uterus would be “a crime” and that doctors “had to wait until there was no heartbeat.”.
Texas, like Arkansas, has a criminal abortion ban. In hospitals that follow standards from the World Health Organization and other medical associations. doctors typically offer to empty the uterus in settings like Barnica’s—when a cervix opens too soon. signaling an “inevitable miscarriage. ” or when water breaks before the fetus can survive (previable preterm premature rupture of membranes. or PPROM). even if there is still a heartbeat because infection risk is high.
“This is basic obstetrics,” said Dr. Alison Goulding, a maternal-fetal-medicine specialist in Texas. “Everyone should know that you have to provide an abortion in these settings or women can die.”
Barnica waited for 40 hours in the hospital until the heartbeat stopped. She died three days after delivering, ProPublica reported in October 2024, from a deadly infection. The hospital declined to comment. saying its responsibility was to comply with applicable state and federal laws and that physicians exercise independent judgment. The doctors involved did not respond to requests for comment.
Waldorf’s case unfolded in the same kind of legal squeeze. On her fourth morning, when her water broke, Waldorf was sitting on the toilet and felt something heavy fall. There was so much blood she couldn’t see what it was. A nurse confirmed it was a blood clot 3 inches across. All morning, amniotic fluid drained out of her.
By then, there was virtually no chance the fetus could develop to viability in seven weeks. What mattered more was infection—and how quickly it could turn life-threatening.
Waldorf thought the doctors would finally induce her. After confirming her fetus still had heart tones, the OB-GYN on duty, Dr. Britte Smith, told her she couldn’t induce yet. First she needed to consult the hospital’s risk-management team.
“Oh,” Waldorf thought. “I’m a liability.”
Smith returned about two hours later with two options: remain under observation at the hospital, or drive nearly four hours to Kansas, where abortion is legal at Waldorf’s gestational stage. The hospital would not authorize a transfer or arrange for an ambulance. No explanation was given.
Medical records note that the risk-management team was consulted twice over the next 31 hours, and that Smith wrote, “Since there is still a heartbeat and no signs of maternal infection, we can not proceed” with induction of labor. Smith did not respond to requests for comment.
Waldorf called the maternal-fetal-medicine team at the University of Arkansas for Medical Sciences in Little Rock. the state’s only academic health center. The team told her the standard guidelines recommended induction if she didn’t deliver within 12 to 24 hours because infection risk rises every hour. But they also told her: “It can’t be done in Arkansas.”.
The road to Kansas was not just long; it was dangerous in the family’s view. Waldorf’s sister, Elizabeth Rowe, had almost died of hemorrhaging during childbirth, so a drive through rural roads without medical support wasn’t an option.
Her family watched the clock anyway. On day five. with 24 hours having passed since her water broke. Waldorf texted a friend from college that her temperature had risen to 99.3 degrees. Her friend Lindsey Haire wrote back asking what was next and whether they could help her now. Waldorf replied, “I think it has to be like 100.4. They will continue to monitor my temp or my symptoms.” Haire wrote, “Dear lord.”.
In her journal that morning, Waldorf spelled out the trap she felt she was in: if she needed a blood transfusion and it stabilized her condition, doctors couldn’t induce; if her temperature kept spiking, then they could.
When Rowe walked in, she saw Waldorf with eyes wide and glazed over, jaw tense. Justin slumped on the couch. “Are they going to let me die?” Waldorf asked.
Rowe had never seen her sister this way. “That’s crazy,” Rowe said. “We’re in a hospital. People come to the hospital for them to save your life, not to let you die.”
Some hospitals in states with abortion bans have tried to protect patients by adopting consistent. statewide approaches—Ohio provides an example from 2022 and 2023. when a group of hospitals met to hash out collective policies and interpreted PPROM as a medical emergency. “There’s power in numbers,” said Dr. Justin Lappen, chair of the Society for Maternal Fetal Medicine’s committee on reproductive health. The hospitals resolved to interpret the vague law the same way at the same time. hoping uniform practice would also provide legal protection.
