Grumet: Ever so quietly, Texas tinkers with abortion bans to protect patients' lives

Imagine, as governor, you signed a bill to protect patients and ensure doctors could deliver life-saving care. A humble brag would be in order.

At a minimum, you’d tout the measure on social media. Maybe you’d issue a press release or livestream a signing ceremony alongside the very people who needed this law, because, without it, some Texans suffered harrowing experiences.

But we got none of that with House Bill 3058. The Legislature passed the bill with scant discussion near the end of the regular session, and Gov. Greg Abbott quietly signed it last month.

It’s almost like they didn’t want to draw attention to the fact that Texas’ abortion bans needed to be fixed — even though Abbott had acknowledged last year that some women “are not getting the health care they need to protect their life,” and polls show more than 80% of Texans support access to abortion when the mother’s life is endangered.

“It was navigating a minefield just to accomplish something the vast majority of Texans support,” said Rep. Donna Howard, D-Austin, one of the bill’s co-sponsors.

HB 3058 isn’t a total solution, but a notable first step. It shores up legal protections for ending pregnancies in two specific situations: ectopic pregnancies, when a fertilized egg implants outside the uterus; and premature rupture of membranes, when a mother’s water breaks early in the pregnancy, before the fetus can survive outside the womb.

In theory, Texas law already says it’s not an abortion to end an ectopic pregnancy, which will eventually rupture and threaten the mother’s life. As I reported last year, however, some pharmacies had refused to fill doctor-ordered prescriptions for drugs to end ectopic pregnancies, fearing criminal penalties or lawsuits under Texas’ abortion bans.

Meanwhile, numerous expectant mothers have developed serious infections when their water broke months early — dooming the pregnancy — but doctors felt like they couldn’t intervene because fetal cardiac activity was still present.

That was the story of Amanda Zurawski, an Austin woman who nearly died last year as a much-wanted pregnancy unraveled. She had to wait three days to become sick enough to qualify for the life-saving exception to Texas’ abortion bans.

Her plight was no anomaly. Since Texas’ first abortion ban went into effect, patients with failing pregnancies are nearly twice as likely to suffer serious health complications, according to a study at two Dallas hospitals last year. All but two of the patients in that study needed treatment for premature rupture of membranes, just like Zurawski.

I wondered what Zurawski thought of HB 3058. After all, passing a new law for patients in her situation was a tacit acknowledgment that existing state laws had failed them.

But she was disappointed by the limited scope of HB 3058. Zurawski stands alongside 14 other plaintiffs who have sued Texas because abortion bans interfered with essential care for pregnancy complications. Many of those complications, such as severe fetal abnormalities, are not addressed in HB 3058.

“They had this opportunity to do something major and really help, and they didn’t,” Zurawski said.

She also bristled at the idea of Texas law enumerating which specific conditions qualify for life-saving care for the mother.

“You shouldn’t have to deserve health care in this country,” she said. “And that’s what they’re making it feel like.”

Howard had proposed a different bill that would have allowed doctors to provide the care they deem necessary to any patient suffering a pregnancy complication. That measure didn’t even get a hearing in committee.

Rep. Ann Johnson, a Democrat whose Houston district includes the Texas Medical Center, tried a different approach with HB 3058, threading the needle between various advocacy groups. The bill doesn’t create exceptions to the abortion bans. But it says doctors can successfully defend themselves in court if they were providing care for ectopic pregnancies or premature rupture of membranes.

It doesn’t cover every scenario. But it allows doctors “to care for patients in difficult situations without as much fear of breaking laws or being criminalized for offering evidence-based, compassionate care for patients in Texas,” said Dr. Kimberly Pilkinton, president of the Texas Association of Obstetricians and Gynecologists.

Pilkinton’s predecessor, Dr. John Thoppil, also said he feels better with HB 3058 on the books.

“I am comfortable with this language that I could do what is in my medical judgment, the right thing to do in this scenario,” said Thoppil, who has his own Austin-based practice and chairs the OB/GYN department at St. David’s North Austin Medical Center.

“But,” he added, “we are hoping for further progress on this issue.”

The governor’s office did not respond to my questions about this bill, including whether Abbott believes more work is needed to protect care for mothers when a pregnancy falls apart.

This isn’t a question of elective abortions, a matter that deeply divides Texans. This is a question of protecting mothers in cases where their pregnancies cannot be saved — allowing doctors to intervene before the patient's own life hangs in the balance. Texas laws are making progress in better acknowledging these cases. But what a pity it can only happen quietly.

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: Grumet: Texas quietly tinkers with abortion bans to protect patients