Avery Davis Bell was 18 weeks into her pregnancy with a baby boy.

At 34, Bell, who resides in Atlanta, Georgia, is a mother to a 3-year-old son who eagerly watched the “Daniel Tiger” special about becoming a big brother.

Since they met at ages 19 and 20, she and her husband, Julian, had envisioned the family they wished to create.

On October 17, Bell found herself in a hospital bed, bleeding heavily with large clots, and leaking amniotic fluid. She had endured almost 20 hours without the urgent medical attention she required.

During what she described as a second-trimester miscarriage, Bell experienced delays in her care at Emory Decatur due to Georgia’s stringent abortion legislation.

“Your baby is dead or dying inside you, and you’re just waiting for everything to collapse,” Bell told YSL News days after she underwent a D&E, or dilation and evacuation, which saved her life. “I wanted to survive, both for myself and for my current child. The baby had no chance of survival anyway.”

‘Our goal was always to have two children’

Having earned her doctorate in Genetics and Genomics from Harvard Medical School, Bell and her husband, an MIT graduate, resided in Boston for seven years. Returning to Atlanta in 2020 was part of their family planning, aiming to be closer to relatives, despite concerns about the state’s potential “heartbeat bill,” which had been proposed around 2019, before the Dobbs ruling in 2022 disrupted federal abortion rights.

In November 2022, Georgia enacted a severe six-week abortion ban known as the “LIFE Act,” making most abortions illegal after six weeks of pregnancy with few exceptions, including cases deemed medically futile and emergencies that threaten the mother’s life, as well as situations involving rape and incest, but only if reported to the police.

Since the Dobbs decision, various states have passed laws ranging from almost total abortion bans to protections for patients travelling from other states seeking the procedure. Many families and healthcare workers have left states like Georgia and Idaho, yet Bell and her husband decided to remain living there.

Once they settled in their home in Decatur, the couple welcomed their first son in the summer of 2021.

“My older child, I mean, my only child,” she corrected after a reflective pause, “is a complete delight. My husband and I both had always desired to be parents since childhood, and we envisioned having two kids.”

The couple strategically delayed their second pregnancy until summer, just before their son turned three.

In June, she learned she was pregnant again, but this time the experience was not typical.

At approximately seven weeks into her pregnancy, ultrasounds indicated that Bell had a subchorionic hemorrhage or subchorionic hematoma. This condition occurs when blood accumulates between the uterine wall and the chorionic membrane, the outer layer separating the amniotic sac from the uterus, explained by the Cleveland Clinic. The bleeding results from the chorion being detached from the uterine wall.

Subchorionic hematomas are a prevalent source of vaginal bleeding for pregnant individuals between 10 and 20 weeks, representing about 11% of occurrences, as per the National Library of Medicine. Most cases resolve independently without causing significant issues or needing medical intervention.

In Bell’s case, the size of her hemorrhage was notably larger than typical subchorionic hematomas, which are usually smaller and cause minimal or no vaginal bleeding.

She continued her bi-weekly appointments for monitoring, and by her second trimester, the hemorrhage had stabilized, which made her optimistic. She began to share news of her pregnancy with friends and family, and they told their 3-year-old he would soon have a sibling.

“He was thrilled about the baby,” she remarked. “Every time he saw me, he would give me a big hug and say, ‘Hug mama, hug baby.’ He completely understood, and he would gently pat my belly, saying, ‘Touch baby.’

The pressure of a mandatory 24-hour waiting period

However, by 16 weeks, she began to experience heavy bleeding again, raising alarms about her decreasing hemoglobin levels, which were not improving.

Avery Davis Bell experienced multiple hospital visits and was eventually placed on bed rest.

She said the only time she broke that bed rest was to cast her early vote in the presidential election, which happened to be the same day she was hospitalized for the last time. In November, measures concerning abortion will be on the ballots in ten states.

During her final hospital admission, her doctors grew increasingly worried about her severe bleeding.

“One of the major concerns for my health was the possibility of experiencing a blood crisis or a hemolytic crisis. If that happened, they would have to end the pregnancy to save my life,” she explained. “At that time, they mentioned that in Georgia, they couldn’t consider anything unless it was a life-or-death situation for me. They said, ‘We need to discuss this because of the laws in Georgia.'”

“We were already addressing the types of healthcare I could receive due to the state I’m in,” she said. “I lost a significant amount of blood.”

Tests conducted that Thursday night in October revealed she was anemic. While in the hospital for her bleeding, her water broke prematurely, increasing her risk of infection.

Bells and her doctors decided that a D&E, or dilation and evacuation procedure, was the safest option. A D&E is typically performed after the first trimester for abortions or following a miscarriage to remove left-over tissue. It entails dilating the cervix and surgically removing tissue from the uterus, often done using aspiration and surgical instruments.

Bell stated that her doctors believed the procedure was crucial for controlling the bleeding and ensuring her safety.

“At that moment, we realized we wouldn’t get to meet my baby,” she recalled, holding back tears.

According to Bell, her baby still had “cardiac activity,” but she described the situation as a “slow ending to the pregnancy” that was “definitely over.”

Despite the severe bleeding, Bell mentioned that she still needed to provide consent for an abortion and that the hospital staff stated her condition wasn’t urgent enough to bypass Georgia’s 24-hour waiting period requirement.

