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Abortion bans in Texas are still confusing despite new guidance : Shots - Health
News The Texas Medical Board has drafted guidelines for doctors to decide when
an abortion is necessary and legal under the state's strict ban. The rules were
widely panned at a recent public hearing.


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SHOTS - HEALTH NEWS


NEW RULES ARE IN THE WORKS ABOUT ABORTION BANS IN TEXAS. ALMOST NOBODY'S HAPPY.

May 25, 20248:00 AM ET

By 

Selena Simmons-Duffin

, 

Diane Webber

The "Rally for Life" march at the Texas State Capitol in Austin in January. Even
groups that oppose abortion are asking for more clarity on exceptions to the
state's abortion bans. Suzanne Cordiero/AFP via Getty Images hide caption

toggle caption
Suzanne Cordiero/AFP via Getty Images

The stakes are high for doctors in Texas when it comes to abortion.

With three overlapping laws, Texas bans nearly all abortions and has some of the
strictest penalties for doctors in the country, including thousands of dollars
in fines, the loss of a medical license and even life in prison.

That’s the backdrop for a process happening now to give doctors more clarity
about when abortions can be performed and considered in compliance with the
narrow medical exception in Texas abortion law.

The state’s Supreme Court asked – and an official petition required – the Texas
Medical Board to clarify how doctors should interpret the exception, which says
abortion is allowed to save a woman’s life or “major bodily function.”

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The board has drafted those clarifying rules but at a public meeting on Monday,
the board heard repeatedly that they’d missed the mark.

The rules say doctors need to document in significant detail efforts that were
made to save the pregnancy. And it says, if time allows, they should transfer
patients “by any means available” to hospitals with a higher level of expertise
to try to save a fetus. If there isn’t enough time for a transfer, doctors have
to document that.

Texas Medical Board President Dr. Sherif Zaafran, an anesthesiologist based in
Houston, presided over the online meeting along with the board’s executive
director Brint Carlton.

It lasted more than four hours. The Texas Medical Association, representing
57,000 physicians, residents and medical students, the Texas Hospital
Association, representing 460 hospitals, and the American College of
Obstetricians and Gynecologists all told the board its rules are still not clear
enough.

In some respects, the proposed rules “may do more harm than good,” said Steve
Wohleb of the Texas Hospital Association.

The two dozen commenters also included Texas doctors, lawyers, representatives
from organizations that oppose abortion rights, and patients, including Kate
Cox.

Cox is a Texas woman who was in the middle of a serious pregnancy complication
when she appealed to the Texas Supreme Court to try to get an abortion. She was
denied the procedure and traveled to another state to end her pregnancy. The
case, however, did lead the court to pressure the Texas Medical Board to come up
with guidance.

Kate Cox, right, attended the State of the Union address in March. She's seated
next to Maria Shriver, the author and former First Lady of California. Andrew
Caballero-Reynolds/AFP via Getty Images hide caption

toggle caption
Andrew Caballero-Reynolds/AFP via Getty Images

Cox said the state of Texas didn’t help her when she needed an abortion in
December 2023. “I'm afraid the rules this board is now proposing wouldn't have
helped me either,” she told the panel.



Many people commented that the rules failed to reassure physicians that they can
provide an abortion without having to wait for a patient to get sicker and
sicker.

Elizabeth Weller, who first told her story to NPR in 2022, had that experience.
Her water broke too early for her pregnancy to survive, but she had to wait
until she showed signs of infection before she was given an abortion. She
concluded her remarks with this:

“I hope that you can all go to sleep at night and that you never have any blood
on your hands for the women that are going to have to suffer through this. I
hope that your rules are clear. I hope no one has to die because of this.”

Both Cox and Weller are plaintiffs in a lawsuit against the state that seeks to
clarify the medical exception. Four other plaintiffs in that case, Dr. Austin
Dennard, Lauren Miller, Amanda Zurawski, Dr. Judy Levison, and lead attorney
Molly Duane of the Center for Reproductive Rights, also commented on the rules.
The Texas Supreme Court is expected to issue its decision by the end of June.
Two patients who are not involved with the case commented as well about their
experiences with delayed care during serious pregnancy complications.

The message from anti-abortion groups was strikingly similar – they also wanted
the rules to say more clearly that doctors need not wait for a woman’s condition
to become life-threatening before they act. Texas Right to Life’s Miranda
Willborg said the board should clarify “the fact that imminence” of death is not
required.

“Women do not need to be at death's door for a physician to take action,”
Willborg said, although she added that, overall, her group was pleased with the
proposed rules.

Board President Zaafran pushed back on the idea that, under the proposed rules,
doctors would have to delay care as long as possible. “I don't think that
there's any information that you have to wait until the patient became septic
and potentially at death's door before you would need to act or intervene,” he
said. “If there's something that we said in the proposed rules that intimate
that, then we're happy to take suggestions along those lines, but that's
certainly nothing that we intended.”



Steve Bresnen, an attorney and lobbyist in Austin, replied, “It's what was not
said, doctor.”

Bresnen, along with his wife and business partner Amy Bresnen, filed the
petition that forced the Texas Medical Board to write the rules.

He said the board needs to say in writing that a patient doesn’t need to be
imminently in danger of harm to be able to receive an abortion legally.

“If you fail to do that, you're not achieving anything,” Bresnen said. He also
encouraged the board to scrap their proposed rules and try again. “Don’t be
afraid to start with a blank slate.”

For now, nothing changes with the Texas abortion ban. If the board decides to
start over, the process could take months.

 * abortion
 * Texas
 * abortion bans
 * kate cox

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