new york — Russia blocked a U.N. Security Council resolution Wednesday reaffirming the need to prevent a nuclear arms race in outer space.

The measure was proposed jointly by the United States, a nuclear power, and Japan, the only nation ever to be attacked with nuclear bombs.

“We have only begun to understand the catastrophic ramifications of a nuclear explosion in space,” said U.S. Ambassador Linda Thomas-Greenfield. “How it could destroy thousands of satellites operated by countries and companies around the world — and wipe out the vital communications, scientific, meteorological, agricultural, commercial and national security services we all depend on.”

The failed text recalled the responsibility of states to comply with the 1967 Outer Space Treaty, which is the basic framework on international space law. It says outer space is to be shared among nations and shall be free of nuclear weapons or other weapons of mass destruction. The treaty also says the moon and other celestial bodies “shall be used exclusively for peaceful purposes,” and astronauts shall be “regarded as the envoys of mankind.”

The proposed resolution also called on states “not to develop nuclear weapons or any other kinds of weapons of mass destruction specifically designed to be placed in orbit around the Earth, or to be installed on celestial bodies, or to be stationed in outer space in any other manner.”

Thomas-Greenfield noted that President Vladimir Putin has said publicly that Russia has no intention of deploying nuclear weapons in space.

“And so, today’s veto begs the question: Why? Why, if you are following the rules, would you not support a resolution that reaffirms them?” she asked. “What could you possibly be hiding? It’s baffling, and it’s a shame.”

Thomas-Greenfield just returned from Japan, where she visited Nagasaki, a city on which the United States dropped one of two atomic bombs at the end of World War II.

“It was a reminder of our profound responsibility to prevent the scourge of war and ensure that no place experiences the horror of nuclear weaponry ever again,” she said.

“Adopting this draft resolution would have been a positive and practical contribution to the promotion of the peaceful use and exploration of outer space,” said Japanese Ambassador Kazuyuki Yamazaki. “If adopted, we could have demonstrated our unity in reaffirming the principle of no placement of any weapons of mass destruction in outer space and in opposing the development of such capabilities.”

The proposed resolution, which had more than 60 co-sponsors, created no new international obligations, but reaffirmed existing ones. It was supported by 13 of the 15 council members. After failing to get an amendment added to it, Russia vetoed it and China abstained.

“Today, our council is once again being involved in a dirty spectacle prepared by the U.S. and Japan,” Russian Ambassador Vassily Nebenzia said. “This is a cynical ploy. We are being tricked.”

He said Moscow wanted a text that would have gone further, banning weapons of any kind in outer space.

China’s new U.N. ambassador, Fu Cong, echoed that, saying the draft needed “other substantive elements.” 

US concerns

In February, U.S. officials said Russia is developing a space-based weapon to attack satellites. They do not believe it would target people or cause destruction on Earth.

Analysts at the Washington-based Safe World Foundation think tank say on their website that Russia is most likely developing a system “that would use a nuclear explosion to create weapons effects, most likely an electromagnetic pulse (EMP), that would in turn disable or destroy satellites.”

There are thousands of satellites in space that run the gamut from sophisticated military purposes to running a car’s GPS or providing television programming.

Although the U.S. resolution was not adopted, Thomas-Greenfield said Washington would continue to pursue bilateral arms control discussions with Russia in good faith.

The U.S. also has concerns about China’s work in space, where officials say they are rapidly developing a range of counterspace weapons and using outer space to strengthen the capabilities of their military forces on Earth.

“Over the last six years they have tripled the number of intelligent surveillance and reconnaissance satellites in orbit, and they have used their space capabilities to improve the lethality, the precision and the range of their terrestrial forces,” said General Stephen Whiting, commander of the U.S. Space Command.

He spoke by phone to regional journalists Wednesday from Tokyo, where he is meeting with allies.
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Before the creation of engines, the ocean was full of low-emission vessels — they were called sailboats. Now a next-generation zero-emissions laboratory vessel called the Energy Observer recently docked in New York City to show off what this team hopes is the next generation of earth-friendly boats. Elena Wolf has the story, narrated by Anna Rice. Videographer: Max Avloshenko 
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cologne, germany — For the past year, five fit, academically superior men and women have been spun in centrifuges, submerged for hours, deprived temporarily of oxygen, taught to camp in the snow, and schooled in physiology, anatomy, astronomy, meteorology, robotics, and Russian.

