Overview of Texas Campaign for Mothers

• Currently, there are two abortion bans in practice in Texas put in place in 2021 and 2022.

1. 1. Human Life Protection Act: This is Texas’ most restrictive abortion law, prohibiting all terminations from the point of conception, except for a “life-threatening physical condition” to a mother that “poses a serious risk of substantial impairment of a major bodily function.” This “trigger ban” took effect in August 2022, when the US Supreme Court overturned Roe v. Wade. Medical professionals found in violation face criminal, professional, and civil penalties including a minimum $100k fine, medical license revocation, and up to life in prison.
   2. Texas Heartbeat Act: Widely referred to as SB 8, the Heartbeat Act prohibits abortions once fetal heartbeat is detected and includes exceptions for “medical emergencies.” Violations of SB 8 are not punishable as crimes, but rather enforced by a civil bounty-hunter enforcement scheme (vs government action) which allows private citizens (whether or not they have a connection to the patient) to bring lawsuits against medical providers and anyone who “aids and abets” an illegal abortion. Successful plaintiffs are eligible for a minimum $10k reward, court costs, and attorney’s fees. This law went into effect in Sept. 2021, but other than its civil enforcement action, has been effectively trumped by the trigger ban from conception.

Together, the trigger ban and SB 8 create an abortion ban from conception. The only exception is when the mother’s life is in danger; however, the law’s ambiguity makes it challenging for physicians to determine how dangerous the situation must be to ensure they will not be penalized for terminating a pregnancy. Neither law provides exceptions fatal fetal abnormalities, rape, or incest.

• In May 2023, in response to complaints from medical professionals, patients, and community leaders about the law’s lack of clarity, the Texas Legislature passed HB 3058 which provides medical professionals an affirmative defense if they perform a medical abortion in the case of two specific pregnancy complications: (1) ectopic pregnancy and (2) preterm premature rupture of membranes (PPROM). However, the law does not cover additional medical emergencies that might require a pregnancy to be terminated as outlined by evidence-based medicine.
• Across all Texas abortion laws, a pregnant woman is explicitly exempt from liability and prosecution.

• Both the Human Life Protection Act and the Texas Heartbeat Act include exceptions for “medical emergencies” where physicians, in the exercise of their reasonable medical judgment, determine that a pregnant woman is suffering from a “life-threatening physical condition” that unless the abortion occurs, is at risk of death or “substantial impairment of a major bodily function.” 
• These laws do not clearly outline what qualifies as a “medical emergency,” “life-threatening,” or “substantial impairment,” nor do they define “major bodily function,” which makes it very difficult for medical professionals to properly provide care to pregnant women with serious medical complications. This ambiguity endangers the lives of Texas mothers because physicians, amidst this uncertainty and the threat of life in prison, may delay or deny care because they are unsure if the patient indisputably qualifies. Furthermore, many hospitals, fearing legal liability amidst the law’s ambiguity, have increased restrictions on when they allow a physician to terminate a pregnancy, putting women at risk of undue medical complications.

• Current laws have interfered with critical health care for pregnant women, including life-saving treatment for pregnant mothers diagnosed with cancer or other health issues, the choice to terminate a non-viable twin to save the life of a healthy twin, and physicians’ ability to provide full information to pregnant mothers about their health care and to treat them with longstanding, safe, and medically recognized standards of care. The fear of prosecution for “aiding and abetting” has had a detrimental impact not only on physicians’ ability to provide full information to their patients about their health care, but it has also created fear in medical staff in supporting physicians in medically necessary terminations, often leading to dangerous delays in care.   
• We’ve seen disturbing reports of the tragic deaths of Josseli Barnica, Nevaeh Crain, and Porsha Ngumezi, three Texas women who died from delayed emergency pregnancy care. News of these deaths sparked outrage across Texas with calls to amend state reproductive health laws to prevent any further loss of life. 
• On the Brink, ABC’s documentary on Hulu which includes the heartbreaking stories of six Texas women with pregnancy health complications, provides a comprehensive portrayal of the impact of these laws on women who want to have babies and build their families. Similarly, the documentary film Zurawski v Texas, powerfully spotlights three plaintiffs of the groundbreaking lawsuit brought on behalf of Texas women denied critical medical care while facing serious pregnancy complications. 
• Most of us Texans watched the Texas Supreme Court deny Kate Cox the right to terminate her non-viable pregnancy, forcing her to leave the state to receive treatment. This, and other alarming stories, are described on our website’s “Stories” page.

No. In fact, Texans overwhelmingly support exceptions when there is serious endangerment to a woman’s health (85%), in cases of rape and incest (80%), and when there is a strong chance of serious birth defects (73%). Even 75% of Texas Republican primary voters favor modifying state abortion laws to (1) add exceptions for rape, incest, and fatal fetal abnormalities and (2) eliminate severe penalties for medical providers who treat women with pregnancy complications. It is paramount that Texans know their rights and that legislators hear the voices of their constituents and act upon them. Texas Campaign for Mothers hopes to facilitate both for the greater good of women’s health and for Texas’ medical landscape. As a growing state in terms of business and population, it’s vital that Texas medical practitioners be able to provide the highest level of care to their patients so that the state can continue to attract new industries.

• Confusing and redundant Texas laws force doctors into impossible situations where they must choose between complying with the law – which could result in a malpractice suit – or providing the best care for their patients – and risk life in prison. Under current laws, medical professionals face serious legal risks, including minimum $100,000 civil penalties, civil suits by strangers with no connection to the patient (the “Texas bounty hunter law”), loss of medical license, and criminal penalties, up to 99 years in prison. Even with a weak claim, physicians could be required to spend thousands of dollars and countless hours defending themselves, none of which is covered by medical malpractice insurance. The legal environment in place creates ethical dilemmas for physicians, compromises the quality of medical education, and delays care in cases of immediate risk.
• Understandably, these risks are significantly deterring skilled healthcare providers from practicing in Texas because the laws as currently written limit their ability to offer safe, comprehensive care that prioritizes patient needs. A recent study surveying ~450 Texas OB-GYNs on the impact of state reproductive health laws found that:

• • 76% believe they cannot practice according to evidence-based medicine.
  • 60% fear legal repercussions from practicing evidence-based medicine.
  • 21% have thought about or are planning to leave Texas to practice in another state.
  • 13% are planning to retire early. 
  • 10% have already left Texas or are leaving their obstetrics practice or medicine altogether.

• The unintended consequences of these laws pose a great threat to our state’s economic, intellectual, and health outcomes. Since these laws went into effect:

• • Texas’ maternal mortality rate has increased 56% vs. an average 11% increase in other states.
  • Texas’ infant mortality has increased by a staggering 13% vs. 1.8 for the rest of the US.
  • The rate of sepsis, a life-threatening infection, has increased 55% in second trimester pregnancy loss hospitalizations.
  • Texas saw a 16% decrease in applications to OB-GYN residency programs and a 12% decrease across all specialties during the 2023-2024 application cycle.
  • Texas is seeing a dangerous exodus of medical providers as evidenced by a recent Texas OB-GYN workforce study which found that of the physicians surveyed, 21% have thought about or are planning to leave Texas to practice in another state, 13% are planning to retire early, and 10% have already left Texas or are leaving their obstetrics practice or medicine altogether.
  • 66% of “top talent” (adults ages 18-64 with a college degree who are working full time or looking for full-time work) says the Texas abortion ban would discourage them from working in the state.
• Our state cannot afford these negative impacts, especially the loss of quality medical providers as 47% of Texas counties are already maternal care deserts and 60% of rural Texas hospitals lack obstetric care due in part to a lack of physicians.