The Plaintiffs and Their Stories: Zurawski v. State of Texas

The Center for Reproductive Rights filed Zurawski v. State of Texas 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. After the original case was filed, many Texans came forward to tell their stories about being denied abortion care; eight more women joined the case as additional plaintiffs on May 22, 2023, and seven more joined on November 14, 2023, bringing the total number of plaintiffs to 22.

At the press conference to discuss the case held outside the Texas State Capitol March 7, 2023, four of the original plaintiffs shared their stories and Center leaders spoke about the case. Watch brief highlights in the clip below, read the plaintiffs’ remarks here, or view the replay of the full press conference here.

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The stories of the women denied abortion 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.

About the Original Plaintiffs

• Amanda Zurawski, from Austin, lead plaintiff in the case, was denied abortion care after she experienced preterm pre-labor rupture of membranes (PPROM) at 18 weeks of pregnancy. She was seen at a Catholic hospital in Austin, where she was denied an abortion because her doctors could still detect fetal cardiac activity. Three days later, she showed signs of infection and was diagnosed with sepsis, a life-threatening condition. Although doctors then performed an emergency induction abortion, she spent the next three days in the ICU fighting for her life. She ultimately survived, but the infection caused one of her fallopian tubes to become permanently closed, compromising her future ability to have children. She has been forced to turn to in vitro fertilization (IVF) in attempt to start a family. 

• Lauren Miller, from Dallas, was hospitalized at eight weeks of pregnancy for severe nausea, vomiting, and dehydration, and was diagnosed with hyperemesis gravidarum—a condition posing significant risks to the patient and her pregnancy. She also learned at that time she was pregnant with twins. But at 12 weeks, Lauren learned that one of her twins had trisomy 18—a condition that causes multiple structural abnormalities and makes the fetus unlikely to survive to birth. Due to Texas’s abortion bans, doctors denied Lauren a fetal reduction abortion procedure, despite it being necessary to give Lauren and the second fetus the best chance of survival. After being again hospitalized for hyperemesis gravidarum at 15 weeks, she traveled out of state to Colorado to obtain the fetal reduction abortion. Lauren has recovered and is expecting to give birth this month.

• Lauren Hall, from outside of Dallas, discovered at 18 weeks pregnant that her fetus had anencephaly, a condition which prevents fetuses from developing a skull. Her fetus had no chance of survival and continuing the pregnancy posed severe risks to her, including hemorrhage and pre-term birth. Although Lauren wanted an abortion, her obstetrician refused to provide one or to help in any way. In addition, her medical specialist was afraid to give her a referral for an abortion out of state and refused to even send her medical records. Lauren was forced to travel out of state to obtain an abortion at a clinic outside of Seattle. She is now pregnant again, due in September but scared to be pregnant under the state’s laws.

• Anna Zargarian, from Austin, Texas, was 19 weeks pregnant when her water broke and she began cramping. In the emergency room, doctors told Anna there was no chance that her baby would survive and that based on her condition, she was at risk of infection, hemorrhage, and sepsis. Anna was told that she needed an abortion but could not get one in Texas and would need to leave the state. Anna decided to fly to Colorado for an abortion, despite her fear of going into labor on the way. While she still wants to have children, she is afraid to go through pregnancy again in Texas.

• Ashley Brandt, from Dallas, was pregnant with twins but at 12 weeks, learned that one of the twins had acrania—and the longer she stayed pregnant with both twins, the less likely it was that both would survive the pregnancy. Ashley’s doctors told her that because of S.B. 8, she would need to go out of state to obtain a fetal reduction abortion procedure, which she traveled to Colorado to obtain. Back in Texas after her procedure, her doctors were reluctant to acknowledge that she’d had an abortion. For the remainder of her pregnancy, until she gave birth to a full term, healthy baby, Ashley remained terrified for her life and that of her baby.