On Monday, the five Europeans and an Australian graduated from basic training with a new title: astronaut.

At a ceremony in Cologne, Germany, ESA added the five newcomers to its astronaut corps eligible for missions to the International Space Station, bringing the total to 11.

ESA has negotiated with NASA for three places on future Artemis moon missions, although those places will likely go to the more senior astronauts, according to ESA Director General Josef Aschbacher. The agency is also supplying the service module for the Orion crew capsule. ESA relies on NASA and others to get its astronauts to space.

It is only the fourth astronaut class since 1978 for the 22-country agency, chosen from among 22,500 applicants. Another 12 were selected as reservists, but were not sent to basic training. Not surprisingly, the five have resumes studded with advanced scientific and medical degrees, military training, experience flying planes, helicopters, gliders and balloons, and “leisure” activities like rowing, scuba diving, hiking, skydiving, cycling, sailing, and kayaking.

The group formed “a very good team” devoid of personal rivalry, said Aschbacher. “I told them, one of you will fly first and one will fly last, and they accepted that of course, but from the heart, not just lip service … the team spirit is very pronounced.”

Sophie Adenot, a French air force helicopter test pilot, said the group was “a fantastic crew and a fantastic team.” The moment that struck her the most was leaving the airlock for underwater spacewalk simulation when the instructor said, “Welcome to space.”

“And for me it was mind-blowing, I had goosebumps. … In a few years it is going to be me in space, not in the water with safety divers.”

When she was a girl dreaming of space travel, “I couldn’t count the number of people who told me, this dream will never come true. ‘You have unrealistic dreams, and it will never happen.’ … Listen to yourself and don’t listen to people who don’t believe in you.”

In addition to Adenot, the ESA class consists of:

— Pablo Alvarez Fernandez, a Spanish aeronautical engineer who has worked on the Rosalind Franklin Mars rover intended for a joint mission with Russia that was suspended after the invasion of Ukraine;

— Rosemary Coogan, a British astronomer who has researched radiation emissions from black holes;

— Raphael Liegeois, a Belgian biomedical engineer and neuroscientist who has researched degenerative diseases of the nervous system, and also flies hot-air balloons and gliders;

— Marco Alain Sieber, a Swiss emergency physician who achieved sergeant rank as a paratrooper during his service with the Swiss army.

The group was joined by Katherine Bennell-Pegg from Australia, who underwent training under a cooperation agreement between Australia and ESA. She remains an employee of the Australian Space Agency. It’s up to the Australian agency to find a way for her to travel in space.

Their yearlong basic training included preparation for the hostile environment encountered in space. They were exposed to multiple times the force of gravity in a centrifuge and spent hours underwater using scuba gear to float around mockups of space station modules to simulate working in zero gravity.

They learned how to recognize symptoms of hypoxia, or lack of oxygen, by experiencing it themselves in a low-pressure chamber. Survival training included dealing with potential splashdown in the ocean and staying warm in winter while waiting to be recovered in case a landing goes off course. On top of that came academic work on scientific topics and learning about the space station’s modules and equipment.

Intensive Russian language is still part of the program, even though ESA has suspended work with Russia except for the space station, where one of the working languages is Russian.
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Experts say one of the health care challenges in Africa is a shortage of training and education for workers. To help, a U.S. charity called Mission to Heal is training local workers who serve patients in remote locations. Juma Majanga reports from Ngurunit village in northern Kenya. Videographer: Jimmy Makhulo
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WASHINGTON — A ancient giant snake in India might have been longer than a school bus and weighed a ton, researchers reported Thursday.

Fossils found near a coal mine revealed a snake that stretched an estimated 11 meters to 15 meters. It’s comparable to the largest known snake at about 13 meters that once lived in what is now Colombia.

The largest living snake today is Asia’s reticulated python at 10 meters.

The newly discovered behemoth lived 47 million years ago in western India’s swampy evergreen forests. It could have weighed up to 1,000 kilograms, researchers said in the journal Scientific Reports.

They gave it the name Vasuki indicus after “the mythical snake king Vasuki, who wraps around the neck of the Hindu deity Shiva,” said Debajit Datta, a study co-author at the Indian Institute of Technology Roorkee.

This monster snake wasn’t especially swift to strike.

“Considering its large size, Vasuki was a slow-moving ambush predator that would subdue its prey through constriction,” Datta said in an email.