But that wasn’t what Waldorf saw in Arkansas.
A 2024 Senate Finance Committee report. commissioned after ProPublica’s reporting on Amber Thurman’s death. found that many hospital leaders and lawyers left doctors to fend for themselves. The report described situations where hospital lawyers refused to meet with physicians for months. were “pretty much impossible” to reach during “life or death” scenarios. and provided little more than “regurgitating” the law. It also described guidance being treated like “need-to-know” information rather than written down for care teams.
ProPublica found that hospitals in different regions of Texas took vastly different approaches to treating miscarriage and that miscarrying patients were far more likely to become gravely ill where hospitals weren’t offering abortions without signs of infection. In Arkansas specifically. ProPublica reported that none of 10 hospitals with significant labor and delivery wards it surveyed disclosed their policy on PPROM to the public—only one responded to questions.
The University of Arkansas Medical Sciences shared frequently asked questions that. in part. stated. “Under Arkansas law. may an abortion be performed if the mother’s life is at risk?. It depends.” According to the hospital’s general counsel. only abortions “necessary” to preserve a patient’s life are allowed—not abortions that could prevent “possible” emergencies.
In interviews with seven doctors who worked in Arkansas, all said no hospitals allowed doctors to provide abortions for patients with “inevitable miscarriage” or PPROM without signs of infection.
Dr. Dina Epstein. an OB-GYN in Little Rock. said doctors faced cases like Waldorf’s often and that they were always excruciating. Her patients panic and beg for help. But none of them have had the resources to travel to another state. she said. leaving doctors negotiating among themselves over what counts as sick enough. “What organ needs to fail?. What thing needs to happen that pushes us over the edge?” she said.
Waldorf’s search for a way out was, in her family’s account, both relentless and humiliating. Rowe called private ambulance companies but said they wouldn’t drive Waldorf because they considered her condition unstable. A medevac helicopter could cost in the tens of thousands of dollars. Rowe considered putting it on a credit card.
Then Rowe called the governor’s office.
On Waldorf’s fifth day in the hospital, Rowe reached an aide at 9:27 a.m., according to Waldorf’s journal. Rowe tried to emphasize the personal connections between Waldorf and Gov. Sarah Huckabee Sanders: they both attended Ouachita Baptist University. four years apart. and Waldorf had joined the same sorority. known as a social club. Rowe also pointed to the web of acquaintances in small-town Baptist circles.
The aide’s reply, as Rowe recounted it, was that they recommended legal advice.
“This is an emergency,” Rowe said. “We need some help now!”
The aide asked: “What is it you expect the governor’s office to do?”
Rowe and her sister say they never received another call. A friend also called the governor’s office twice, reached two different aides, and got similar responses. ProPublica asked the governor’s office if Sanders was aware of the calls at the time and. if not. what her message would be to women facing this kind of situation. The spokesperson did not respond. The office said: “Governor Sanders has prioritized not just the wellbeing of Arkansas’ unborn children but also at-risk kids and mothers.”.
For the family, the governor’s office was supposed to be a back door. It became another dead end.
So their attention shifted to legal advocacy. Rowe reached out to Molly Duane. then a senior attorney at the Center for Reproductive Rights. representing dozens of women denied medical care under abortion bans—including Amanda Zurawski. a Texas woman who contracted sepsis and lost a fallopian tube in 2021 after doctors refused to induce her at 18 weeks pregnant in circumstances described as similar to Waldorf’s.
In response to Zurawski’s case, the Texas Supreme Court said PPROM should count as a medical emergency.
When Duane took Waldorf’s case call. she said she believed she could fix any fear or misunderstanding by showing it was legal to provide standard care. “This is not a hospital in the middle of nowhere,” Duane said. “This is the hospital where she works. Surely I can convince them that providing the standard of care is legal.”.
