Grumet: 'On death's door': Texas needs to clarify abortion exception for mother's health

It wasn’t just patients and doctors.

Last fall, Gov. Greg Abbott was saying it, too — that lawmakers this session needed to look at Texas’ abortion laws and “clarify what it means to protect the life of the mother.”

In an October interview with Dallas TV station WFAA, Abbott acknowledged cases of women not getting timely treatment for an ectopic pregnancy or a miscarriage, because the wording of Texas’ abortion bans left some hospitals, doctors and pharmacies worried about violating the law.

“I've even seen some other situations that some women are going through where they are not getting the health care they need to protect their life,” Abbott continued, adding that the legal exception for such cases “must be clarified.”

Yet here we are, just one month left in the legislative session, with no clarity on the maternal health exception to Texas’ abortion laws.

Bills have languished in committee. Nothing is headed for the desk of the governor, who is now silent on the issue.

The inaction is infuriating, considering the stakes are life and death, and Texans overwhelmingly support access to abortion when the mother’s health is at risk.

But among our lawmakers, the zeal to legislate abortion just a few years ago has turned into a reluctance to touch it. Perhaps Republicans have noticed the restrictions they passed are deeply unpopular with half of the state.

Overlooked then and now are the patients who need urgent care when their pregnancies don’t go according to plan.

These are not hypotheticals. A few weeks after Abbott gave that TV interview last fall, I shared the story of Amanda Zurawski, an Austin woman who went into septic shock and nearly died because doctors felt they couldn’t immediately intervene in her failing pregnancy.

“I cannot adequately put into words the trauma and despair that comes with waiting to either lose your own life, your child’s life, or both,” Zurawski said last month, as she and four other women sued over Texas’ abortion laws interfering with the care they needed.

They're asking the courts to do what lawmakers, so far, have not: clarify the "medical emergency" exceptions under Texas' abortion bans.

More: Five women sue Texas, say the state’s abortion ban put their lives and fetuses at risk

How sick is sick enough?

Texas’ laws allow for an abortion if the mother faces a “life-threatening” condition or “serious risk of substantial impairment of a major bodily function.”

But how sick is sick enough? No doctor wants to end up in court to find out, especially since the penalty for violating Texas' abortion law is up to life in prison and six-figure fines.

Since Texas’ trigger law criminalizing most abortions went into effect last year, “we have heard and read horrific accounts from hospitals and doctor's offices across the state about pregnant women in need who are turned away and told to return when their condition worsens,” Rep. Donna Howard told me.

“Physicians have repeatedly told me that, under the current law, they are forced to wait for women to start dying. This is unconscionable,” added Howard, an Austin Democrat who chairs the Texas Women's Health Caucus. “We have had the opportunity to provide clarifications this session, but the Legislature has chosen to ignore the calls from Texas physicians and has decided that the law is fine as it stands.”

Certainly, the governor could have made it a priority. (Abbott’s office did not respond to my inquiries this past week.)

More: With abortion illegal in Texas, Democrats renew push for reproductive health care coverage

Howard and others filed bills on this issue, only to watch them languish in committee without a hearing. (The office of Rep. Stephanie Klick, R-Fort Worth, who chairs the House Public Health Committee, did not respond to my inquiries, either.)

And to be clear: The problems in the law have not gone away.

The threat of criminal prosecution for terminating a pregnancy is especially worrisome to doctors treating patients with complications, said Dr. Kimberly Pilkinton, president of the Texas Association of Obstetricians and Gynecologists. Malpractice insurance does not cover the cost of mounting a criminal defense.

“It's kind of frightening to think that you could be doing the medically best thing for a patient, but have criminal charges brought against you by (someone) who may not understand the entire acute situation that you're dealing with,” she told me.

When will lawmakers act?

Doctors are relying on the guidance of hospital attorneys, and those interpretations of the law can vary from one institution to the next. Pilkinton said she’s heard of doctors transferring their patients from one hospital to another so they can provide the needed care.

In a piece published last year in the New England Journal of Medicine, University of Texas researchers said multiple doctors reported sending home patients who were experiencing a miscarriage, only to see them return with signs of sepsis.

A patient whose water broke at 19 weeks, well before the fetus could survive outside the womb, told UT researchers she flew to another state to get her pregnancy terminated. She knew getting on a plane in her condition was dangerous, but “it was still the safer option for me than sitting in Texas and waiting, and I could potentially get sicker,” she said.

More: Kamala Harris decries Texas actions to ban abortion after Supreme Court ends Roe v. Wade

Another specialist told UT researchers, “People have to be on death’s door to qualify for maternal exemptions” to Texas’ abortion laws.

At some point that could be someone you care about. A sister. A daughter. A friend.

There is no reason for them to suffer under abortion laws that, at least in theory, weren’t supposed to put mothers’ lives at risk. Even Abbott — a former state attorney general and Texas Supreme Court justice — recognized last year that the law “must be clarified.”

Texas lawmakers have the power to fix it. They’re running out of time and excuses not to.

Grumet is the Statesman’s Metro columnist. Her column, ATX in Context, contains her opinions. Share yours via email at bgrumet@statesman.com or via Twitter at @bgrumet. Find her previous work at statesman.com/news/columns.

This article originally appeared on Austin American-Statesman: Texas Legislature running out of time to clarify abortion laws