Texas’s “Life of the Mother Act” Is an Abortion Ban in Sheep’s Clothing
As an abortion provider living in Texas, I can confidently say that this bill will not help me save additional lives.
Pro-choice supporters rally for reproductive rights at the Texas Capitol on May 14, 2022.
(Photo by Montinique Monroe / Getty Images)
The Texas legislature is rushing to pass several dangerous anti-abortion bills this week, including the so-called “Life of the Mother Act” (HB 44 and SB 31). As a board-certified ob-gyn, a board-certified complex family planning specialist, a mother, a Texan, and an abortion doctor, I want to be very clear: I oppose this bill.
Currently, Texas has multiple criminal abortion bans with narrow exceptions for medical emergencies and life endangerment. These abortion bans have caused a chilling effect for physicians across the state, not only causing delays and denials of “legal” abortion care, but also obscuring timely decision making for miscarriages, ectopic pregnancies, and even molar pregnancies. This has led to soaring sepsis rates, increased maternal morbidity, and even several deaths.
While offered as a bipartisan “fix” to the multiple confusing abortion bans in Texas right now, these bills fall short of actually helping Texans and instead present real harms—including beyond the state’s borders. We’ve seen time and time again that the tactics used by the Texas legislature are a blueprint for anti-abortion politicians across the country. Make no mistake: What happens in Texas does not stay in Texas. If this bill goes into effect, neighboring states will similarly open up their communities to ongoing harm. We must stop these continued attacks in our name by taking mass action against the passage of this legislation.
No matter where people live, they deserve timely medical care and healthcare providers who are unafraid to provide that care. Bills like this one don’t get us closer to that reality.
On the surface, HB 44 may sound like a step in the right direction. In many ways, it’s a response to demands from patients and advocates for clarification on the state’s medical emergency exception in its abortion bans. And, the Democratic coauthors of the bill claim that it clarifies language that will help doctors like me save lives. However, the legislation falls far short of that. In fact, HB 44 is simply a political word game that everyday Texans cannot afford to play.
HB 44 continues to require physicians to decipher convoluted, nonmedical terminology to determine if the emergency abortion they are providing falls within the legal exceptions. Even if the physician assesses that the abortion is legally permitted by the bill, research from me and my colleagues in Texas shows that hospitals routinely overinterpret abortion bans, exacerbating the chilling effect of the laws.
As one of the few physicians in Texas who actually applies these laws to clinical practice in order to provide that life-saving abortion care, I can confidently say that this bill will not help me save additional lives.
While legislators argue that striking out the words “life threatening” in one sentence but keeping “places the female at risk of death” in the next is a substantive change, quibbling over definitions is a distraction. People’s lives are truly on the line. The harm of HB 44 lies in its amendment of a century-old abortion ban.
Along with Texas abortion funds, I sued Ken Paxton and other prosecutors in 2022 for trying to enforce that century-old abortion ban. We won. In our injunction, the judge found that the bill was repealed by implication and could not be enforced. But by amending the 100-plus-year-old statute, HB 44 resurrects and legitimizes that dead ban. In doing so, it paves the way to criminalize abortion funds (which patients rely on to access the care that they need), abortion support networks (which assist in providing practical support for patients, particularly those traveling long distances for care), doctors that provide abortion information (like me), and everyday people who need abortions and the families who support them.
This bill will not help me provide abortion care for a pregnant 11 year-old in Texas. But HB 44 will criminalize me for making a referral for that 11-year-old to obtain an abortion out of the state. It criminalizes the 11-year-old’s parents for driving her out of state for that abortion. It criminalizes abortion funds for financially assisting with travel and medical care. It even criminalizes the 11-year-old for “procuring the means” to an abortion.
Ken Paxton has already said that he plans to use pre-Roe abortion prohibitions to force prosecutions. That should tell you everything you need to know about whether this bill can “fix” Texas’s maternal healthcare crisis.
Still, some pro-choice legislators are championing this bill in the hope that it will relieve the suffering of the people I care for every single day. Unfortunately, the lives entrusted in my care cannot hinge on the hopes and promises of politicians. The facts remain: Doctors who provide abortion care across Texas oppose this bill because it will further harm the communities we serve. The American College of ob-gyns oppose this bill because we have decades of evidence that even well-meaning “exceptions bills” don’t work. Abortion patients, like the plaintiffs in Zurawski v. Texas—who sued the state in order to gain clarification on the state’s medical emergency exception—oppose this bill because it would not alleviate the devastating harms they experienced. Abortion rights lawyers in Texas and nationally oppose this bill because of the cascading legal harm it will cause in Texas for anyone seeking abortion care. Abortion funds in Texas oppose this bill because it is poised to immediately shut down their work helping tens of thousands of people travel across state lines to access abortion care.
If the legislators want a solution, they should oppose or, at the very least, amend the bill to make clear that this 100+ year-old law cannot be used against the people we are intending to protect.
Writing this piece is difficult, because many pro-choice legislators will be upset that an experienced Texas abortion doctor and staunch abortion advocate opposes their bill. Some will say we should take what little we can get because we are in Texas, which was one of the first states in the country to begin fully banning abortion, in 2021. But I’m an ob-gyn who has dedicated my career to providing abortion care for Texans: I don’t beg for crumbs at the expense of my community.
Those seasoned in political work will advise that dissent with allies should be kept private, so they won’t be mad at us in the future. But I’m a Texas abortion doctor who unwaveringly serves her community; politicians will always be mad at me. Pro-choice legislators will implore that they are on our side, and this is how you play the game. Ultimately, my side is always the people I care for: people who need abortions.
I invite every person who cares about pregnant Texans to contact local legislators and ask them to oppose or amend HB 44 and SB 31. There isn’t a moment to waste.
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