In a devastating blow to reproductive rights, the Texas Supreme Court on Monday night overturned an earlier ruling that had granted a woman named Kate Cox the right to an abortion due to severe medical complications. Cox, 31, was 15 weeks pregnant when she received the shocking news that her baby had been diagnosed with trisomy 18, a chromosomal abnormality that leads to life-threatening medical issues.
Doctors told Cox that continuing the pregnancy put both her life and long-term fertility at grave risk. However, under Texas’ restrictive abortion bans enacted after the fall of Roe v. Wade, doctors are prohibited from performing abortions except in medical emergencies. Cox filed an emergency lawsuit last week pleading for an exemption so she could terminate the nonviable pregnancy, but the Texas high court ultimately denied her plea in a ruling issued late Monday.
“The court acknowledged Ms. Cox’s extremely complicated pregnancy but said some serious pregnancy difficulties still do not meet the criteria for Texas’ limited medical exemption,” said reproductive rights lawyer Nancy Northup in a statement. “This legal rollercoaster has been devastating for Ms. Cox.”
A Rare Glimpse Into The Harrowing Realities Of Banning Abortion
Cox’s wrenching petition for basic healthcare peeled back the curtains on the harrowing realities now facing Texans after the elimination of their right to abortion access. It offered rare insight into the confusion and obstacles people endure while navigating the state’s byzantine, medically-questionable abortion restrictions.
Cox’s case vividly demonstrated how Texas’ vague and inconsistent exemption standard fails vulnerable pregnant people by leaving life-or-death abortion decisions to the whims of judges rather than doctors. It also showed how subjecting private medical choices to court proceedings takes a severe emotional and physical toll on patients needing urgent care.
Most poignantly, Cox’s denied petition shattered assumptions that abortion bans only affect hypothetical situations instead of real people confronting actual pregnancies gone horribly wrong. Cox laid bare the false promises that “life of the mother” exceptions would prevent blanket abortion bans from causing irreparable harm in cases like hers.
Woman Forced To Flee Texas While Battling Critical Pregnancy Complications
Exhausted from the prolonged legal fight and rapidly declining health, Cox ultimately fled Texas this week to obtain an abortion out-of-state. However, most people lack the means and mobility to escape a state denying them essential medical services.
Cox implored the Texas Supreme Court to still issue a decision for the sake of setting vital precedent, even though obtaining immediate care preempted further appeals.
“We will proceed with Kate’s case because the devastating issues she has endured could easily repeat for other Texas women under the state’s radical abortion bans,” said Cox’s ACLU lawyer, Molly Duane. “Kate’s nightmare spotlights how these laws threaten people’s basic rights, dignity and power to determine their own futures.”
Doctors: Pregnancy Posed “Severe Threat” To Woman’s Health
In pleadings, Cox said physicians stressed that continuing the pregnancy posed a “severe threat” to her physical and mental health, potentially causing permanent harms.
Cox already endured two previous cesarean sections, her lawyers said, putting her at heightened risk of life-endangering complications if forced to have another major abdominal surgery to deliver a dying fetus. Moreover, they said an induction abortion offered the best chance of preserving Cox’s fertility after losing the nonviable pregnancy.
“I desperately want the opportunity to have more children,” Cox told the court. “I want access to the medical care that gives me the best chance at another baby.”
Doctors further warned Cox that carrying to term could mean delivering a stillborn baby, watching the newborn die in her arms, or seeing the infant languish on life support before inevitably passing away.
“I do not want my baby to arrive in this world only to watch her suffer a heart attack or suffocation,” Cox said.
Texas AG: “I Don’t Care If Doctors Say Pregnancy Could Kill You”
Shockingly, Texas Attorney General Ken Paxton filed a brief dismissing Cox’s doctors’ warnings that continuing the doomed pregnancy jeopardized her safety and future child-bearing ability.
Essentially, Paxton argued that imminent threats to a woman’s health and fertility should not qualify as legally-permitted reasons for abortion under Texas law. Put simply, Paxton told the state’s highest court: “I don’t care what Ms. Cox’s physicians say, she should be forced to stay pregnant even if it kills her.”
Reproductive rights advocates condemned Paxton’s stance as an open admission that Texas lawmakers value theoretical embryos over the life and wellbeing of living, breathing women with families dependent on them.
“Ken Paxton is aggressively arguing that no amount of pregnancy-related suffering or long-term harm should justify abortion for Texas women under the state’s radical new vision of so-called ‘pro-life’ policymaking,” said CRR President Nancy Northup.
“According to Texas’ top legal officer, doctors should be overruled, pregnant patients silenced and basic healthcare denied even when physicians warn that their patient could lose essential bodily functions, future fertility or – most shockingly – their very life due to pregnancy complications.”
Court Cites Doctors’ Discretion Despite AG’s Arguments
In the ruling against Cox, the all-Republican Texas Supreme Court technically contradicted Paxton by acknowledging that doctors retain medical discretion over abortion decisions. However, the unsigned opinion failed to explain why Cox’s physicians deserved to have their emergency determination dismissed.
“The law leaves abortion decisions to doctors using reasonable medical judgment given each patient’s unique situation,” the court declared. Yet in the next breath, it allowed politicians rather than practitioners to decide Cox’s case.
Reproductive rights advocates called out Texas courts for hypocritically claiming to empower doctors while judges overturn those very doctors’ expert opinions when politically inconvenient. They say that charade proves Texas bans serve an ideological agenda rather than sound medicine.
”Legal Rollercoaster From Hell”: Critics Decry Courts Politicizing Pregnancy Emergencies
Throughout Cox’s gutting legal saga, politicians repeatedly inserted themselves into wrenching private dilemmas playing out in doctors’ offices. Critics argue Texas essentially compelled a vulnerable pregnant patient battling critical health issues to wage a public court fight just to vindicate her physicians’ medical advice.
“This past week of legal limbo has been a hellish ordeal for Ms. Cox,” said Nancy Northup of the Center for Reproductive Rights, which represented Cox. “Her health hung in the balance while her private agony became a public spectacle against her will.”
With Cox forced to flee Texas just to follow her doctors’ orders, Northup said her case proved that theoretical abortion ‘exceptions’ fail in reality.
“While Ms. Cox had the means to escape Texas’ radical new anti-choice regime, most women don’t and would essentially face mandated pregnancy that could kill them.”
Courts Called Out For Skirting Accountability By Issuing Non-Binding Ruling
Even after Cox already left Texas to have an abortion out-of-state, her lawyers implored the state’s Supreme Court to still issue a substantive ruling that could guide future abortion cases. Instead, the court handed down a non-binding opinion scolding the lower-court judge who originally ruled in Cox’s favor.
The unsigned ruling admonished the Austin judge for supposedly failing to give proper weight to the state’s sweeping bans. But the court declined to meaningfully instruct lower courts how to interpret Texas’ concerningly vague “medical emergency” exception standard moving forward.
“Essentially, the Texas Supreme Court wants to have its cake and eat it too,” said University of Houston constitutional law professor Dana Boyd. “The justices still got to signal their political opposition to abortion rights to conservative voters. But by not setting firmer precedent, they also shielded themselves from some accountability for the disastrous implications of denying Ms. Cox’s plea.”
ACLU attorney Molly Duane agreed. “The court seems more concerned with blaming reasonable judges for granting abortions than providing meaningful guidance to prevent the healthcare denials endured by Ms. Cox from recurring,” she said.