In response to inquiries about the abortion care provided at their facilities, Emory Healthcare issued the following statement:

“Emory Healthcare relies on expert consensus, medical literature, and legal guidance to assist our providers in making personalized treatment recommendations in accordance with Georgia’s abortion regulations. Our foremost concern remains the safety and well-being of our patients.”

Bell recounted a scenario where her medical team was unsure how to appropriately treat her without risking legal ramifications.

“They were anxious to get the necessary paperwork signed to initiate the process,” she said. “If my life was indeed in danger, they could proceed. But determining that threshold is challenging; my doctors, understandably, prefer not to wait until you’re critically ill to intervene. This isn’t a decision they should have to face.”

Bell reported that the medical team had difficulties determining the optimal time to start her procedure. Her cervix would need time to dilate; however, it was ambiguous whether initiating the dilation would be seen as progressing an abortion before it was legally permissible.

“These are issues that I shouldn’t have to consider, and they shouldn’t have to face either. Their priority should be my safety, and they should be able to start the necessary treatment immediately. But they couldn’t do that.”

She mentioned that she was transported to Emory Midtown, a facility better equipped to handle her situation, via ambulance.

On that Friday, she and her husband found themselves “waiting for doctors” who were “trying to determine when I could have my surgery.” After additional tests, it was revealed that her hemoglobin levels had dropped dangerously low, nearly reaching the threshold for an automatic transfusion. Because of this, they advanced the surgery rather than delay until the next day, though it still had to be authorized by a designated committee at the hospital that reviews procedures to ensure compliance with the state’s abortion laws.

An Emory spokesperson declined to provide further information or answer specific questions about the committee and its decision-making process.

During her surgery, Bell required a blood transfusion and underwent two iron infusions. She is still under the care of a hematologist and may need additional infusions to recover from the lingering anemia. Doctors informed her that it could take up to six months for her body to return to its normal condition.

‘Doctors Are in Difficult Situations’

Bell expressed gratitude towards the medical staff and advancements in health care for ultimately saving her life; however, she conveyed that she felt “angry that the process was unnecessarily complicated.”

“If it were 200 years ago, I would likely not have survived thanks to modern medical facilities,” she remarked. She also pointed out how, in 2024, differing abortion regulations across states can affect health care.

“In Massachusetts, I would have a very low chance of dying. But if I were in Idaho, where there are no OBs due to stringent laws, or in Texas, which is constantly facing lawsuits, my life could be at risk,” she explained.

“We are placing doctors in impossible situations.”

“This is Your Mom”

Currently, Bell is not only healing physically but also dealing with the emotional aftermath of losing her second child. The toughest moment for her was informing her son that he would no longer become a big brother.

“It’s a deep sadness,” she reflected, “when your child says, ‘I guess I’m not going to be a big brother anymore since the baby isn’t here?’”

Bell and her husband still hope to expand their family in the future when they’re ready. For now, they have chosen to remain in Georgia, but they have considered relocating due to the strict abortion regulations.

She felt it was important to share her story to encourage others to “make their voices heard” and to pay tribute to her unborn child.

“This is who your mother is,” she stated.

Understanding Georgia’s Abortion Laws

In Georgia, abortions are prohibited after six weeks, with some exceptions. The state enacted this ban in November 2022, and it was confirmed by the state supreme court in 2023.

Georgia’s “heartbeat law,” known as the LIFE Act, has undergone conflicting rulings in state courts. Initially, it was invalidated by Fulton County Superior Court Judge Robert McBurney, who said it was “definitively unconstitutional,” as it was introduced prior to the dismantling of Roe v. Wade in 2019.

However, in October last year, the higher court ruled that the new standard established by the reversal should guide abortion-related issues in a 6-1 decision.

Just last month, Judge McBurney declared the ban unconstitutional once again, but it was reinstated a week later after Georgia Attorney General Chris Carr filed an emergency motion requesting the state supreme court to reinforce the LIFE Act while the case was reviewed. An injunction was put in place to temporarily stop the lower court’s ruling.

The ban allows for exceptions in medical emergencies, instances where a pregnancy is deemed nonviable, or cases of rape or incest, but only if reported to authorities and performed at or before 20 weeks.

Some exceptions also apply to “removing a deceased unborn child following a miscarriage or an ectopic pregnancy.”

Unlike regulations in other states, Georgia’s LIFE bill does not clearly state that a pregnant person will not face prosecution for seeking an illegal abortion. Medical professionals found guilty of unlawful abortions risk up to 10 years in prison, fines, and repercussions to their medical licenses.

To access an abortion in Georgia, individuals must endure a mandatory 24-hour waiting period and attend a consult at least a day before the procedure. During this consult, they receive information about the risks of abortion, details on carrying to term, fetal development milestones, and resources related to childbirth. They must then give written consent to acknowledge they’ve received this consultation, except in emergencies.

The Georgia Department of Health defines an “emergency” as “any condition that, in reasonable medical judgment, complicates a pregnant woman’s medical condition to the point that immediate abortion is required to prevent death or to avoid severe risk of significant or irreversible impairment of a major bodily function or death of the unborn child.”