Cox v. Texas: The Case in Depth

See the “Case Updates” section below for the latest news on the case.

(Updated 12.12.23) The Center for Reproductive Rights filed this case in Texas state court on behalf of Kate Cox, a pregnant woman seeking an emergency abortion. Cox is asking the court to temporarily block the state’s abortion bans so she can obtain the urgent care she needs in the state and avoid the dangerous risks to her life and health from being forced to stay pregnant.

The week before the case was filed, Cox received confirmation that her pregnancy had Trisomy 18—a condition causing multiple structural abnormalities—and had no chance of survival. Cox has already undergone two C-sections, and if she is forced to stay pregnant, she would likely need a third. Her OB-GYN and MFM specialist warned her that continuing to carry the pregnancy to term could jeopardize her health and future fertility, since a third C-section would place her at high risk for multiple serious medical conditions such as uterine rupture and hysterectomy. Kate also had certain other underlying health conditions that placed her at a higher risk for dangerous health complications. She and her husband wish to have more children, and undergoing another C-section to deliver this pregnancy would lessen the likelihood that she’d be able to safely have more children in the future.

Cox v. Texas asks the state court to:

• Temporarily halt Texas’s abortion bans as they apply to Cox as well as her husband, Justin Cox, who fears liability under S.B. 8—the law also known as Texas’s “vigilante” abortion ban.
• Allow obstetrician-gynecologist (OB-GYN) Dr. Damla Karsan to provide Cox with an abortion in Texas without the threat of prosecution, loss of license, and civil fines.

Physicians found to have violated Texas’s abortion laws face fines of at least $100,000, up to 99 years in prison, and revocation of their state medical licenses.

Plaintiffs: Kate Cox, Justin Cox, and Damla Karsan, M.D.

Center Attorneys: Molly Duane, Nicolas Kabat, Marc Hearron, and Astrid Ackerman

Co-Counsel/Cooperating Attorneys: Jamie Levitt and Alexander Lawrence of Morrison & Foerster LLP and Austin Kaplan of Kaplan Law Firm

12.12.23: Texas Supreme Court Rules Kate Cox Can’t Get an Abortion in the State

• Overruling a lower state court’s order, the Texas Supreme Court denied Cox’s request to obtain emergency abortion care in the state. “Kate’s case is proof that exceptions don’t work, and it’s dangerous to be pregnant in any state with an abortion ban,” said Molly Duane, senior staff attorney at the Center. 

12.11.23: Texas Woman Who Needs Emergency Abortion Forced to Flee State

• After a week of legal limbo in Texas, Cox traveled out of state to obtain the time-sensitive abortion care she needed. “This is the result of the Supreme Court’s reversal of Roe v. Wade: women are forced to beg for urgent healthcare in court,” said Nancy Northup, Center president and CEO. “She desperately wanted to be able to get care where she lives and recover at home surrounded by family. While Kate had the ability to leave the state, most people do not, and a situation like this could be a death sentence.”  

12.08.23: Texas Supreme Court Temporarily Halts Ruling That Allowed Pregnant Woman to Have Emergency Abortion

• The Texas Supreme Court said it needed more time to weigh in on the matter—despite the urgency of Cox’s request—and stayed the lower court ruling allowing Cox to access abortion care in the state. Duane commented, “. . . in this case we fear that justice delayed will be justice denied.”

12.07.23: Texas Judge Grants Temporary Order Allowing Pregnant Woman to Access Abortion Care in the State

• In granting Cox’s request to temporarily block the enforcement of Texas’s abortion bans so she could access emergency abortion care in the state, the judge said from the bench, “I am going to grant the Temporary Restraining Order for the Coxes and Dr. Karsan. The idea that Ms. Cox wants so desperately to be a parent and this law may have her lose that ability is shocking and would be a genuine miscarriage of justice. So I will be signing the order and it will be processed and sent out today.”

12.05.23: Center Sues Texas on Behalf of Pregnant Woman Seeking an Emergency Abortion to Protect Her Health, Life and Fertility

• Cox v. Texas is the first case since the overturning of Roe v. Wade filed on behalf of a pregnant woman seeking emergency abortion care. The plaintiff, Kate Cox, is asking the court to temporarily block the state’s abortion bans so she can obtain urgent abortion care and avoid the dangerous risks to her life, health and future fertility of being forced to stay pregnant. The case was filed in the District Court of Travis County, Texas.

• Texas Supreme Court Ruling, 12.11.23
• Amicus Brief Submitted by the American College of Obstetricians and Gynecologists and Society for Maternal-Fetal Medicine, 12.11.23
• Notice to the Courts, 12.11.23
• State of Texas Reply in Support of Petition for Writ of Mandamus, 12.09.23
• Texas Supreme Court Ruling, 12.08.23
• Response to State’s Petition for Writ of Mandamus and Emergency Motion for Temporary Relief, 12.08.23
• Letter to Judge Guerra Gamble, 12.07.23
• Appellees’ Notice of Supplemental Authorities, 12.07.23
• State of Texas Emergency Motion for Temporary Relief, 12.07.23
• State of Texas Petition for Writ of Mandamus, 12.07.23
• Temporary Restraining Order, 12.07.23
• State of Texas Response, 12.06.23
• Complaint, 12.05.23

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The Center for Reproductive Rights is dedicated to helping all people access abortion in their communities, including people who are denied care while facing pregnancy complications. If you have been denied care and want to speak to a lawyer about your options, please reach out to [email protected].