Her arguments didn’t move quickly inside Arkansas. In a conversation Duane later described, the hospital’s director of risk management, Andrew Cozart, and the hospital’s general counsel, Thomas Olmstead, warned that they couldn’t ignore the risk of an overzealous prosecutor, Duane said.
Duane sent Cozart evidence about medical standards and the exception in the law. ProPublica reviewed a letter Duane sent and reached out to Cozart and Olmstead, who did not respond to requests for comment.
At 5 p.m.—about an hour after Duane’s email was sent—Larry Shackelford, the hospital CEO, knocked on Waldorf’s door. Waldorf, flustered, told the nurse she needed to put on clothes first.
Shackelford entered looking disheveled, as if he’d run from his desk. Waldorf and Justin recalled him standing awkwardly at the foot of the bed while she watched him with her arms crossed. “I feel like a ticking time bomb right now,” Waldorf told him. “I’ve been here for five days, and you guys have not done anything for me.”.
“We’re going to take the very best care of you,” Shackelford said, according to the couple’s recollections.
He did not say much more. When he left, the family was unsure whether this was an actual shift toward induction or a political visit to calm them down.
Dr. Large returned with a decision that didn’t change. She wrote in the medical record that Waldorf still had a positive fetal heart rate and no evidence of maternal distress or severe illness. The record said they were unable to augment or induce labor to expedite delivery. and it advised they should consider going home.
Soon after, Washington Regional officials told Duane they would agree to transfer Waldorf to a hospital in Kansas.
A transfer required carefully scripted language. Large told Waldorf she had to say specific words. “Repeat after me,” Large said, the Waldorfs and Rowe recall. “I no longer want to receive care here. I would like to transfer to another hospital with a higher level of care.” Waldorf repeated the words. and they were noted in her medical record.
At 10:20 p.m., Waldorf was strapped into a five-point harness in the back of an ambulance for the bumpy ride along rural roads. Her husband and sister followed behind, watching her anxiously through the window.
When she arrived in Kansas, the scene felt different immediately. At the University of Kansas hospital system, women in green scrubs and hairnets lined up to greet her as her stretcher rolled out of the elevator. Their leader, Dr. Megan Thomas, spoke first: “We are so glad you made it.”
That sense of arrival came after a history. Two years earlier. the same University of Kansas system had blocked care for a woman named Mylissa Farmer for PPROM at 17 weeks. even though Kansas did not have a sweeping abortion ban. The Biden administration investigated that case as a violation of the Emergency Medical Treatment and Labor Act and interpreted it as requiring hospitals to offer abortions in emergency situations even if they are in states with bans. Federal investigators said University of Kansas officials deemed the political climate “too hot and heated” to help Farmer. The government cited the hospital for violating the law and threatened fines if the system didn’t correct issues that led to the denial of care. The hospital said Farmer’s care was in line with hospital policy. medical standards. and the law based on facts known at the time.
Now, Waldorf’s care went forward.
Soon after she arrived, she received misoprostol to induce labor and delivered around 1 p.m. She and Justin held their daughter for a few precious moments as her heartbeat stilled. They named her Bee. in honor of the interconnectedness of the natural world. and so they could see reminders of her each spring.
Then the mood turned sharply. Her placenta had trouble detaching. Blood kept gushing out, soaking the pads under her dark red. The nurse kept weighing them. “Is that a lot of blood?” Waldorf asked.
“It’s a lot of blood,” the nurse replied.
The monitor began beeping. Waldorf’s blood pressure was dangerously low. Justin watched her face turn white.
Working in the intensive care unit, Waldorf had seen patients die with that exact combination of symptoms. “This is it,” she thought.
A doctor reached elbow-deep into her uterus, trying to loosen the placenta. The team was about to take her to the operating room when the doctor finally detached it. Doctors said she lost a liter of blood and her complications were likely worse for having been forced to wait so long to deliver.
Waldorf realized that if she had gone into labor at home or on the road, she would not have made it to the hospital in time.
