Texas Supreme Court rules on woman at center of abortion battle

Kate Cox, the Dallas-area woman who petitioned a judge for an abortion in Texas, has left the state for abortion care after a week of legal flogging.

Late Friday night, the Texas Supreme Court temporarily blocked a lower court ruling that would have allowed Cox to obtain an abortion under the state’s near-total abortion ban, and later Monday night reversed the lower court’s decision.

Cox, a 31-year-old mother of two, had sought an abortion after learning that her fetus had a fatal genetic disease and that the duration of the pregnancy might jeopardize her future fertility. The case is the first case in which an adult pregnant woman asks the court for permission to terminate a pregnancy under the abortion ban. Roe v. Wade was decided in 1973.

Travis County District Judge Maya Guerra Gamble issued a temporary restraining order on Dec. 7 to allow Kate Coxs’ doctor to perform an abortion in Texas. (Video: AP)

The Coxs’ lawsuit was widely seen as a test case for other abortion lawsuits across the country. Advocacy groups have tried several different ways to repeal or temporarily block the bans in whole or in part since the Supreme Court overturned. Roe in June 2022. Recently, several cases have focused on women directly affected by the law, rather than abortion clinics or doctors.

The Center for Reproductive Rights, an organization representing Cox in the case, said earlier Monday that she could no longer wait for abortion care.

The past week of legal uncertainty has been hell for Kate, said Nancy Northup, CEO of the Center for Reproductive Rights. His health is at risk. He’s been in and out of emergency rooms and he couldn’t wait any longer.

Travis County District Judge Maya Guerra Gamble, an elected Democrat, on Thursday granted a temporary restraining order allowing Cox to obtain an abortion with narrow exceptions to the state’s ban on medical emergencies. But Texas Attorney General Ken Paxton (R) asked the Texas Supreme Court to intervene to prevent Cox from obtaining an abortion.

Four women describe in the booth how the Texas abortion law has harmed them

In a separate letter Thursday, Paxton threatened legal action if Cox had the procedure in the state, warning doctors and hospitals that anyone involved in performing an abortion on Cox would face civil and criminal liability, which could include first-degree criminal charges. He argued that the Coxs’ case did not meet all the requirements to fall within an exception to Texas’ abortion laws and that the judge was not medically qualified to make that decision.

The case drew national attention when Cox described in a Dallas Morning News article how she ended up seeking an abortion after learning her fetus had trisomy 18. Almost all such pregnancies end in miscarriage or stillbirth. Cleveland Clinic. Babies who survive often die prematurely.

I just never thought I’d be in the position I’m in now. “Twenty weeks pregnant with a baby that will not survive and may endanger my health and future pregnancy,” Cox wrote.

He also explained why he sought legal authorization in Texas for the procedure.

I’m from Texas. Why should I or any other woman drive or fly hundreds of miles to do what we think is best for ourselves and our families, to determine our own future? Cox said.

According to the original complaint, Cox had been to the emergency room at least three times during her pregnancy, experiencing cramps, diarrhea and leaking an unidentified fluid. Cox has had two previous C-sections and likely would have needed a third if she carried this pregnancy to term, a procedure doctors say could have affected her ability to have more children in the future, according to the complaint.

The state supreme court held that the situation itself was not sufficient grounds for granting an exception.

The Texas Supreme Court wrote that any parent would be shocked to learn of their unborn child’s diagnosis of Trisomy 18. However, some pregnancy difficulties, even serious ones, do not cause increased risks for the mother, which are covered by the exception.

The American College of Obstetricians and Gynecologists, the leading OB/GYN professional association, highlighted the risks Cox faces in an amicus brief submitted to the court on Monday.

In addition to this devastating diagnosis, Mrs. Cox has other risk factors, according to the group. If Mrs. Cox is forced to carry her pregnancy to term, her risk factors will increase again.

In states where abortion is legal, prohibited, or threatened

Doctors and hospitals across the country watched closely as the Coxes’ legal battle unfolded.

In Thursday’s letter, Paxton laid out the clearest and most credible threat yet to hospitals and doctors in the wake of the U.S. Supreme Court’s decision. Although medical professionals have feared what might happen if they perform abortions that are later deemed illegal, no medical professional has yet been prosecuted under the new abortion bans.

In Texas, a doctor who performs an abortion can be sentenced to life in prison.

This is the most direct confrontation we’ve seen, said Mary Ziegler, a law professor at the University of California, Davis, who specializes in reproductive policy. There has been some interest in prosecuting people who are in the wider abortion support network, but not doctors.

The Texas attorney general’s office was probably eager to prevent Cox’s case from becoming a model for future trials across the country, Ziegler added.

Days after Cox filed her lawsuit, another pregnant woman filed a lawsuit challenging Kentucky’s abortion ban. The class-action lawsuit filed Friday could have broader implications for abortion across the state. Instead of just citing her abortion, the unidentified pregnant woman is trying to overturn the ban entirely.

Cox’s suit is unrelated to a separate, broader case in the state, Zurawski v. State of Texas, in which a group of women who experienced pregnancy complications sued the state over its abortion ban. The women claim the state law denied them proper health care and put their lives at risk. The Texas Supreme Court held a hearing on the case last month.

Pradnya Joshi contributed to this report.

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