About the Additional Plaintiffs

Added May 22, 2023

• Dr. Austin Dennard, who lives in Dallas, Texas, with her husband and two children, is a board-certified obstetrician and gynecologist joining this case as a patient plaintiff. When Dr. Dennard was 11 weeks pregnant, she found out that her baby had anencephaly—a condition she knew was not compatible with survival. Sadly, Dr. Dennard had been through this before: she and her husband made the difficult choice to end her first pregnancy after her baby was diagnosed with a rare genetic condition. But while she had previously been able to obtain care at a clinic in her home community, Texas’s new abortion bans now forced her to travel out of state. When Dr. Dennard learned that her patient, Lauren Miller, went through the same experience she had and that Lauren was one of the plaintiffs in this lawsuit, she decided to join the case and tell her story. Dr. Dennard is now pregnant again with her long-awaited third child.

• Kylie Beaton lives with her husband and their daughter in Fort Worth, Texas. Kylie was thrilled to learn she was pregnant with their second child, but at her 20-week scan, she discovered the baby had a condition, alobar holoprosencephaly, in which the brain does not develop normally and the head grows abnormally quickly. After learning the baby would barely survive past birth, Kylie considered traveling to New Mexico for abortion care. But the baby’s head was already measuring at close to 24 weeks—a size past the gestational cutoff for the New Mexico clinic—and Kylie had no choice but to continue the pregnancy. At Kylie’s 28-week ultrasound appointment, she begged to be induced before the baby’s head grew too large to deliver vaginally, but her doctors refused due to Texas’s abortion bans. After rushing to the hospital with abdominal pain at 35 weeks, Kylie was finally sent for an emergency Cesarean, and her baby died four days after he was born. Kylie said that having to go through the birth and death of her son made losing him much harder, and she fears for her health, safety, and ability to get pregnant again in the future.

• Jessica Bernardo, from Frisco, Texas, was thrilled to discover she was pregnant after two years of fertility challenges. Upon learning at 14 weeks that their baby likely had Down syndrome, she and her husband began researching how to support children with disabilities. But Jessica soon learned that her daughter had several other severe medical conditions, including fetal anasarca, and would not survive to birth—and continuing the pregnancy put her at risk of developing a potentially fatal condition. Her doctor contacted the hospital ethics committee for an exclusion, but the request was denied. Using what felt to her like coded language, Jessica told her doctor that they had a residence in Colorado and asked if they should go there; her doctor told her yes. After finding that the clinics in Colorado were all booked, Jessica was eventually able to get an appointment for an abortion in Seattle, where she was the third patient from Texas that week alone. Jessica describes this experience as the worst trauma of her life. She is terrified to get pregnant naturally again in Texas and has decided to start IVF.

• Samantha Casiano, who lives in East Texas with her partner and their children, learned at her 20-week scan that her baby had anencephaly and would not survive. She asked her doctor what her options were—but since she lacked the time, finances, and resources to travel out of state, she was told she had none but to continue with the pregnancy. As the months wore on, Samantha found it excruciating to have people constantly congratulating her, and she worried relentlessly about how she would afford a funeral for her daughter. Though the baby was born breech (positioned backwards), which usually necessitates a Cesarean section, Samantha was not given the option to have the procedure; she noted the hypocrisy of treating her daughter like a healthy baby only while she was in utero. Her daughter died four hours after birth, and, after a simple funeral, Samantha resolved to tell her story publicly in the hope that others would not have to go through the same experience. She wished she had been able to put her daughter to rest earlier, since she was going to have to rest either way.

• Taylor Edwards, from Austin, learned at 17 weeks pregnant that her daughter had a fatal condition called encephalocele and would die at or before birth. Continuing the pregnancy posed risks to Taylor as well. After a second opinion confirmed the diagnosis, Taylor decided to travel to New Mexico to have an abortion, despite the daunting logistics and expense. Her doctors in Texas told her that if her condition had occurred a year and a half earlier, they could have offered her the care she needed, but not anymore. Three hours before her flight was scheduled to leave, the New Mexico clinic canceled Taylor’s appointment due to a shortage of medication needed for the procedure. Taylor searched for other appointments in New Mexico, but none were available. She soon started vomiting daily, struggling both physically and emotionally, and she was terrified that she would be too far along for an abortion by the time she found an appointment. Taylor was eventually able to obtain an abortion at a Colorado clinic, though she returned to Texas feeling she was back at square one with IVF. Taylor and her husband still want a child, but she fears being pregnant again in Texas.

