Health care
BY HANNAH NORTON & BEN THOMPSON
Texas Medical Board clarifies abortion ban exceptions
The Texas Medical Board approved guidelines for limited medical exceptions to the state’s near-total abortion ban June 21. The new rule requires physicians to document the need for an emergency abortion and the asso- ciated risks; initial documentation must happen within seven days of the procedure, according to TMB documents. The decision came almost two years after Texas’ “trigger law” took effect in August 2022, banning nearly all abortions except to save a pregnant person’s life or prevent serious injury. The law does not include exceptions for rape or incest. The June update came after months of feedback from Texans, many of whom testified that the proposal wasn’t clear enough for physicians or their patients to decide when exceptions to the law could be made. What you need to know The board initially proposed guidance about abortion exceptions in March, following months of pressure from patients, doctors and lawmakers. The proposal relied heavily on existing state statute and did not list specific conditions that warrant an emergency abortion. In both that proposal and the adopted rule, a medical emergency was defined as “a life-threat- ening physical condition aggravated by, caused by or arising from a pregnancy that, as certified by a physician, places the woman in danger of death or a serious risk of substantial impairment of a major bodily function unless an abortion is performed.” If carrying out an abortion, the new rule requires physicians to document the need for the procedure by noting:
Breaking down the law According to state data, 80 abortions were performed in Texas between August 2022—when the “trigger law” took effect—and December 2023. All of these procedures were performed in hospitals, and no patients died. The state has not yet released data for 2024.
60K 50K 40K 30K 20K 10K 0
53,949 50,783
January-July: 17,194 August-December: 18
• A pregnancy can be terminated if the patient has “a life-threatening physical condition” or faces “a serious risk of substantial impairment of a major bodily function.” • Physicians who violate the abortion ban face life in prison, at least $100,000 in fines and the loss of their medical licenses. The state law, which was passed in 2021 and took effect in August 2022, says:
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2020
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2022
2023
*IN-STATE FOR TEXAS RESIDENTS
SOURCES: TEXAS HEALTH AND HUMAN SERVICES COMMISSION, TEXAS LEGISLATURE ONLINE/COMMUNITY IMPACT
• That the patient faced a medical emergency putting them in danger of dying or serious risk of “substantial impairment” of their major bodily functions • Which bodily functions were at risk • What led the patient to be at risk of dying or impairment • How the determination of risk was made Medical board President Dr. Sherif Zaafran said the new determination allows for medical discre- tion while protecting the doctor-patient relation- ship. The rule does not involve a detailed list of circumstances when abortions could be permitted, despite some calls for clarity on that point. “What is black and white are the exceptions. What is grey is the medical judgment, and that’s
why we’re sitting here,” Zaafran said June 21. A closer look In May, some physicians said the proposed rule would do little to alleviate the “fear and misun- derstanding” surrounding the abortion law. Zaafran said he believes it’d be a “no-brainer” under the rule for a doctor to carry out an abor- tion if a women’s life is clearly at risk. And to the reverse, he noted that a physician declining to provide medically-necessary abortion care in an emergency could warrant sanctions. Zaafran also called the rule “a work in progress” that could be revised in the future depending on changing circumstances and how any potential complaints are handled.
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