Fragments of the snake’s backbone were discovered in 2005 by co-author Sunil Bajpai, based at the same institute, near Kutch, Gujarat, in western India. The researchers compared more than 20 fossil vertebrae to skeletons of living snakes to estimate size.

While it’s not clear exactly what Vasuki ate, other fossils found nearby reveal that the snake lived in swampy areas alongside catfish, turtles, crocodiles and primitive whales, which may have been its prey, Datta said.

The other extinct giant snake, Titanoboa, was discovered in Colombia and is estimated to have lived around 60 million years ago.

What these two monster snakes have in common is that they lived during periods of exceptionally warm global climates, said Jason Head, a Cambridge University paleontologist who was not involved in the study.

“These snakes are giant cold-blooded animals,” he said. “A snake requires higher temperatures” to grow into large sizes.

So does that mean that global warming will bring back monster-sized snakes?

In theory, it’s possible. But the climate is now warming too quickly for snakes to evolve again to be giants, he said.
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Sydney — Australian researchers have built an electrical generator that consumes carbon dioxide, generates electricity and admits no exhausts.  They say the technology could create a new industrial-scale carbon capture method.  

Scientists say too much carbon dioxide, or CO2, in the atmosphere is main driver of warming temperatures.  

Researchers at the University of Queensland have created a generator that consumes carbon dioxide and produces electricity.

The carbon-negative “nano-generator” has been built by the university’s Dow Centre for Sustainable Engineering Innovation.

The prototype device uses what is known as a poly amine gel to absorb carbon dioxide to create an electrical current.  

The design team acknowledges the technology needs further development and refinement but believes it could help to significantly curb global CO2 emissions.

Zhuyuan Wang from the University of Queensland told the Australian Broadcasting Corp. the concept has great potential.  

“We actually just finished the proof of concept that proves this can work but the current power density and efficiency is not high enough to compete with other energy sources, like solar panel[s], like the wind turbine,” he said.

The Queensland researchers hope their prototype could have industrial applications to help, for example, power plants reduce their emissions, as well as smaller units for use at home.

Carbon capture and storage techniques are used by the oil and gas sector to try to offset its emissions of greenhouse gases. Current methods involve harnessing CO2 produced by power companies, for example, and then burying it deep underground where it becomes trapped in rock formations. There are several large-scale CO2 burial sites in the United States.

However, the Climate Council, an Australian advocacy organization, claims that carbon capture and storage technology “has not been trialled and tested – anywhere in the world – at the scale required to tackle the climate crisis.” 

Australia’s national science agency, the Commonwealth Scientific and Industrial Organisation, states that “emissions of CO2 from fossil fuels make the largest contribution to climate change.” 

Australia is the world’s 14th highest emitter, contributing just over 1% of global emissions.  It has, however, some of the world’s highest per capita emissions.  Coal and gas generate much of Australia’s electricity, but solar and wind are leading an energy transformation. 

The Climate Council states that almost a third of Australia’s energy is renewable and will soon reach 50%.
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SEATTLE — Saturday marks marijuana culture’s high holiday, 4/20, when college students gather — at 4:20 p.m. — in clouds of smoke on campus quads and pot shops in legal-weed states thank their customers with discounts.

This year’s edition provides an occasion for activists to reflect on how far their movement has come, with recreational pot now allowed in nearly half the states and the nation’s capital. Many states have instituted “social equity” measures to help communities of color, harmed the most by the drug war, reap financial benefits from legalization. And the White House has shown an openness to marijuana reform.

Here’s a look at 4/20’s history:

WHY 4/20?

The origins of the date, and the term “420” generally, were long murky. Some claimed it referred to a police code for marijuana possession or that it derived from Bob Dylan’s “Rainy Day Women No. 12 & 35,” with its refrain of “Everybody must get stoned” — 420 being the product of 12 times 35.

But the prevailing explanation is that it started in the 1970s with a group of bell-bottomed buddies from San Rafael High School, in California’s Marin County north of San Francisco, who called themselves “the Waldos.” A friend’s brother was afraid of getting busted for a patch of cannabis he was growing in the woods at nearby Point Reyes, so he drew a map and gave the teens permission to harvest the crop, the story goes.

