Families are grieving the tragic deaths of Porsha Ngumezi and Brenda Yolani Arzu Ramirez, two Black women who died following preventable pregnancy complications. Both experienced life-threatening miscarriages but were denied timely, critical care. Health professionals and loved ones are demanding accountability, saying Texas’ near-total abortion ban played a role in their deaths.
According to a Dallas Morning News investigation published on Aug. 18, both women were denied critical medical procedures: dilation and evacuation (D&E) — a surgical procedure commonly used in second-trimester miscarriages to remove fetal tissue — and dilation and curettage (D&C), in which the cervix is dilated and the uterine lining is surgically cleared. These procedures are often necessary to prevent life-threatening infections like sepsis, or in the case of a D&C, to stop severe hemorrhaging. However, under Texas’ restrictive abortion laws, the use of both has become limited and legally fraught, even when medically indicated.
What happened to Porsha Ngumezi?
In April 2023, 35-year-old Ngumezi began bleeding at 11 weeks pregnant. Already diagnosed with several blood disorders, she went to a Houston hospital where she passed clots and likely the fetus in a restroom. She continued hemorrhaging for hours. Despite worsening symptoms, her dangerously low blood pressure, and her husband’s request for urgent care, hospital staff delayed performing a D&C. Instead, she was given medication that works more slowly. Nine hours after she arrived, Porsha gasped for air and went into cardiac arrest. She died shortly after.
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Medical experts reviewing her case believe Ngumezi’s condition called for immediate surgical intervention. One OB-GYN said her care reflected a clear delay in treatment and a failure to listen to her and her family.
“Delay in care, delay in care, delay in care,” said Dr. Deborah Bartz, an associate professor of medicine at Harvard Medical School and a reproductive medicine specialist in Boston, after reviewing the case. “Not offering the care that was needed, and ultimately, not listening to the patient, and then the patient’s husband, as it related to what her symptoms were.”
Dr. Karen Swenson, a former OB-GYN, interviewed by the Dallas Morning News, acknowledged that fear is shaping medical decisions in cases of pregnancy loss. Under the Texas Heartbeat Act, established in 2021, doctors can face civil lawsuits from private citizens if they perform or assist in an abortion after a fetal heartbeat is detected, usually around six weeks into pregnancy. The law permits anyone, regardless of personal involvement or harm, to sue and collect a minimum of $10,000 in damages, along with legal fees if successful.
“Do I think the law could have contributed to this? Yes, because I think doctors are terrified,” Dr. Swenson said outright.
Ngumezi’s husband has since filed a malpractice lawsuit.
What happened to Brenda Yolani Arzu Ramirez?
Sadly, Ramirez faced a similar fate. In November 2021, she was five months pregnant when she arrived at a Georgetown hospital with signs of severe infection. Her baby had died in utero. Her OB-GYN suspected she needed a D&E and ordered a transfer to a larger hospital. But once there, doctors opted for a vaginal delivery, which took several hours. During that time, Ramirez’s infection escalated into septic shock. By the fourth day, she was in multi-organ failure. Though she briefly recovered, a seizure later stopped her heart. Ramirez died at 33, leaving behind two sons.
Experts believe a surgical evacuation could have saved Brenda’s life, but few doctors in Texas remain trained or willing to perform D&E procedures due to legal risk. Doctors say she should have been considered high-risk due to her previous pregnancies; “she had faced complications — preeclampsia, which can cause dangerously high blood pressure in pregnancy and after birth,” the investigation noted.
“As soon as she hit the door for the second hospital, she should have had a D&E,” Bartz said.
Despite mounting evidence that abortion laws are delaying necessary care, Texas officials are not investigating maternal deaths from 2022 and 2023. Lawmakers passed the “Life of the Mother Act” to reassure doctors that abortions are allowed to save a patient’s life, but critics say it doesn’t go far enough.
Physicians fear more lives will be lost unless state leaders fully confront the consequences of abortion bans. For the families of Brenda and Porsha, it’s already too late. It doesn’t have to be this way. In 2024, the Centers for Disease Control and Prevention (CDC) reported that over 80% of pregnancy-related deaths in the U.S. are preventable with timely and appropriate care. Yet Black women remain disproportionately at risk when complications arise. They are three times more likely to die from pregnancy-related causes than white women, a gap driven by systemic inequities in healthcare access, treatment, and outcomes.
We must do better.
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