• Kiersten Hogan, of the Dallas-Fort Worth area, was surprised but excited to learn she was pregnant. When her boyfriend became violent and insisted she get an abortion, Kiersten left him and moved to Texas. There, several instances of cramping and bleeding sent her to the emergency room, but doctors repeatedly assured her that everything looked normal. Then, just weeks after Texas abortion ban S.B. 8 took effect, her water broke. Hospital staff told Kiersten that if her cervical insufficiency had been diagnosed earlier, she could have had a procedure to prevent this; now, it was too late. She was forced to stay in the hospital against her will, where religious counselors repeatedly came to visit her and staff told her that if she tried to leave, it could be used as evidence that she was trying to kill her baby. Four days later, Kiersten delivered her son stillborn. She says being detained against her will made her feel like a criminal during the biggest medical emergency of her life.

• Lauren Van Vleet and her husband were delighted to learn she was pregnant. But a severe snow and ice storm delayed Lauren’s 20-week scan by two weeks, and at the rescheduled scan, the couple learned that their son had anencephaly and would not survive. Lauren’s doctor told her that due to Texas’ laws, there was nothing she could do but wait for the baby’s heart to stop beating or carry the pregnancy to term. She would have to go out of state if she wanted an abortion. Lauren was 23 weeks pregnant when she began searching for appointments and was concerned she’d be unable to obtain an abortion at this stage. She was terrified of legal liability and avoided texting anyone about her plans. Luckily, family members in Maryland were able to provide logistical and financial support, and Lauren received an abortion there at 24 weeks. She has spent the last several months trying to heal; while she still wants children, she is afraid to be pregnant again in Texas.

• Elizabeth Weller, of Kingwood, Texas, had a relatively smooth pregnancy at first. She opted not to do any genetic testing: Elizabeth herself was born with a physical disability, brachial plexus Erb’s palsy, and she knew she would want to continue the pregnancy regardless. At 19 weeks, however, Elizabeth’s water broke. Though her baby would not be able to survive and continuing the pregnancy meant risking her fertility and her life, hospital staff refused to perform an abortion because Elizabeth had already been prescribed antibiotics, saying she had put herself in a “legal gray area” by attempting to fend off infection. Her options were to stop taking the antibiotics and stay in the hospital, or go home, monitor herself for signs of worsening infection, and wait for her baby to die inside her. After she was diagnosed with chorioamnionitus, an infection of the placenta and the amniotic fluid, a medical board finally approved an abortion for her. Elizabeth said her experience made her feel like she was being punished by the state of Texas for failing to carry a wanted pregnancy to term. While she and her husband still want children, they are traumatized by the experience and afraid of the serious risks associated with being pregnant in Texas.

Added November 14, 2023

• Kristen Anaya, of the Dallas-Fort Worth area, was 16 ½ weeks pregnant when her water broke. At the hospital, she lost more amniotic fluid, spiked a fever, and began having rigors, or uncontrollable shaking—symptoms that she would later learn were early signs of sepsis. Kristen’s doctor told her that her pregnancy could not continue without amniotic fluid, but since her daughter still had a heartbeat, the hospital would not provide abortion care unless her life was in danger. Over the next 22 hours, Kristen’s fever climbed higher, and she shook and vomited constantly. After presenting Kristen’s case to hospital administration several times, her doctor was finally able to obtain permission for her to receive an abortion. Immediately after the procedure, Kristen’s fever subsided and the vomiting stopped. She recovered from the septic infection after five days in the hospital. Kristen and her husband still want to have children but fear for her safety if she gets pregnant again. They’ve started IVF treatments and believe they’ve found a surrogate who can carry for them—but the surrogate also lives in Texas. Kristen decided to join this case after realizing that so many other Texans shared her experience.