During fall 1971, at 4:20 p.m., just after classes and football practice, the group would meet up at the school’s statue of chemist Louis Pasteur, smoke a joint and head out to search for the weed patch. They never did find it, but their private lexicon — “420 Louie” and later just “420” — would take on a life of its own.

The Waldos saved postmarked letters and other artifacts from the 1970s referencing “420,” which they now keep in a bank vault, and when the Oxford English Dictionary added the term in 2017, it cited some of those documents as the earliest recorded uses.

HOW DID 420 SPREAD?

A brother of one of the Waldos was a close friend of Grateful Dead bassist Phil Lesh, as Lesh once confirmed in an interview with the Huffington Post, now HuffPost. The Waldos began hanging out in the band’s circle and the slang spread.

Fast-forward to the early 1990s: Steve Bloom, a reporter for the cannabis magazine High Times, was at a Dead show when he was handed a flyer urging people to “meet at 4:20 on 4/20 for 420-ing in Marin County at the Bolinas Ridge sunset spot on Mt. Tamalpais.” High Times published it.

“It’s a phenomenon,” one of the Waldos, Steve Capper, now 69, once told The Associated Press. “Most things die within a couple years, but this just goes on and on. It’s not like someday somebody’s going to say, ‘OK, cannabis New Year’s is on June 23rd now.’”

While the Waldos came up with the term, the people who made the flier distributed at the Dead show — and effectively turned 4/20 into a holiday — remain unknown.

HOW IS IT CELEBRATED?

With weed, naturally.

Some celebrations are bigger than others: The Mile High 420 Festival in Denver, for example, typically draws thousands and describes itself as the largest free 4/20 event in the world. Hippie Hill in San Francisco’s Golden Gate Park has also attracted massive crowds, but the gathering was canceled this year, with organizers citing a lack of financial sponsorship and city budget cuts.

College quads and statehouse lawns are also known for drawing 4/20 celebrations, with the University of Colorado Boulder historically among the largest, though not so much since administrators banned the annual smokeout over a decade ago.

Some breweries make beers that are 420-themed, but not laced, including SweetWater Brewing in Atlanta, which is throwing a 420 music festival this weekend and whose founders went to the University of Colorado.

Lagunitas Brewing in Petaluma, California, releases its “Waldos’ Special Ale” every year on 4/20 in partnership with the term’s coiners. That’s where the Waldos will be this Saturday to sample the beer, for which they picked out “hops that smell and taste like the dankest marijuana,” one Waldo, Dave Reddix, said via email.

4/20 has also become a big industry event, with vendors gathering to try each other’s wares.

THE POLITICS

The number of states allowing recreational marijuana has grown to 24 after recent legalization campaigns succeeded in Ohio, Minnesota and Delaware. Fourteen more states allow it for medical purposes, including Kentucky, where medical marijuana legislation that passed last year will take effect in 2025. Additional states permit only products with low THC, marijuana’s main psychoactive ingredient, for certain medical conditions.

But marijuana is still illegal under federal law. It is listed with drugs such as heroin under Schedule I of the Controlled Substances Act, meaning it has no federally accepted medical use and a high potential for abuse.

The Biden administration, however, has taken some steps toward marijuana reform. The president has pardoned thousands of people who were convicted of “simple possession” on federal land and in the District of Columbia.

The Department of Health and Human Services last year recommended to the Drug Enforcement Administration that marijuana be reclassified as Schedule III, which would affirm its medical use under federal law.

According to a Gallup poll last fall, 70% of adults support legalization, the highest level yet recorded by the polling firm and more than double the roughly 30% who backed it in 2000.

Vivian McPeak, who helped found Seattle’s Hempfest more than three decades ago, reflected on the extent to which the marijuana industry has evolved during his lifetime.

“It’s surreal to drive by stores that are selling cannabis,” he said. “A lot of people laughed at us, saying, ‘This will never happen.’”

WHAT DOES IT MEAN?

McPeak described 4/20 these days as a “mixed bag.” Despite the legalization movement’s progress, many smaller growers are struggling to compete against large producers, he said, and many Americans are still behind bars for weed convictions.

“We can celebrate the victories that we’ve had, and we can also strategize and organize to further the cause,” he said. “Despite the kind of complacency that some people might feel, we still got work to do. We’ve got to keep burning that shoe leather until we get everybody out of jails and prisons.”

For the Waldos, 4/20 signifies above all else a good time.

