Zurawski v. State of Texas

Case update: On May 31, 2024, the Texas Supreme Court ruled in this case, refusing to clarify the exceptions to the state’s abortion bans. The court rejected claims brought by 20 women who were denied abortions despite dire pregnancy complications. Read more here.

The Center for Reproductive Rights filed this groundbreaking lawsuit on March 6, 2023 asking the state of Texas to clarify the scope of the “medical emergency” exceptions under its abortion bans. The case was filed on behalf of seven original plaintiffs: five Texas women denied abortion care—who as a result faced risks to their health, fertility and lives—and two Texas obstetrician-gynecologists.

With a growing number of women denied abortion care in the state, several more have joined this lawsuit. With eight more Texas women joining the case on May 22 and seven more on November 14, there are now 22 plaintiffs—including 20 women denied abortion care.

The case, filed in state court in Austin, is the first lawsuit brought on behalf of women denied abortions since the U.S. Supreme Court eliminated the constitutional right to abortion in June 2022. 

Texas has three state laws banning abortion:

• A trigger ban, which outlaws abortion entirely;
• S.B. 8, the “vigilante” ban that prohibits abortion after about six weeks of pregnancy; and
• A pre-Roe criminal ban that several courts have determined to be implicitly repealed.

While the laws contain an exception for the life and health of the pregnant person, Texas’s hostile abortion landscape has made physicians afraid to rely on the exception. These extreme bans criminalizing abortion have stoked fear and confusion among pregnant people and doctors throughout the state.   

The Center argues that Texas’s abortion bans contain conflicting language and non-medical terminology, making it unclear when physicians are permitted to provide care under the laws’ “medical emergency” exception. The state has also failed to provide any guidance to doctors on this issue, despite repeated requests. 

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. Such legal risks, combined with the bans’ unclear language, are deterring Texas physicians from providing their patients with abortion care— a necessary, life-saving procedure crucial for treating many dangerous pregnancy conditions to their patients. As a result, patients in Texas have experienced severe physical harm and mental anguish.  

The two physician plaintiffs in the case—both board-certified ob-gyns—joined the lawsuit because the Texas bans prevent them from meeting their ethical obligations as physicians and providing the medical care their patients need. 

The Center’s lawsuit asks the court to clarify Texas’s abortion bans by creating a binding interpretation of the laws’ “medical emergency” exception. The Center argues that the court’s interpretation should allow physicians to exercise their good-faith judgment regarding what patients qualify under medical exceptions, rather than allowing politicians and state officials to make those decisions.  

The Center also argues that the threatened enforcement of Texas’s bans against pregnant people suffering from dangerous medical conditions and the physicians that treat them violates the Texas Constitution’s guarantees to life, liberty, and equality.

• The Center filed an amended complaint on May 22, 2023, adding eight new plaintiffs and requesting the court to grant a temporary injunction to block Texas’s abortion bans as they apply to pregnancy complications while the case proceeds. 
• On July 19-20, 2023, a hearing was held in Texas state court addressing the plaintiffs’ request and the state’s attempt to dismiss the case. Five of the plaintiffs in the case—four women denied abortions and an OB-GYN—provided testimony at the hearing, along with two experts in obstetrics and emergency medicine. Read a wrap-up of the hearing here.
• A Texas district judge on August 4, 2023, issued an injunction blocking Texas’s abortion bans as they apply to dangerous pregnancy complications, clarifying that doctors can use their own medical judgment to determine when to provide abortion care in emergency situations. The ruling also denied the state’s request to throw out the case, and it found S.B. 8—Texas’s citizen-enforced abortion ban—unconstitutional. The judge recognized in her ruling that the women who brought this case should have been given abortions. The state immediately appealed the ruling to the Texas Supreme Court, blocking it from taking effect.
• The Center filed an amended complaint on November 14, 2023, adding seven more Texas women denied abortion care as plaintiffs in the case and bringing the total number of plaintiffs to 22.
• The Texas Supreme Court heard oral arguments on November 28, 2023, on the state’s appeal of the district court’s ruling.
• The Texas Supreme Court ruled in this case on May 31, 2024, refusing to clarify the exceptions to the state’s abortion bans. The court rejected claims brought by the 20 plaintiffs who were denied abortions despite dire pregnancy complications. Read more about the ruling here.

