A Dallas woman’s abortion law became an issue when she realized her husband’s email and kids were running around underfoot – a case study in Texas

On a recent Friday night, as her husband made dinner at the family’s home in Dallas and her toddlers ran around underfoot, Dr. Austin Dennard saw an email come in on her phone.

A judge who heard her testify last month about Texas’s abortion law reached a decision. 13 women sued the state after they argued that the current abortion bans were not clear about when it came to pregnancies that could result in death. She was pregnant when she was on the stand and nearing the end of her baby’s life.

“I didn’t anticipate the amount of emotion that was just going to pour out of me when I read it,” she says. “I just scrolled through it and just cried.”

The Texasban on abortion for pregnancies with anencephaly diagnoses is back in effect after all. Texas women who get that diagnosis today have to leave the state as Dennard did, or carry the doomed pregnancy to term as Casiano did. That means they face all the considerable risks of childbirth to a person’s health and future fertility.

A district court judge ruled earlier this month that Texas must stop enforcing its abortion laws when doctors are treating patients with serious pregnancy complications, but Texas appealed her decision and the bans are back in effect.

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“My husband burst into tears after giving me a big hug.” And it just – it felt really good. It felt like a win but you never thought you’d have to fight for it. “I was reading it through tears, and there’s all this lawyer jargon in it. We have the internet and I’m trying to understand the whole thing with different terms that I find.

Dennard also thought about her OB-GYN patients, and the possibility of speaking to them openly when they face complications. She says that she felt great to hear people’s stories and conclude that the law needed to be changed.

That means the ban on abortions when a fetus has a condition “incompatible with life,” as doctors often deliver the news to patients, is back in force in Texas.

“I went back to clinic and put on my white coat and just started seeing patients again with the same laws that are in place,” Dennard says. It’s emotional whiplash.

During the July hearing, Assistant Attorney General Amy Pletscher asked each witness if Attorney General Ken Paxton had personally denied them an abortion. Dennard, who was the last patient to testify, retorted, “You know, I never thought to ask him.”

O’Donnell told NPR that she was there to keep an eye on it and watch how it goes. She said she believes that the laws are clear as is. She said that doctors can provide standard of care if they exercise reasonable medical judgment.

Next, the attorneys for the state of Texas have to file a filing with the Texas Supreme Court related to their appeal. The court will decide whether or not to hear the case after the attorneys file a response. There’s no set timeline for this to unfold.

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Dr. Thoppil credits Johnson as “a tremendous advocate for women’s health.” The new law will be helpful, according to him. The law will help prevent some of the heartbreaking circumstances patients have experienced since the ban took effect, he says, because he says the two conditions mentioned are common complications that OB- gyns see.

“Standing alongside some incredibly brave women talking about abortion – which is such a taboo subject – and really putting it all out there in such a raw way, is difficult to say the least,” she says.

It has also been energizing to be a part of the lawsuit, she says. She hopes it’s helping to change how people think about abortion restrictions and how they affect people’s lives.

In August 2022, Hughes wrote a letter to the Texas Medical Board asking for an investigation into “disturbing allegations” that patients with serious pregnancy complications were being sent home from the hospital without care. “Pregnancy complications such as these should be swiftly and reasonably treated to prevent or address a medical emergency determined by the physician,” he wrote, asking the Texas Medical Board to issue guidance on this issue.

According to John Thoppil, an Austin OB-GYN and past President of the Texas Association of Obstetricians and Gynecologists, the law was already clear and that doctors were to blame for the uncertainty. He says it’s unfair to blame doctors for the threats of felony charges and losing their license if the original law is poorly written.

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Hughes helped line up key supporters, according to Johnson. “I’m glad that we were able to have honest conversations,” she says. This would not have been accomplished if he did not get it through the Senate.

The bill passed in the Senate unanimously, and was signed into law by the governor a few days after the session ended. George Christian, the senior Counsel at the Texas Civil Justice League wrote about helping to draft the legislation in regards to that being a “minor miracle”.

“It happened because of the masterful and discreet way that the bill’s House author, Rep. Johnson, and Senate sponsor, Sen. Hughes, handled things in their respective chambers,” he wrote.

Johnson knows of that criticism. “Yes, there are absolutely other pregnancy complications,” she says. This is what we can do in this moment. In this moment, we could get bipartisan agreement of the recognition of ectopic pregnancy and ruptured membrane.”

She introduced a bill a few weeks after the Texas legislative session started. Originally, the bill broadly allowed doctors to provide “medically necessary” services.

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Rep. Ann Johnson: The Lack of Guidance in the Texas Medical Exception is How Doctors and OB-GYNs Delay Pregnancies

State agencies and medical groups aren’t able to solve these problems with guidance, according to Rep. Ann Johnson. “You read the black letter of the law,” she says. You cannot say that you thought abortion meant something else when you first read the book.

She stated in her post that the Texas health department, Texas Medical Board, the Texas Medical Association, and the Texas Hospital Association all could help ward off dangerous situations by educating and giving guidance. “The prolonged silence of the medical, legal, and bureaucratic organizations that could end the confusion is unconscionable,” she wrote.

These stories have concerned even some ardent supporters of the abortion bans. When a doctor does not intervene to save a mother’s life, women are being hurt unnecessarily, even if the doctor agrees with the standard of care. She works for the Charlotte Lozier Institute, a part of Susan B. Anthony Pro-life America. Skop was the only witness called by attorneys for the state in the Zurawski hearing last month.

There is research on the effects of delaying care. A study published last year documented the outcomes for 28 Texas patients whose water broke too early for the fetus to survive. When they were first diagnosed their doctors waited for their fetal heart to stop, meaning they did not get an abortion. Nearly half of these patients developed a serious condition, including 10 who developed infections, five who needed blood transfusions, and one who required a hysterectomy.

A lawsuit against the state argues that language in the medical exception is vague and confusing, causing hospitals and doctors to delay care, which harms patients. The plaintiffs include 13 patients and two physicians, and they’re represented by the Center for Reproductive Rights. The doctor delayed an abortion and Zurawski developed sepsis and almost died.

“If you have a general practitioner or a dermatologist treating psoriasis or rheumatoid arthritis of a 34-year-old woman who has no intentions of getting pregnant, and then she gets pregnant six months later and that pregnancy terminates because of that medication,” that doctor could get charged with a felony, Johnson says.

The laws don’t just affect OB-GYNs, Johnson says, pointing to a recent law that imposes criminal penalties on prescribers of certain medications that can cause abortions. She gives the example of methotrexate, a drug used to treat cancer and autoimmune disorders. It can also be used to perform a very early medication abortion.

The Texas Medical Center is represented by State Representative Ann Johnson. She says after Texas’s abortion bans took effect, her constituents would stop her when she took walks around the district.

The governor of Texas spoke at a rally in support of the abortion ban after the Supreme Court overturned the Wade decision.