“We’re not political. We’re jokesters,” Capper has said. “But there was a time that we can’t forget, when it was secret, furtive. … The energy of the time was more charged, more exciting in a certain way.

“I’m not saying that’s all good — it’s not good they were putting people in jail,” he continued. “You wouldn’t want to go back there.”
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Osaka, Japan — Wider access to abortion in Japan has largely remained elusive a year after the historic approval of medical abortion pills.

In April last year, lawmakers approved the use of the two-step abortion pill — MeFeego Pack — for pregnancies up to nine weeks. Before that, women in the East Asian nation could only receive a surgical abortion in private clinics by designated surgeons that often charge as much as $370.

Financial strain aside, women were often required to provide proof of spousal consent to receive an abortion, making it nearly impossible for them to make the decision on their own. Reports showed that even for single women, doctors still asked for permission of a male partner before agreeing to perform such surgeries.

Despite the approval of the abortion pill, only 3% of all clinics with abortion services in Japan provide them a year after the pill’s approval, according to Kumi Tsukahara, independent researcher of reproductive health and rights, “and none of them have a Maternal Body Protection Law (MBPL) designated doctor,” Tsukahara told VOA News.

Under the MBPL, the controversial requirement for spousal consent before a doctor can prescribe oral abortion medication still exists — it’s the same condition for gaining permission for a surgical abortion.

“Unfortunately, there are no signs of change with regard to either,” the expert said.

In contrast to countries with better abortion access, Japan’s approved abortion pills cannot be administered more than once — sometimes, multiple tries are necessary — and the pregnant women will still need to resort to surgical abortion that involves a serious risk to their health.

Since such surgeries are only allowed in private clinics and are considered profitable by designated doctors, they often charge the same price or higher for abortion pills as for a surgical abortion. Neither measure is covered by Japan’s national health system.

“The high prices and low affordability depending on individual doctors, the inaccurate information given by doctors who cannot use drugs to guide people to conventional surgical procedures, the unjust situation and the state’s failure to respond, and the women are disempowered to have a sense of entitlement on their part,” Tsukahara explained.

Abortion rights activist Kazuko Fukuda, who spearheads a grassroots movement to push for women’s rights to end pregnancies in Japan, echoed the sentiment.

“The abortion rights [in Japan] didn’t improve,” Fukuda told VOA News. “Of course, this [approval of oral abortion] was better than nothing, but conservative politicians went against such pills before the approval. … It’s mandated that women have to stay in hospitals that provide beds until the end of the abortion, but designated private clinics don’t usually have beds.”

Women in Japan are banned from taking abortion pills at home. They must be in hospitals and take the pills in front of the doctors as authorities fear that they might resell them. If violated, these women can be subject to imprisonment for up to a year.

Male-dominated political scene

Abortion is still a big taboo in politics, and real rights improvement will go a long way, Fukuda added.

“News of women being arrested for giving birth alone and abandoning them is still very common — we hear that just a few days ago. … The government should repeal the criminalization of abortion. [Things don’t work] as doctors are still afraid of being sued so they require signatures from boyfriends to prescribe abortion pills.”

Last year, Japan started a study, selling morning-after pills over the counter without prescription. However, the study suffers limited availability in many cities. Girls under 15 are not allowed to purchase them, and those ages 16 to 18 must be accompanied by a parent to buy the pills.

Both experts VOA spoke with say that the information and availability of these contraceptive pills doesn’t appear high in online searches — the usual method for the targeted group to look for contraception.

Japan ranked among the lowest of developed countries in a March report this year by the World Bank in terms of women’s rights.

Currently, women account for less than 10% in Japan’s lower house of parliament and 27% in the upper house. In local politics, only 15% of women are on the front line. The gender pay gap in Japan reached 40%, according to a report from the Organization for Economic Co-operation and Development (OECD).

Women’s issues like abortion access or contraceptive measures are often not viewed as priorities for female politicians.

“In the male-dominated politics, a lot of women have to become more conservative and look strong to be accepted so it’s really hard for women to liberal or supportive in this kind of thing [abortion and contraception in the parliament],” Fukuda said.

Women blamed for low fertility rate

Social stigma connected to abortion remains strong as Japan blames women for its low fertility rate. The country hit a record low number of births last year.

