Health care
BY HANNAH NORTON
Texas Medical Board considers exceptions to abortion ban
After months of pressure, the Texas Medical Board proposed narrow medical exceptions to the state’s near-total abortion ban during its March 22 meeting. The board has been silent on the issue since 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 board opted to consider new guidance following months of calls for clarity from patients, doctors and lawmakers. On May 31, the Texas Supreme Court unanimously upheld the law, ruling against 22 women who argued the law is too broad for doctors to intervene when women experience severe pregnancy complications. The medical board relied on existing state statutes to craft its proposed rule. It did not list exceptions for specific medical conditions, instead deferring to physicians to determine when an emergency abortion is necessary. The rule defines an emergency 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.” Board President Dr. Sherif Zaafran said the board has the ability to “enforce the law as it’s written,” but the law can only be altered “through the legislative process.” The Texas Legislature is not scheduled to meet until January 2025. What they’re saying The women who sued the state said they hoped the board would provide clearer guidance to help doctors provide the best medical care for their
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 license. The state law, which was passed in 2021 and took effect in August 2022, says:
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2020
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*IN-STATE FOR TEXAS RESIDENTS
SOURCES: TEXAS HEALTH AND HUMAN SERVICES COMMISSION, TEXAS LEGISLATURE ONLINE/COMMUNITY IMPACT
patients in emergencies. Lead plaintiff Amanda Zurawski said she “prob- ably would have died” if doctors had waited any longer to perform an abortion in 2022. Zurawski experienced a condition called preterm premature rupture of membranes, which caused her water to break too early and led to a severe infection. “No person should have to ask themselves, ‘Can I take my dying wife to the hospital?’” Zurawski’s husband, Josh, said. Dr. Ingrid Skop, a San Antonio OB-GYN who previously testified in favor of the abortion ban, said the proposed rule is a good start but is still lacking. “Doctors are frightened,” Skop said. “They feel that they are making decisions in a vacuum and that if they make the wrong decision, they could lose their medical license, they could go to jail and they
could incur severe financial penalties.” Stay tuned Dozens of Texans shared their concerns about the law’s ambiguity and the risks doctors face when terminating nonviable pregnancies during a virtual public hearing May 20. The board is expected to discuss the proposed rule June 20-21, although it is unclear when the rule will be approved. Texans can submit comments about the proposal on the Texas Medical Board website. “I know this is an emotional issue,” Zaafran said May 20. “And I know that there’s some very strong feelings one way or the other. We as a medical board are trying, as best we can, to stay within the con- straints of the law while helping give clarity to the physicians as to how they can navigate these issues.”
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