Plaintiffs: Patients Amanda Zurawski, Lauren Miller, Lauren Hall, Anna Zargarian, Ashley Brandt, Kylie Beaton, Jessica Bernardo, Samantha Casiano, Austin Dennard, D.O., Taylor Edwards, Kiersten Hogan, Lauren Van Vleet, Elizabeth Weller, Kristen Anaya, Kaitlyn Kash, D. Aylen, Kimberly Manzano, Danielle Mathisen, M.D., Cristina Nuñez, and Amy Coronado; and health care providers Damla Karsan, M.D. and Judy Levison, M.D., M.P.H. Read the plaintiffs’ stories here.

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

Co-Counsel/Cooperating Attorneys: Jamie A. Levitt, J. Alexander Lawrence, and Aditya V. Kamdar of Morrison & Foerster LLP, and Austin Kaplan of Kaplan Law Firm

Legal Documents

• Texas Supreme Court Ruling, 05.31.24
• Amended Petition, 11.14.23
• Temporary Injunction Order, 08.04.23
• State of Texas Amended Motion to Dismiss, 07.12.23
• Application for Temporary Injunction, 05.22.23
• Amended Petition, 05.22.23
• Complaint, 03.06.23

The stories of the women denied abortion care in the case exemplify the threats Texas’s bans pose to pregnant people’s lives and make clear that Texans in obstetrical emergencies are not getting the care they need.

• Read the plaintiffs’ stories.
• Read the original plaintiffs’ full remarks and watch the video replay of a March 7 press conference about the case.

• Texas Supreme Court Rules Against Women Denied Abortion Care Despite Dangerous Pregnancy Complications, 05.31.24
• Center Argues Case on Abortion Bans’ Medical Exceptions at Texas Supreme Court, 11.28.23
• Center’s “Emergency Medical” Exceptions Case Heads to Texas Supreme Court November 28, 11.21.23
• More Women Join Lawsuit Against Texas After Being Denied Abortion Care Despite Dangerous Pregnancy Complications, 11.14.23
• Even More Women Sue Texas After Being Denied Abortions for Dangerous Pregnancy Complications, 11.14.23
• Texas Ruling to Allow Abortions for Severe Pregnancy Complications and Fatal Fetal Diagnoses is Blocked While Appeals Proceed, 08.08.23
• Hearing Wrap-up, 07.21.23
• Hearing in Texas “Emergency Exceptions” Case Starts Wednesday, July 19, 07.17.23
• More Women Join Lawsuit Against Texas After Being Denied Abortion Care to Treat Dangerous Pregnancy Complications, 05.22.23
• Center Sues Texas on Behalf of Women Denied Abortions After Facing Dangerous Pregnancy Complications, 03.07.23

March 06, 2023	The Center files a groundbreaking lawsuit asking the state of Texas to clarify the scope of the “medical emergency” exceptions under its abortion bans.
May 22, 2023	The Center files an amended complaint in the case adding eight new plaintiffs and requesting the court to grant a temporary injunction to block Texas’s abortion bans as they apply to pregnancy complications while the case proceeds.
July 12, 2023	The state of Texas files a motion to dismiss the case.
July 19, 2023	Two-day hearing begins in a Texas state court in Austin on the plaintiffs’ request to temporarily block the bans and on the state’s request to dismiss the case.
August 04, 2023	A Texas district judge issues an injunction blocking Texas’s abortion bans as they apply to dangerous pregnancy complications, clarifying that doctors can use their own medical judgment to determine when to provide abortion care in emergency situations. The ruling also denies the state’s request to throw out the case and finds S.B. 8—Texas’s citizen-enforced abortion ban—unconstitutional.
August 04, 2023	The state immediately appeals the judge’s ruling, blocking it from taking effect.
November 14, 2023	Seven more Texas women denied abortion care join the case as plaintiffs.
November 28, 2023	Texas Supreme Court hears oral arguments on the state’s appeal of the district court ruling.
May 31, 2024	Texas Supreme Court rules in the case, refusing to clarify the exceptions to the state’s abortion bans and rejecting claims brought by the plaintiffs.