The Rally for Life march at the Texas State Capitol in Austin in January. Even pro-life groups are demanding further clarity on exceptions to the state’s abortion ban.
Suzanne Cordiero/AFP via Getty Images
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Suzanne Cordiero/AFP via Getty Images
Texas doctors face high stakes when it comes to abortion.
Texas has three overlapping laws that ban nearly all abortions and impose some of the nation’s harshest penalties on doctors, including thousands of dollars in fines, the loss of medical licenses and even life in prison.
That’s the backdrop to a process now underway to give doctors a clearer idea of when abortions can be performed and to consider adhering to the narrow medical exceptions in Texas abortion law.
The state’s highest court asked — and required a formal petition — the Texas Medical Board to clarify how doctors should interpret the exception, which says abortions are allowed to save a woman’s life or a “major bodily function.” .
The board has drafted those clarifying rules, but during Monday’s public meeting the board heard multiple times that they fell short of their goals.
The rules require doctors to keep detailed records of efforts to save a pregnancy. It also said that if time permits, they should try to save the fetus by transferring the patient to a more specialized hospital “by any available means.” If there is not enough time to perform the transfer, the doctor must document it.
Dr. Sharif Zafran, president of the Texas Medical Board and a Houston anesthesiologist, moderated the virtual meeting along with board Executive Director Brint Carlton.
It lasted more than four hours. The Texas Medical Association, which represents 57,000 physicians, residents and medical students, the Texas Hospital Association, which represents 460 hospitals, and the American College of Obstetricians and Gynecologists all told the board that its rules were still not clear enough.
In some ways, the proposed rule “could do more harm than good,” said Steve Wolleb of the Texas Hospital Association.
The two dozen commenters also included Texas doctors, lawyers, representatives from anti-abortion rights groups and patients including Kate Cox.
Cox was a Texas woman who was facing severe pregnancy complications when she appealed to the Texas Supreme Court to try to have an abortion. She was denied surgery and traveled to another state to terminate the pregnancy. The case did, however, lead the court to pressure the Texas Medical Board to issue guidance.
Kate Cox (right) attends the State of the Union address in March. She sat next to Maria Shriver, author and former first lady of California.
Andrew Caballero-Reynolds/AFP via Getty Images
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Cox said that when she needed an abortion in December 2023, the state of Texas did not help her.
Many commented that the regulations failed to reassure doctors that they could provide abortions without having to wait for patients to become increasingly sick.
Elizabeth Weller had this experience when she first told her story to NPR in 2022. Her water broke too early for the pregnancy to be viable, but she had to wait until signs of infection appeared before having an abortion. She summarized her speech this way:
“I hope you can sleep at night, and I hope you never have any blood on your hands, helping women who are going to suffer. I hope your rules are clear. I hope no one dies from this.
Cox and Weller are both plaintiffs in a lawsuit against the state seeking to clarify medical exceptions. The four other plaintiffs in the case, Dr. Austin Dennard, Lauren Miller, Amanda Zulawski, Dr. Judy Levison and lead attorney for the Center for Reproductive Rights, Molly Duane, also filed a lawsuit Comments on these rules. The Texas Supreme Court is expected to issue a ruling by the end of June. Two patients who were not involved in the case also commented on their experiences of delayed care during severe pregnancy complications.
The message from anti-abortion groups is strikingly similar — they also want the rules to make it clearer that doctors don’t have to wait until a woman’s condition is life-threatening before taking action. Miranda Wilberg of Texas Right to Life said the committee should clarify that the “fact” that death is “imminent” is not necessary.
“Women don’t need to be dying for doctors to take action,” Wilberg said. But overall, she added, her team was pleased with the proposed rule.
Board Chairman Zafran pushed back against the idea that under the proposed rule, doctors would have to delay treatment as much as possible. “I don’t think there’s any information to suggest that you have to wait until a patient becomes septic and potentially dying before you need to take action or intervene,” he said. “If we had mentioned that in the proposed rule, then we would be happy to accept those suggestions, but that was certainly not our intention.”
Steve Bresnen, an Austin attorney and lobbyist, responded: “This is how it used to be. no Say, doctor.
Bresnan, along with his wife and business partner Amy Bresnan, filed a petition to force the Texas Medical Board to enact these rules.
He said the board would need to show in writing that patients do not need to be in immediate danger of harm to legally receive an abortion.
“If you can’t do that, you’re not going to accomplish anything,” Bresnin said. He also encouraged the board to rescind the proposed rule and try again. “Don’t be afraid to start with a blank slate.”
Currently, there are no changes to Texas’ abortion ban. If the board decides to start over, the process could take months.