“The Japanese government has attributed the ‘decreasing number [fertility rate] to ‘women who don’t give birth,’ women are made to feel socially guilty for trying to choose not to give birth. Of course, such an issue construction is itself highly biased and misogynistic,” said researcher Tsukahara.

Fukuda said that the government’s support of favorable reproductive policies stops with women who don’t want babies.

“Anything against that [wanting babies] is not supported at all. Many people think that ‘contraception’ is a taboo and even taking [morning after] pills can expose to judgment as a promiscuous woman. It’s not easy for women to talk about it.”
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WASHINGTON — One woman miscarried in the lobby restroom of a Texas emergency room as front desk staff refused to check her in. Another woman learned that her fetus had no heartbeat at a Florida hospital, the day after a security guard turned her away from the facility. And in North Carolina, a woman gave birth in a car after an emergency room couldn’t offer an ultrasound. The baby later died.

Complaints that pregnant women were turned away from U.S. emergency rooms spiked in 2022 after the U.S. Supreme Court overturned Roe v. Wade, federal documents obtained by The Associated Press reveal.

The cases raise alarms about the state of emergency pregnancy care in the U.S., especially in states that enacted strict abortion laws and sparked confusion around the treatment doctors can provide.

“It is shocking, it’s absolutely shocking,” said Amelia Huntsberger, an OB/GYN in Oregon. “It is appalling that someone would show up to an emergency room and not receive care — this is inconceivable.”

It’s happened despite federal mandates that the women be treated.

Federal law requires emergency rooms to treat or stabilize patients who are in active labor and provide a medical transfer to another hospital if they don’t have the staff or resources to treat them. Medical facilities must comply with the law if they accept Medicare funding.

The Supreme Court will hear arguments Wednesday that could weaken those protections. The Biden administration has sued Idaho over its abortion ban, even in medical emergencies, arguing it conflicts with the federal law.

“No woman should be denied the care she needs,” Jennifer Klein, director of the White House Gender Policy Council, said in a statement. “All patients, including women who are experiencing pregnancy-related emergencies, should have access to emergency medical care required under the Emergency Medical Treatment and Labor Act (EMTALA).”

Pregnancy care after Roe

Pregnant patients have “become radioactive to emergency departments” in states with extreme abortion restrictions, said Sara Rosenbaum, a George Washington University health law and policy professor.

“They are so scared of a pregnant patient, that the emergency medicine staff won’t even look. They just want these people gone,” Rosenbaum said.

Consider what happened to a woman who was nine months pregnant and having contractions when she arrived at the Falls Community Hospital in Marlin, Texas, in July 2022, a week after the Supreme Court’s ruling on abortion. The doctor on duty refused to see her.

“The physician came to the triage desk and told the patient that we did not have obstetric services or capabilities,” hospital staff told federal investigators during interviews, according to documents. “The nursing staff informed the physician that we could test her for the presence of amniotic fluid. However, the physician adamantly recommended the patient drive to a Waco hospital.”

Investigators with the Centers for Medicare and Medicaid Services concluded Falls Community Hospital broke the law.

Reached by phone, an administrator at the hospital declined to comment on the incident.

The investigation was one of dozens the AP obtained from a Freedom of Information Act request filed in February 2023 that sought all pregnancy-related EMTALA complaints the previous year. One year after submitting the request, the federal government agreed to release only some complaints and investigative documents filed across just 19 states. The names of patients, doctors and medical staff were redacted from the documents.

Federal investigators looked into just over a dozen pregnancy-related complaints in those states during the months leading up to the U.S. Supreme Court’s pivotal ruling on abortion in 2022. But more than two dozen complaints about emergency pregnancy care were lodged in the months after the decision was unveiled. It is not known how many complaints were filed last year as the records request only asked for 2022 complaints and the information is not publicly available otherwise.

The documents did not detail what happened to the patient turned away from the Falls Community Hospital.

‘She is bleeding a lot’

Other pregnancies ended in catastrophe, the documents show.

At Sacred Heart Emergency Center in Houston, front desk staff refused to check in one woman after her husband asked for help delivering her baby that September. She miscarried in a restroom toilet in the emergency room lobby while her husband called 911 for help.

“She is bleeding a lot and had a miscarriage,” the husband told first responders in his call, which was transcribed from Spanish in federal documents. “I’m here at the hospital but they told us they can’t help us because we are not their client.”

Emergency crews, who arrived 20 minutes later and transferred the woman to a hospital, appeared confused over the staff’s refusal to help the woman, according to 911 call transcripts.

