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Texas Supreme Court upholds strict abortion ban


More than 20 women in Texas sued their state, saying they were harmed by its abortion ban. Today, the Texas Supreme Court ruled against the women, keeping the abortion ban - with its narrow medical exception - in place. NPR's Selena Simmons-Duffin is here in studio to tell us about the decision. Hi there.


SUMMERS: So Selena, remind us, if you can, about this case. Tell us about the background.

SIMMONS-DUFFIN: Well, the lead plaintiff is Amanda Zurawski. And when she was pregnant in 2022, her water broke far too early. And when that happens, there's a risk of infection, so an abortion procedure called a D&C is standard treatment. In Texas, abortion is banned except when a patient's life or major bodily function is at risk, and doctors say they don't know how to interpret that. And if they make the wrong call, they could face prison time, thousands of dollars in fines, the loss of their medical license. In Zurawski's case, doctors sent her home until she showed signs of infection. And I was in the courtroom in Austin last July when she told the district court what happened next.


AMANDA ZURAWSKI: I went from feeling physically OK to shaking uncontrollably. I was freezing cold, even though it was 110 degrees out. My teeth were chattering violently. I couldn't get a sentence out.

SIMMONS-DUFFIN: She was diagnosed with septic shock. She was in the ICU for days. She almost died. She is one of 20 patients on this case, all with different medical situations. And the Center for Reproductive Rights, which represented them, argued the medical exception is too narrow and too hard to understand, and it's harming patients.

SUMMERS: And Selena, today, the Texas Supreme Court unanimously decided against the plaintiffs. What did the court say?

SIMMONS-DUFFIN: The decision found that the abortion law is already clear and that the medical exception is adequate to protect patients' lives. In a case like Zurawski's, the decision says that the law does not require doctors to wait until she is ill enough, and that's a misinterpretation of the current law. Texas Attorney General Ken Paxton and anti-abortion rights groups cheered the decision. The Texas Alliance for Life wrote in a statement that it was ecstatic.

SUMMERS: I mean, you've been following this case. How much of a surprise was this decision?

SIMMONS-DUFFIN: You know, I asked Liz Sepper about that. She's a professor at Texas Law in Austin.

LIZ SEPPER: The outcome was predictable and, I think, revealed by the Supreme Court's handling of the Cox case in December.

SIMMONS-DUFFIN: So the Cox case she's referring to is the case of Kate Cox.

SUMMERS: Mmm hmm, yeah.

SIMMONS-DUFFIN: You might remember she was facing a serious pregnancy complication. While she was facing that, she asked the state for permission to have an abortion in Texas. And in December, these same judges ruled against her. The Center for Reproductive Rights, the group that brought this case, held a press call this afternoon with several OB-GYNs. They said this decision did very little to give them clarity on what to do in these kinds of cases. And there were also 10 patients on the call, including Amanda Zurawski, and she said the ruling felt like a gut punch.

SUMMERS: So Selena, is this the end of the road for this case?

SIMMONS-DUFFIN: Well, on that call, the lead attorneys said they were looking at the legal path forward, but Zurawski herself put it bluntly.


ZURAWSKI: While this feels like the end of Zurawski v. Texas, it is not the last that you will be hearing from us in this fight for justice.

SIMMONS-DUFFIN: In fact, she asked the Texas Medical Board at a public meeting earlier this month to clarify that doctors can provide abortions without waiting for patients to get sicker. That is in the process of making the rules right now - that's ongoing. And I think Zurawski is right. We'll be hearing more from these patients. There was a time when speaking this openly about your abortion and telling the state to listen to you was really unheard of. And as these patients have said, there's strength in numbers.

SUMMERS: Thanks, Selena.


SUMMERS: That's NPR's Selena Simmons-Duffin.

(SOUNDBITE OF RAPSODY SONG, "ASTEROIDS") Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Selena Simmons-Duffin reports on health policy for NPR.
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