A bill filed in the state Legislature could address doctors' concerns that the medical exception to Texas’ abortion ban lacks clarity. The development follows reports of delayed care that has led to higher rates of sepsis in pregnant women and even death in some cases.
Senate Bill 31, also known as the Life of the Mother Act, has the support of the Texas Medical Association, a trade nonprofit that advocates for physician interests. Dr. Zeke Silva, a San Antonio radiologist who serves as chair of TMA’s council on legislation, said the bill would make a difference when caring for women with complicated pregnancies.
“TMA has been involved in the drafting of this bill," Silva said, "and we think that this bill provides important clarifications for physicians caring for these patients."
Treatment without delay
SB 31 was filed by Republican Sen. Bryan Hughes, who also authored the 2021 legislation that created a six-week abortion ban in Texas. After Roe v. Wade was overturned in 2022, an additional law was triggered that made abortion illegal from conception. Under these overlapping bans, abortion is legal only when the life of the mother or a “major bodily function” is at risk. Doctors who provide an abortion in violation of these laws face significant fines, prison time and the loss of their medical licenses.
Doctors have long said the definition of what constitutes a medical emergency is ambiguous, stymying their ability to give appropriate medical care. Last year, after ProPublica reported the stories of several women who died during emergencies that were attributed to confusion about the law, more than 100 Texas OB-GYNs signed an open letter urging state lawmakers to make changes.
The new bill clarifies that doctors would not have to delay or withhold an abortion or other medical treatment if doing so would increase the pregnant woman’s risk of death or impairment. If passed, this language would reinforce existing guidance from the Texas Medical Board.
"Sometimes providers felt like they had to wait on certain situations. Like, just how sick was mom, you know, and was she bleeding enough? Was she septic enough?" Dr. Todd Ivey, Houston OB-GYN
Dr. Todd Ivey, a Houston OB-GYN who has been a vocal advocate for efforts to clarify the laws, said this provision would help doctors to “act swiftly and not hesitate.”
“Sometimes providers felt like they had to wait on certain situations," he said. "Like, just how sick was mom, you know, and was she bleeding enough? Was she septic enough?”
Ivey said this provision should also allow doctors to care more effectively for women with life-threatening conditions like cancer.
The bill also strengthens protections for doctors treating ectopic pregnancy and PPROM, or premature water breaks, by broadening the definition of those conditions. And it says that conversations doctors have with colleagues or their patients while determining if abortion is the right course of treatment can’t be considered as “aiding and abetting” an illegal abortion under the law.
Dr. Julie Ayala, an OB-GYN in Tyler, said she believed this provision would allow her to discuss all medical options with patients – including those who might be dealing with a lethal fetal condition.
“Previously ... if they had some sort of anomaly or medical condition and they desired to seek care out of state, it was all on them. They just got the worst news of their life, and now they're trying to Google where they can get care,” Ayala said. “Us being able to give an appropriate handoff not only takes a lot of unnecessary pressure off of patients, but also keeps our patients safe.”
The doctors KUT spoke with all agreed the Life of the Mother Act is a good first step. Ivey said he also wanted to see additional exceptions introduced in future legislation for cases of rape, incest and lethal fetal anomalies.
Spreading the word
Previous attempts by Democrats to adjust the state's abortion laws have not gained traction in the Republican-dominated Legislature, and attempts to clarify the law through lawsuits and appeals to the Texas Medical Board have met limited success.
But 12 Republican senators — and one Democrat — have now joined Hughes as co-authors of the bill, and Lt. Gov. Dan Patrick has identified it as a priority. A duplicate House bill, filed by Rep. Charlie Geren, R-Fort Worth, lists both Republicans and Democrats as co-authors.
If SB 31 passes as written, the Texas Medical Board would have to begin offering a course that would teach doctors about their rights under the law.
Ayala said this requirement would ensure doctors across Texas are up-to-date. She noted a 2024 study from Manatt Health that found 29% of Texas physicians say they don’t have a clear understanding of the state’s abortion laws.
“I think without comprehensive education, there are at least a third of physicians that won't even know that there have been further clarifications, that there have been exceptions made, and that they will keep practicing in fear,” she said.
Likewise, Dr. Emily Briggs of New Braunfels said spreading word about these potential changes throughout the medical community would be key – not just to ensure folks understand the law, but also to encourage doctors and medical students who are currently reluctant to practice in Texas.
“If we can show that we are moving in a direction that is more medically appropriate, we can try to get those physicians in training to see, 'No, please give us just a moment. Let us clarify these things. Come and get your education here, keep your families here. Let's make Texas as strong as possible, so that we can have that excellent care provided locally.'"
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