Her Kansas medical record stated the induction was performed “with the intent to preserve the life and health of the mother,” and included four dense paragraphs citing evidence of high risks of sepsis and hemorrhage if the team waited.
Back in Fayetteville, Waldorf’s mother stayed with her. Waldorf continued to bleed heavily and suffered headaches for a week. In her journal, she wrote, “It all feels quite like the Handmaid’s tale,” and said she had to seek refuge and travel by ambulance across borders.
Explaining the loss to her daughter was its own kind of violence. When the older child asked when her little sister would arrive, Waldorf and Justin told her she wasn’t coming anymore—until the questions stopped.
For Alumni weekend, Waldorf canceled a stay at a bed-and-breakfast with the governor. She still went out to see community, hoping it might help. At the opening event, the emcee announced Sanders was in attendance and the audience rose to applaud. Waldorf stayed seated. So did her mother and stepfather, who had supported the governor for years.
Her stepfather tore a Sanders bumper sticker off his car and made it known to local politicians what had happened.
Waldorf’s life kept moving, but not gently. On Dec. 8, she spent the night cleaning and snapping at her daughter. The next morning, she could barely push herself out of the car. Walking into Washington Regional felt like walking back into the trauma—memories of the days she was a patient and of how the CEO and colleagues couldn’t help her.
A month later, she submitted her resignation letter. She said the decision made her feel lighter. “Exhausted. Free.” She started her own physical therapy practice that spring, naming it Hive Therapy after Bee.
She estimates the lost income, startup debt, and out-of-pocket medical costs from the ordeal at more than $147,000, including more than $5,000 for the ambulance ride to Kansas that Washington Regional was unwilling to pay for.
In a letter to Duane. Thomas Olmstead used Waldorf’s own words against her—specifically the phrase Large asked her to repeat. Olmstead wrote the ambulance transfer happened because of Waldorf’s “specific request. ” not because the attending physician believed she needed a “higher level of care.” Olmstead said it wasn’t reasonable for her to demand Washington Regional assume responsibility for a patient-directed transfer. Olmstead has since been promoted to executive leadership and did not respond to requests for comment.
Dr. Large declined to speak about the case, even with Waldorf’s permission, but she said she was glad the topic was being discussed because it was important and that “her voice is being heard.”
The Arkansas Medical Board said it is not currently investigating complaints against the doctors. Local lawyers have been unwilling to take on a malpractice case because Waldorf didn’t die or suffer permanent injuries.
In February 2026. a year after leaving her job. Waldorf joined a lawsuit led by Duane with an OB-GYN and five other women denied care under Arkansas’ abortion law. The case seeks to block the ban on grounds it violates the state constitution. Defendants include Sanders, the Arkansas attorney general, state prosecutors, and members of the state medical board. The state is trying to get the case thrown out on jurisdictional grounds. and the governor’s office said Sanders looks forward to defending Arkansas’ pro-life laws in court.
Waldorf’s story has traveled beyond abortion policy circles. She says the case reached people who don’t usually follow the issue—former boys she knew in college. now in their 40s. who reached out more than 20 years later upset by what happened. A pastor she’d known since childhood defended her on Facebook against anti-abortion attacks. Friends who described themselves as “pro-life” wrote long messages about how her experience sickened them and that they want the law changed.
Still, the trauma returned in everyday ways. Fayetteville is small. Barely a day goes by, Waldorf says, when she doesn’t bump into former co-workers from the hospital at the grocery store, the coffee shop, or during school pick-up. She recently saw Large at a local restaurant.
Each run-in brings back the ultrasound, the risk-management meetings, the blood. But it also brings back the state line—and the relief she felt crossing it.
For Waldorf, the ordeal didn’t end when the doctors finally intervened in Kansas. The question Arkansas forced into her body—whether medicine stops at law—still follows her home.
United States politics Arkansas abortion ban miscarriage PPROM medical emergency exception Washington Regional Hospital Emily Waldorf Sarah Huckabee Sanders Emtala litigation Kansas Texas abortion ban guidance