Texas doctors, women, and lawyers have been asking the state for nearly two years to clarify what is and what is not allowed under strict, overlapping abortion bans. Lawmakers passed a bill this year that makes some exceptions to the bans clearer, but it wasn’t enough to help doctors decide whether they could legally give a Dallas woman, Kate Cox, an abortion. Cox sought permission to end her pregnancy after she learned that her fetus had a fatal genetic condition. A district court judge said she qualified for a medical exception to the bans, but the Texas Supreme Court overturned that decision this week. Before the court ruled, Cox left the state for the procedure, as thousands of Texas women had already done. Her case reveals the dynamics of abortion in Texas: For abortion opponents, including the state’s Republican leaders, confusion and fear among doctors has succeeded in preventing nearly all abortions, even in cases of serious pregnancy complications. Texas has publicly reported only 34 abortions so far this year, down from more than 50,000 in 2020, before the first of the severe restrictions went into effect, The New York Times reports.
In its ruling, the Texas Supreme Court sided with the state’s attorney general, Ken Paxton, who argued that exceptions to the bans were legal only when the health or life of the mother was seriously threatened, and Cox’s case did not appear to meet that standard, based on the arguments presented. The court said that the law allowed for abortions based on a doctor’s “reasonable medical judgment.” If doctors remained confused, the court said, the Texas Medical Board could step in with guidelines. Doctors have said that the risk of performing an abortion that they believed to be necessary but the state could later question that presented them with a stark choice: Go ahead with the procedure and risk felony prosecution, or wait until a woman’s health deteriorates to the point that no one would question the medical need. Doctors have been asking the Texas Medical Board for guidance on the medical exception issue since last year. So far, the board has not taken any action. “We don’t have clarity from this Cox ruling,” said Dr. Rick W. Snyder II, the president of the Texas Medical Association, who added that getting guidance from the medical board would not be enough. “We’re going to want legislative clarity,” he said. “We’re trying to protect physicians, so they don’t have to go to court.”