Texas Supreme Court Refuses to Clarify Abortion Ban Exceptions

5.31.2024 (PRESS RELEASE) – Today, the Texas Supreme Court issued a ruling in Zurawski v. Texas that fails to provide any meaningful clarity on when doctors can perform abortions for dire medical reasons. The ruling largely ignores the women who filed the case, writing them out of the opinion. The Court stated definitively that people cannot have abortions in situations where the fetus has a lethal condition and will not survive, unless the pregnant patient also has a life-threatening condition. The Court dismissed the claims that patients like Kate Cox, Samantha Casiano, and others have constitutional rights to their lives, their health, and their future fertility. While the Court clarified that exceptions can be made for life-threatening conditions like preterm premature rupture of membranes (PPROM), the Court refused to say when in the course of a patient’s deteriorating health situation the exception would apply.

This closely watched case was filed by the Center for Reproductive Rights last year on behalf of 20 Texas women denied abortion care—some of whom almost died as a result—and two Texas OB-GYNs.

The Court stated: “a ‘life-threatening physical condition’ is not necessarily one actively injuring the patient; it is a condition that has the potential to kill the patient. The condition must arise from or be aggravated by the pregnancy, but death need not be imminent . . . The law does not require the life-threatening physical condition to have already caused damage before a physician can act to preserve the mother’s life or major bodily function.” Beyond this statement, the Court provided little guidance to physicians and threw away the lower court ruling, which would have given doctors real clarity on when they can and cannot provide abortions.

“This ruling utterly fails to provide the clarity Texas doctors need for when they can provide abortion care to patients with serious pregnancy complication without risking being sent to prison. To add insult to injury, the opinion erases the women we represent as though their pain and experiences didn’t exist or matter,” said Nancy Northup, President and CEO of the Center for Reproductive Rights. This opinion lays bare the cruel consequences of the Supreme Court’s reversal of Roe v. Wade in the 14 states with draconian abortion bans. Most people assume that if something goes terribly wrong with their pregnancy – a serious risk to their health or a fatal fetal diagnosis – they can make the decision to terminate in consultation with their doctor. As women across the country are finding out, exceptions to abortion bans are illusory and it is dangerous to be pregnant in any state that bans abortion. Pregnancy complications should be managed by doctors, not courts and politicians. We are enormously proud of the women in this case who stood up to Texas’ unjust law. We will continue to pursue every available legal avenue to address the suffering happening in Texas and are currently assessing what, if anything, remains of our clients’ claims in this case.”

“Back in July, we testified in court for hours recounting the medical torture we went through,” said plaintiff Samantha Casiano, whose fetus was diagnosed with anencephaly, which does not qualify for an abortion under the Court’s decision. “I was told my baby would not survive, but I was forced to continue my pregnancy and give birth anyway, then watch her pass away hours later. I don’t know how the court could hear what I went through and choose to do nothing. Texas lawmakers claim to care about protecting ‘the unborn’, but in reality they made my family suffer. I joined this case to make sure no other family goes through that, and I’m devastated that the court is allowing this cruelty to continue. I am embarrassed to be a Texan because of these inhumane laws.”

“I am outraged on behalf of my fellow plaintiffs who the Court deemed not sick enough,” said lead plaintiff Amanda Zurawski, who suffered from PPROM during her pregnancy and not only lost her daughter but almost died herself. “We all deserve bodily autonomy. Every day, people in Texas are being told that they have no options. It’s sickening and wrong. Our Courts should acknowledge all of our suffering and vindicate our fundamental rights to reproductive autonomy. We should not need to beg elected officials for our right to control our own bodies.”

This lawsuit asked the court to give doctors clarity on what circumstances qualify as medical exceptions and to allow doctors to use their own medical judgment without fear of prosecution. The lawsuit argued that the Texas state constitution protects pregnant people’s health and lives, which includes the right to obtain an abortion when facing life or health-threatening conditions as well as physicians’ right to provide that care. The case was originally filed in March 2023 on behalf of five women denied abortions in Texas despite dangerous pregnancy complications, as well as two doctors who struggled to practice medicine under the state’s abortion bans. Since then, more women who were denied abortion care came forward, bringing the total to 22 plaintiffs.

The conflicting and ambiguous language in Texas’ abortion bans has resulted in pervasive fear and uncertainty among doctors as to when they can provide legal abortions to patients with severe pregnancy complications. Every state official charged with enforcing these laws has refused to give doctors any meaningful guidance as to what situations fall under the bans’ “medical emergency” exception. Meanwhile, Texas doctors have been turning patients away because they face up to 99 years in prison, at least $100,000 in fines, and the loss of their medical license for violating the abortion bans. This means pregnant patients have been forced to either wait until they are near death to receive care or flee the state if they are able. A recent report shows that this is happening across the country.

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

The lawsuit was filed by the Center for Reproductive Rights, Morrison & Foerster LLP, and Kaplan Law Firm on behalf of 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.

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