One Texas doctor considers abortion bans to be personal and professional
Austin Dennard, OB-GYN, argues that Texas’s abortion laws are unclear with pregnant fetus and brain complications
On a recent Friday night, as her husband made dinner at the family’s home in Dallas and her toddlers ran around, Austin Dennard saw an email on her phone.
She testified about Texas’s abortion laws in an Austin courtroom last month and the judge reached a decision. Dennard is among 13 women who sued the state arguing that the current abortion bans are unclear when it comes to pregnancy complications. She is also an OB-GYN, and she’s nearing the end of a healthy pregnancy – she was visibly pregnant while on the stand.
“I didn’t anticipate the amount of emotion that was just going to pour out of me when I read it,” she says. I just scrolled through it and cried.
In August of last year she learned that she was pregnant with a fetus that had a fatal condition that prevented its brain and skull from fully developing. She decided to get an abortion on the east coast.
When Texas doctors treat pregnant patients with serious complications that don’t quite fit that definition, they have to choose between intervening early, with the risk they could be charged for violating the abortion ban, and delaying care, with the risk that their patient sues them for malpractice for not providing standard medical treatment.
The Texas Supreme Court’s ruling on an abortion ban for fetus with “incompatible with life” is back in force in the presence of a judge’s eye
“My husband came over and gave me a big hug and he was crying. It felt good. It felt like a victory that you so wanted but never really thought you were going to have to fight for,” Dennard says. “I was reading it through tears, and there’s all this lawyer jargon in it. And so we have Google up, and I’m Googling different terms and we’re trying to really understand the whole thing.”
Dennard thought about the possibility of talking to her OB-GYN patients openly when they are in dire straits. She says it felt validating for a person in power to listen to all of their stories and conclude the law needed to change.
That means the ban on abortions when a fetus has a condition “incompatible with life,” as doctors often deliver the news to patients, is back in force in Texas.
“I went back to clinic and put on my white coat and just started seeing patients again with the same laws that are in place,” Dennard says. “It’s emotional whiplash.”
During the July hearing, Assistant Attorney General Amy Pletscher asked each witness if Attorney General Ken Paxton had personally denied them an abortion. Dennard was the last patient to testify and he said, “You know I never thought to ask him.”
O’Donnell was also present at the hearing in Austin, telling NPR she was there “just to keep an eye on it and watch how it unfolds.” She thinks the laws are clear. “Doctors can exercise reasonable medical judgment; they can provide the standard of care,” she said.
The state of Texas needs to submit a filing for their appeal at the Texas Supreme Court. After attorneys for the plaintiffs are able to file a response, the court will decide if the case should be heard. There’s no set timeline for this to unfold.
OB-GYNs and Pro-Life: The Bounds on Abortion from the Texas Medical Association and Texas Hospital Association
Dr. Thoppil believes that Johnson is a tremendous advocate for women’s health. He’s happy with the new law and thinks it will be helpful. He says the two conditions mentioned are common complications that OB-GYNs see and that the law will help avert some of the heartbreaking circumstances patients have experienced since the bans took effect.
It’s hard to put it all out there in a raw way, and she says that being by some incredibly brave women talking about abortion is even harder.
She says that being a part of the lawsuit has made her happy. She hopes it’s helping to change how people think about abortion restrictions and how they affect people’s lives.
The Texas Medical Association and Texas Hospital Association told NPR that they were present when the bill was signed into law. The National Review quoted Hughes as saying that pro-life groups were present at the signing. It is set to go into effect on September 1.
The assertion that doctors are to blame for uncertainty is false, according to John Thoppil, an Austin OB-gyn and past president of Texas Association of Obstetricians and Gynecologists. If you endanger the patients you care for by using a poorly written original law it is wrong to blame the doctors who are trying to care for them.
The Minor Miracle of a State Senator: Expanding Abortion Access in Texas, a Legislator Gets Creative, Softened Quietly
In the legislature, Johnson says Hughes was a big help in lining up key supporters. “I’m glad that we were able to have honest conversations,” she says. This wouldn’t have happened without the Senate approving it.
The bill passed with bipartisan support in the Senate, and made its way to the governor’s desk by the end of the session. That’s a “minor miracle” according to a blog post by George Christian, senior counsel at the Texas Civil Justice League, who wrote about helping to draft the legislation.
“It happened because of the masterful and discreet way that the bill’s House author, Rep. Johnson, and Senate sponsor, Sen. Hughes, handled things in their respective chambers,” he wrote.
Johnson is aware of that criticism. She says that there are other pregnancies that are not normal. “This is what we can accomplish in this moment. In this moment, we could get agreement on the recognition of ectopic pregnancies.
So a few weeks after the Texas legislative session started at the beginning of the year, she introduced a bill. Doctors were allowed to provide medically necessary services in the past.
Source: To expand abortion access in Texas, a lawmaker gets creative
The Texas Health Department, the Medical Exception, and Pro-Life America can’t Resolve the “Black Letter of the Law,” Rep. Ann Johnson
State agencies or medical groups could not solve these problems according to Rep. Ann Johnson. “You read the black letter of the law,” she says. “When I open the book and it says, ‘Abortion means,’ you don’t get to come later and say, ‘Oh, I really thought abortion meant something else.'”
She stated in her post that the Texas health department, the Texas Medical Board, the Texas Medical Association and the Texas Hospital Association could prevent dangerous situations by educating and providing guidance to doctors. She wrote that the continued silence of the medical, legal and bureaucratic organizations was “unconscionable”.
These stories have concerned even some ardent supporters of the abortion bans. When all obstetricians agree on offering intervention is the standard of care, women are still being hurt unnecessarily, even when there is confusion and refusal to intervene. She works at the Charlotte Lozier Institute, part of Susan B. Anthony Pro-Life America. The Zurawski hearing only had one witness called by the state.
There’s also research on the effects of delaying care. The 28 patients with the early water break were the focus of last year’s study. They were not offered abortions when first diagnosed – instead their doctors waited for the fetal heart to stop or their condition to worsen. Nearly half of these patients developed a serious condition, including 10 who developed infections, five who needed blood transfusions, and one who required a hysterectomy.
The lawsuit claims that confusing language in the medical exception causes hospitals and doctors to delay care and hurts patients. The plaintiffs include 13 patients and two physicians, and they’re represented by the Center for Reproductive Rights. Zurawski developed sepsis, a condition that leads to death, after doctors delayed an abortion.
“If you have a general practitioner or a dermatologist treating psoriasis or rheumatoid arthritis of a 34-year-old woman who has no intentions of getting pregnant, and then she gets pregnant six months later and that pregnancy terminates because of that medication,” that doctor could get charged with a felony, Johnson says.
The laws don’t just affect OB-GYNs, Johnson says, pointing to a recent law that imposes criminal penalties on prescribers of certain medications that can cause abortions. She shows an example of methotrexate being used to treat cancer and autoimmune disorders. It can also be used to treat ectopic pregnancy and for very early medication abortions.
Texas State Representative Ann Johnson represents District 134, which includes the Texas Medical Center. After Texas’s abortion ban took effect her constituency would stop her from walking around.
Texas’s Republican Governor Greg Abbott addressed a rally earlier this year, celebrating the abortion bans that took effect after the Supreme Court overturned Roe v. Wade.
Doctors in Texas, the US’ second-largest state, have said that the state’s abortion bans are unclear with pregnant fetuses and brain complications. Austin Dennard, an OB-GYN, said that doctors in Texas have to choose between intervening early with the risk they could be charged for violating the abortion ban and delaying care, with the risk of their patient suing them for malpractice.