Texas Supreme Court Rejects Challenge to Medical Exceptions to State Abortion Ban

The Texas Supreme Court on Friday dismissed a lawsuit challenging the state’s ban on abortion because of its medical exceptions.

The court ruled against a group of women who suffered serious pregnancy complications and became the first in the country to testify in court about the denial of access to abortion since the overturning of Roe v. Wade in 2022.

In a unanimous decision, the court upheld the Texas law after the women filed a lawsuit in March 2023 seeking clarification on when exceptions to the abortion ban are allowed, arguing that the The law was confusing for doctors who might turn away patients for fear of repercussions.

The same issue was at the center of a separate lawsuit filed last year by Dallas mother Kate Cox, who asked the court for permission to have an abortion after her fetus developed a fatal illness during a pregnancy that resulted in multiple visits to the emergency room. She ultimately left the state to undergo the procedure.

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Protesters march and rally near the Texas State Capitol in Austin following the U.S. Supreme Court’s decision to overturn Roe v. Wade on June 24, 2022. (AP Photo/Eric Gay)

The court said Friday that the law’s exceptions are broad enough and that doctors would misinterpret the law if they decided not to perform an abortion when the mother’s life is in danger.

“Texas law permits life-saving abortion,” the court wrote in the order signed by Judge Jane Bland.

The ruling closed, at least for now, another avenue for opponents trying to force the state to clarify when exceptions to abortion are allowed. Last year, the plaintiffs in the lawsuit testified in court that they carried babies they knew would not survive and continued pregnancies that put their health at risk.

Plaintiff Kaitlyn Kash, whose fetus developed severe skeletal dysplasia, was told that even the simplest movements could break her bones in utero. Her life was not in danger, but she still chose to leave Texas to have an abortion.

“I wanted to end my child’s pain before it could start,” Kash said. “The state has just told me that as a mother, I do not have the right to make these decisions for my child. (…) If you want to expand your family, if you want to have children, you should leave Texas.

Texas law says doctors who perform abortions face life in prison, fines of up to $100,000 and can lose their state medical license.

“Now we know the courthouse doors are closed to them,” said Molly Duane, an attorney with the Center for Reproductive Rights, which represented the Texas women’s group. “It seems like Texans have nowhere to go but to the voting booth as far as what happens next.”

Last year, a lower court granted a temporary injunction blocking Texas from enforcing the ban against doctors who performed an abortion using their “good faith judgment” after determining that a pregnancy was unsafe due to medical complications. That decision, however, was immediately blocked after an appeal by the Texas attorney general’s office to the state Supreme Court.

Pro-choice activists stand outside with signs, one sign saying

The Texas Supreme Court has rejected a lawsuit challenging the state’s ban on abortion because of its medical exceptions. (Reuters/Callaghan O’Hare)

The lawsuit’s lead plaintiff, Amanda Zurawski, had been told she had an illness that meant her baby would not survive. She said she was forced to wait until she was diagnosed with a life-threatening case of sepsis before having an abortion. She spent three days in intensive care and was left with a permanently closed fallopian tube due to an infection, affecting her ability to have more children.

The court ruled Friday that state law does not require that a woman’s death or serious impairment be “imminent” when she is being evaluated by a doctor for possible abortion.

“Ms. Zurawski’s agonizing wait to be ‘sick enough’ for induction, the development of sepsis, and her permanent physical injury are not the outcomes the law requires,” the court wrote.

Zurawski said the decision was “heartbreaking.”

“I am outraged on behalf of my fellow plaintiffs who the Court has found not sick enough,” Zurawski said. “We all deserve bodily autonomy. Every day, Texas people are told they have no choice. It’s sickening and wrong.”

Republican Texas Attorney General Ken Paxton praised the decision after his office defended the law in the case.


Amanda Zurawski introduces President Joe Biden to speak at an event on the campus of George Mason University in Manassas, Va., Tuesday, Jan. 23, 2024, to campaign for abortion rights. (PA)

“I will continue to defend the laws passed by the Legislature and uphold the values ​​of the Texas people by doing everything in my power to protect mothers and babies,” Paxton said on X, the platform formerly known as from Twitter.

The lawsuit argued that Texas law’s exemptions, which allow an abortion to save a mother’s life or prevent impairment of a major bodily function, caused confusion among doctors, who refused certain pregnant women suffering health complications because they feared repercussions.


The plaintiffs said the abortion ban, which allows an abortion to save a mother’s life or prevent impairment of a major bodily function, has caused doctors to fear potential liability if the State does not consider a case a medical emergency.

New guidelines proposed by the state medical board earlier this year did little beyond advising doctors to meticulously document their decision-making. The Republican-led state Legislature is not expected to make any changes to the law’s wording.

The Associated Press contributed to this report.