Texas Supreme Court Rules Against Women Denied Abortion Care Despite Dangerous Pregnancy Complications

Today the Texas Supreme Court denied claims brought by 20 women denied abortion care despite facing dangerous pregnancy complications and refused to clarify exceptions to the state’s abortion bans.

The ruling in the high-profile case, Zurawski v. State of Texas, left physicians without clarity about the circumstances under which they can use their own medical judgement to provide abortion care without fear of prosecution.

The case was brought by the Center for Reproductive Rights in March 2023 on behalf of the women denied abortion care despite risks to their health, lives, and future fertility, and two Texas obstetrician-gynecologists.  

“This outrageous ruling clearly demonstrates that Texas’s ‘medical exceptions’ to its extreme abortion bans just don’t work,” said Molly Duane, senior staff attorney at the Center. “This ruling means that pregnant Texans will continue to suffer because they can’t access the medical care they desperately need.” 

The pregnant plaintiffs in this case experienced complications such as preterm pre-labor rupture of membranes (PPROM) and pregnancies with severe developmental problems and no chance of survival. Denied abortion care, some of the women developed health- and life-threatening infections, some traveled hundreds of miles out of state during their medical crises to obtain care, and others were forced to remain pregnant against their will and deliver babies that were either stillborn or died soon after birth. (Read more about the plaintiffs here.)

Reactions to the Ruling

Molly Duane and lead plaintiff Amanda Zurawski react to the Texas Supreme Court’s ruling:

Court’s Ruling Ignores Pregnant Patients Filing the Case 

In its ruling, the Court largely ignores the women denied abortion care who filed the case. The ruling states that abortions are not permitted 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 also dismissed claims that the Texas law violates patients’ constitutional rights to protect their lives and health.

While the Court clarified that exceptions can be made for life-threatening conditions such as PPROM, the Court refused to say when, in the course of a patient’s deteriorating health situation, the exception would apply.

The Court also threw out an injunction issued by a Texas district judge in August 2023 that blocked the state’s abortion bans and would have allowed abortions for severe pregnancy complications and fatal fetal diagnoses. The state had immediately appealed the judge’s ruling, blocking it from taking effect mere hours after the opinion was issued. 

“This ruling utterly fails to provide the clarity Texas doctors need for when they can provide abortion care to patients with serious pregnancy complications 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. 

“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 after developing sepsis. “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,” Zurawski continued. 

Without protections from the court, it is now up to the Texas Medical Board or the legislature to provide the clarity doctors need. 

Texas Abortion Bans Deter Doctors from Providing Medically Necessary Care 

While Texas’s abortion laws contain an exception for the life and health of the pregnant person, the state’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.   

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.  

Zurawski v. State of Texas is the first lawsuit brought on behalf of women denied abortions since the U.S. Supreme Court eliminated the constitutional right to abortion and cleared the way for states to ban it entirely.

“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,” added Northup. “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.”

The Center for Reproductive Rights has filed lawsuits and complaints in several states on behalf of dozens of women who were denied abortion care despite such serious complications, and physicians who are unable to provide the medically necessary abortion care their patients need because of the harsh criminal, financial, and professional penalties they face.  

• Case information: Zurawski v. State of Texas
• Ruling by the Texas Supreme Court, 05.31.24
• Medical Exceptions to State Abortion Ban Cases