• Kaitlyn Kash, of Austin, pregnant with her second child, discovered after her 13-week ultrasound that her baby had severe skeletal dysplasia—a condition affecting bone and cartilage growth—and the baby was unlikely to survive until birth or would suffocate soon after being born. When Kaitlyn asked what option would ensure the least amount of suffering for her baby, the MFM recommended she seek “a second opinion, but outside Texas.” Kaitlyn was able to obtain abortion care after traveling to a clinic in Kansas, where protestors harassed her and other patients. After becoming pregnant a few months later, Kaitlyn miscarried at seven weeks. Her doctor prescribed medication to help her pass the pregnancy, but because the drug is also used for medication abortion, she struggled to find a pharmacy to fill the prescription. After another miscarriage without medical intervention, Kaitlyn became pregnant and gave birth to a daughter in 2023. After the birth, she needed a dilation and curettage (D&C) procedure to remove remaining placental tissue, but the hospital had difficulty locating the equipment and staff for the procedure. While waiting, Kaitlyn’s condition deteriorated, and after vomiting, losing blood, and losing consciousness, she was transferred to the ICU, where she was later told she was lucky she hadn’t lost her uterus. Kaitlyn still struggles to understand why the hospital had so much trouble providing her with routine postpartum care.

• D. Aylen, of San Antonio, discovered at about 17 weeks into her pregnancy that her baby had a possible neural tube defect, such as anencephaly or spina bifida. At her 19-week anatomy scan, an MFM specialist confirmed the diagnosis of anencephaly. Hoping to prevent more suffering for herself and her baby, D. called out-of-state abortion clinics—most of which had four- to eight-week wait times—and eventually was able to obtain abortion care in San Diego. Losing her child and being forced to travel to California to obtain health care was one of the worst moments of D.’s life. She is glad to be pregnant again but continues to be plagued by fear and receives sonograms every three weeks. D. decided to join this case to honor her baby’s memory and make sure that no other family has to go through what she endured.

• Kimberly Manzano, of the Dallas-Fort Worth area, discovered she was pregnant again after a miscarriage a few months earlier. But an ultrasound at 10 weeks revealed that some of the baby’s organs were growing outside the body. The MFM specialist was concerned that Kimberly’s health was at risk and suggested she obtain an abortion out of state. After an MRI scan revealed that the baby’s spine, genitalia, kidney, bladder and abdominal wall had not developed properly, the MFM specialist told Kimberly and her husband, “If it was my baby, I would want him to be with God now.” Devout Christians, Kimberly and her husband had always considered themselves to be anti-abortion, but it became clear to them that abortion was their only option. Their baby had little or no chance of survival, and if Kimberly continued the pregnancy, she’d be at risk of infection since the baby had no bladder and urine was circulating in her uterus. When Kimberly was 18 weeks pregnant, she was traveled out of state to obtain an abortion in New Mexico. Kimberly and her husband consider losing their baby to be the most challenging thing they have been through. Disgusted that people are made to feel like criminals for making such sacrifices, Kimberly believes it is not her place to judge someone else’s decision about their pregnancy. She decided to join this case in hopes that her baby’s story can make a change and so that no woman has to flee Texas to obtain necessary medical treatment.

