But now her medical decisions are complicated by Ohio's new abortion law, which generally prohibits abortions after six weeks of pregnancy if cardiac activity is detected in the embryo or fetus — which can persist for hours or days even if a pregnancy has no chance of progressing. Given the new law, University Hospitals Cleveland Medical Center has streamlined its system of having an administrator and legal team on call for Puterbaugh and other physicians if anyone questions whether the planned treatment is allowed under the law.

Since the Supreme Court erased the constitutional right to abortion in June, Puterbaugh said these cases put her and doctors like her in an impossible position — squeezing doctors between anti-abortion laws in Ohio and other states and the federal Emergency Medical Treatment & Labor Act. That 1986 law requires hospitals and physicians to provide screening and stabilizing treatment — including abortion, if necessary — in emergency situations.

"It's a challenge to balance both those two things," says Puterbaugh, president of the Society of OB/GYN Hospitalists. "But it's not really a challenge to me because, in my mind, the life and health of the mother always comes first."

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