One first responder told federal investigators that when a Sacred Heart Emergency Center staffer was asked about the gestational age of the fetus, the staffer replied: “No, we can’t tell you, she is not our patient. That’s why you are here.”

A manager for Sacred Heart Emergency Center declined to comment. The facility is licensed in Texas as a freestanding emergency room, which means it is not physically connected to a hospital. State law requires those facilities to treat or stabilize patients, a spokesperson for the Texas Health and Human Services agency said in an email to AP.

Sacred Heart Emergency’s website says that it no longer accepts Medicare, a change that was made sometime after the woman miscarried, according to publicly available archives of the center’s website.

Meanwhile, the staff at Person Memorial Hospital in Roxboro, North Carolina, told a pregnant woman, who was complaining of stomach pain, that they would not be able to provide her with an ultrasound. The staff failed to tell her how risky it could be for her to depart without being stabilized, according to federal investigators. While en route to another hospital 45 minutes away, the woman gave birth in a car to a baby who did not survive.

Person Memorial Hospital self-reported the incident. A spokeswoman said the hospital continues to “provide ongoing education for our staff and providers to ensure compliance.”

In Melbourne, Florida, a security guard at Holmes Regional Medical Center refused to let a pregnant woman into the triage area because she had brought a child with her. When the patient came back the next day, medical staff were unable to locate a fetal heartbeat. The center declined to comment on the case.

What’s the penalty?

Emergency rooms are subject to hefty fines when they turn away patients, fail to stabilize them or transfer them to another hospital for treatment. Violations can also put hospitals’ Medicare funding at risk.

But it’s unclear what fines might be imposed on more than a dozen hospitals that the Biden administration says failed to properly treat pregnant patients in 2022.

It can take years for fines to be levied in these cases. The Health and Human Services agency, which enforces the law, declined to share if the hospitals have been referred to the agency’s Office of Inspector General for penalties.

For Huntsberger, the OB/GYN, EMTALA was one of the few ways she felt protected to treat pregnant patients in Idaho, despite the state’s abortion ban. She left Idaho last year to practice in Oregon because of the ban.

The threat of fines or loss of Medicare funding for violating EMTALA is a big deterrent that keeps hospitals from dumping patients, she said. Many couldn’t keep their doors open if they lost Medicare funding.

She has been waiting to see how HHS penalizes two hospitals in Missouri and Kansas that HHS announced last year it was investigating after a pregnant woman, who was in preterm labor at 17 weeks, was denied an abortion.

“A lot of these situations are not reported, but even the ones that are — like the cases out of the Midwest — they’re investigated but nothing really comes of it,” Huntsberger said. “People are just going to keep providing substandard care or not providing care. The only way that changes is things like this.”

President Joe Biden and top U.S. health official Xavier Becerra have both publicly vowed vigilance in enforcing the law.

Even as states have enacted strict abortion laws, the White House has argued that if hospitals receive Medicare funds they must provide stabilizing care, including abortions.

In a statement to the AP, Becerra called it the “nation’s bedrock law protecting Americans’ right to life- and health-saving emergency medical care.”

“And doctors, not politicians, should determine what constitutes emergency care,” he added.

Idaho’s law allows abortion only if the life, not the health, of the mother is at risk. But the state’s attorney general has argued that its abortion ban is “consistent” with federal law, which calls for emergency rooms to protect an unborn child in medical emergencies.

“The Biden administration has no business rewriting federal law to override Idaho’s law and force doctors to perform abortions,” Idaho Attorney General Raúl Labrador said in a statement earlier this year.

Now, the Supreme Court will weigh in. The case could have implications in other states like Arizona, which is reinstating an 1864 law that bans all abortions, with an exception only if the mother’s life is at risk.

EMTALA was initially introduced decades ago because private hospitals would dump patients on county or state hospitals, often because they didn’t have insurance, said Alexa Kolbi-Molinas of the American Civil Liberties Union.

Some hospitals also refused to see pregnant women when they did not have an established relationship with physicians on staff. If the court nullifies or weakens those protections, it could result in more hospitals turning away patients without fear of penalty from the federal government, she said.

“The government knows there’s a problem and is investigating and is doing something about that,” Kolbi-Molinas said. “Without EMTALA, they wouldn’t be able to do that.”
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