• Dr. Danielle Mathisen, formerly of the Fort Worth area, is currently an obstetrician-gynecologist (OB-GYN) resident physician in Hawai’i. While still living in Texas, Dr. Mathisen learned she was pregnant. But at her 18-week anatomy scan, her doctor diagnosed her baby with several lethal fetal conditions—including a hole in the spine, only one kidney, and no formed brain structures—and said the baby was unlikely to survive or would slowly suffocate soon after birth. Dr. Mathisen’s doctor—who is also her aunt—told her she couldn’t help her and advised her to go on a “vacation” to Colorado. Dr. Mathisen was shocked that her own family member was unable to help her or even openly discuss abortion due to Texas’s bans. Dr. Mathisen and her husband decided abortion was the right decision to prevent further suffering for their baby and themselves. With clinics in Colorado overflowing with Texans, Dr. Mathisen was able to obtain an abortion after traveling to New Mexico. Dr. Mathisen is pregnant again and resides in Hawai’i, where abortion is legal, but she does not feel safe when she visits her family in Texas. She decided to join this case to be a voice for people who can’t share their abortion stories and to prevent other Texans from going through the same trauma.

• Cristina Nuñez, of El Paso, has several medical conditions—including diabetes, cardiovascular issues, and end-stage renal disease—and was advised by doctors to never become pregnant. When she discovered she was six weeks pregnant, Cristina consulted her OB-GYN, who reiterated that continuing the pregnancy would put her life, and her baby’s life, at risk. Cristina asked for an abortion, and although her doctor promised to present her case to the hospital administration, she never heard back. She reached out to a New Mexico clinic and was told that because of her medical condition, she was not eligible for medication abortion, and she was too early in pregnancy to get a surgical abortion. Over the next few weeks, Cristina’s health rapidly deteriorated, requiring an increase in her dialysis treatments. After her arm turned black due to blood clotting issues, and fearful she he was at risk of pulmonary embolism and losing her arm (Cristina is a trained nurse), she went to the emergency room. The hospital staff refused to provide her an abortion. After 11 days of waiting—and only after contacting an organization for legal support and translation services, since Cristina does not speak English—she finally received an abortion. She will never understand why she had to become so sick before receiving the medical care that saved her life.

• Amy Coronado, of Houston, was several months into her pregnancy when she learned that her daughter’s brain had not properly developed and that its appearance was consistent with alobar holoprosencephaly, a condition in which the brain hasn’t divided into two hemispheres. Her MFM specialist told Amy and her husband that there was little to no chance their daughter would survive. In addition, if Amy continued the pregnancy, she would face risks to her own health, including complications from her gestational diabetes and the threat of infection if her daughter died before Amy went into labor. Amy received her fetal diagnosis the same day Texas’s trigger ban took effect, so her doctor was unable to refer her for an abortion as he would have done before the ban. After another MRI confirmed “multiple brain anomalies” consistent with alobar holoprosencephaly, Amy traveled out of state and was able to obtain an abortion in Albuquerque. Since her insurance would not cover the out-of-state procedure, she was forced to pay out of pocket for the procedure and hotel and travel expenses. Amy decided to join this case after seeing a TikTok story from a Tennessee woman who received the same fetal diagnosis and was also denied abortion care due to a state abortion ban. While Amy and her husband are eager to try again to have a baby, she fears for her health and safety if she gets pregnant again in Texas.

Texas’s abortion bans violate the rights of physicians by threatening enforcement against those who provide abortions in good faith for pregnant people with severe pregnancy complications. As such, Texas’s bans impede physicians’ fundamental rights, including physicians’ rights to pursue their profession without risking loss of liberty. 

• Dr. Damla Karsan provides gynecological care, prenatal care, and obstetric care as part of her Houston-based practice. Before Texas’s S.B. 8 law, she provided abortions to her patients in need of such care, but since the law took effect in 2021, she has been unable to provide the care they need. Dr. Karson joined this lawsuit to speak on behalf of other physicians who she knows are afraid to speak out for fear of retaliation.

• Dr. Judy Levison is a faculty member at a medical school in the Houston area. Since S.B. 8 took effect, she has seen how widespread fear and confusion regarding the scope of Texas’s abortion bans have chilled the provision of necessary obstetric care, including abortion care. Dr. Levison partially retired from the practice of medicine in 2022 following the overturning of Roe v. Wade, feeling she could no longer practice medicine the way she was trained and consistent with her ethical obligations as a physician.