Texas Abortion Law: Ectopic Pregnancy Exemption?

Texas has one of the strictest abortion bans in the US. However, the state's abortion laws do not apply to ectopic pregnancies, which are explicitly allowed and distinct from abortions under Texas law. Ectopic pregnancies occur when a fertilized egg implants and grows outside the uterus, usually in the fallopian tubes, and are non-viable. They are the leading cause of maternal mortality in the first trimester, and if left untreated, they can lead to serious bleeding and even death. Despite the exception for ectopic pregnancies in Texas law, there is still confusion around the topic, and hospitals have been accused of violating federal law by denying treatment to women with ectopic pregnancies.

Ectopic pregnancy treatment is explicitly allowed under Texas law

The Texas abortion law, known as the Heartbeat Bill, prohibits abortions once a fetal heartbeat is detected, which typically occurs around six weeks into a pregnancy. The law includes exceptions for ectopic pregnancies and cases where the pregnant person's life is at risk. However, the language of the law is vague and ambiguous, leading to confusion and differing interpretations. This ambiguity has had severe consequences for patients with ectopic pregnancies, who often require urgent medical attention.

In Texas, ectopic pregnancy treatments are distinct from abortions under the law, and this distinction has been clarified by lawmakers. Ectopic pregnancies are considered unviable and are not considered terminations of pregnancy. However, the lack of clarity in the law, coupled with the severe penalties for violating the abortion ban, has instilled fear in doctors and patients alike. Doctors face the risk of prosecution, hefty fines, and the loss of their medical licenses if they are found to violate the abortion restrictions. As a result, some hospitals and doctors have denied or delayed treatment for ectopic pregnancies, putting patients' lives at risk.

The consequences of these delays can be dire. Ectopic pregnancies are the leading cause of maternal mortality in the first trimester, and any delay in treatment can be life-threatening. Two Texas women, Kyleigh Thurman and Kelsie Norris-De La Cruz, nearly died after being denied treatment for their ectopic pregnancies. By the time they finally received treatment, their pregnancies had ruptured or were near rupture, resulting in the loss of their fallopian tubes and damage to their fertility.

Despite the explicit allowance for ectopic pregnancy treatment under Texas law, the broader abortion restrictions and ambiguous language have created a challenging and confusing situation for both patients and healthcare providers. The severe penalties for violating the abortion ban have led to a climate of fear and uncertainty, with doctors fearing prosecution and patients struggling to access timely and potentially life-saving treatment.

Confusion around Texas abortion laws has led to delayed or denied care

Two women in Texas, Kyleigh Thurman and Kelsie Norris-De La Cruz, filed complaints with the Biden administration, alleging that hospitals violated federal law by denying them treatment for their life-threatening ectopic pregnancies. In Thurman's case, despite her OB-GYN informing the hospital of her probable ectopic pregnancy, she was turned away and only received treatment after her doctor had to plead with the hospital staff. The delay caused her ectopic pregnancy to rupture, and she nearly bled to death, forcing her into emergency surgery where she lost a fallopian tube, compromising her fertility. Norris-De La Cruz had a similar experience, and by the time she received treatment, her pregnancy was near rupture, resulting in the loss of a fallopian tube and most of her right ovary.

The complaints filed by these women allege that hospitals violated the longstanding Emergency Medical Treatment and Labor Act (EMTALA), which mandates hospitals to provide stabilizing care, including abortions, to patients facing emergency medical conditions. The Texas Medical Association has also warned that several hospitals in the state have delayed or denied treatment for ectopic pregnancies, with one physician allegedly instructed not to treat an ectopic pregnancy until a rupture occurred, which can be life-threatening.

The confusion surrounding Texas abortion laws and the fear of prosecution among medical professionals have serious consequences for patients. Delays in care, especially for first-trimester conditions such as bleeding, hemorrhaging, and ectopic pregnancies, can become lethal. The severe penalties and ambiguous language in the Texas abortion laws create a challenging situation for doctors, who may err on the side of caution even if it puts patients at risk.

The Texas abortion laws and their exceptions are not properly understood by medical professionals and the general public, leading to delayed or denied care for women with ectopic pregnancies, a life-threatening condition. The fear of prosecution and the potential for life imprisonment have caused doctors to hesitate or deny treatment, putting women's lives and fertility at risk.

Texas abortion laws and their exceptions are ambiguous and confusing

The Texas abortion law, known as the Heartbeat Bill, prohibits physicians from performing abortions once a fetal heartbeat is detected, which typically occurs around six weeks into a pregnancy. The law includes exceptions to save the mother's life or prevent "substantial impairment of major bodily function." However, the language of the law is ambiguous, and it is not clear if life-threatening or harmful pregnancies explicitly constitute an exception. This ambiguity has led to varying interpretations and confusion among medical professionals, with some hospitals and doctors denying or delaying care for pregnancy complications.

The severe penalties for violating the abortion ban, including criminal prosecution, hefty fines, and the loss of medical licenses, further compound the issue. Medical professionals fear prosecution and are therefore erring on the side of caution, even if it puts patients at risk. This has resulted in delays in treatment for conditions such as bleeding, hemorrhaging, septic miscarriages, and ectopic pregnancies, which can become lethal if not addressed promptly.

The confusion surrounding Texas abortion laws is not limited to ectopic pregnancies and miscarriages. The laws also impact the prescription of certain medications, such as methotrexate, misoprostol, and mifepristone, which are used to treat ectopic pregnancies and other medical conditions. Pharmacies have been reluctant to fill prescriptions for these drugs due to their association with abortion, despite their legitimate medical uses.

The ambiguity and confusion surrounding Texas abortion laws have real-life consequences. There have been reports of women being denied treatment for ectopic pregnancies, resulting in permanent fertility damage and life-threatening situations. The severe penalties and fear of prosecution have created a chilling effect, with doctors becoming increasingly cautious and hesitant to provide treatment, even in cases where it is legally permitted.

The situation in Texas highlights the complexities and challenges of abortion laws and their exceptions. While the intention may be to protect the lives of both the mother and the unborn child, the ambiguous nature of the laws and the lack of clear guidance for medical professionals can have detrimental consequences for those seeking critical medical care.

Texas abortion laws and their enforcement have been criticised by medical and legal experts

Medical experts have raised concerns about the impact of Texas abortion laws on patient care and safety. Dr. Natalie Crawford, an OB/GYN and co-founder of a fertility clinic, has highlighted the importance of timely treatment for pregnancy complications, such as ectopic pregnancies, which can become life-threatening if left untreated. The delay or denial of care due to confusion over the laws can have serious, and sometimes lethal, consequences for patients.

Legal experts, such as Joanna Grossman, a professor at Southern Methodist University's Dedman School of Law, have pointed out the lack of clarity in the statutes, which has led to fear and hesitation among medical professionals. The threat of jail time and six-figure fines has made doctors and hospitals reluctant to provide certain treatments, even when they are legally permitted. This has resulted in patients being turned away or experiencing delays in receiving time-sensitive care.

The American College of Obstetricians and Gynecologists has expressed concern about the impact of Texas abortion laws on patient safety and access to care. They provide information and resources to help patients navigate the complex legal landscape and ensure they receive the care they need.

The National Advocates for Pregnant Women also offer free legal assistance to women who have been charged with a crime related to pregnancy loss or miscarriage, which can occur due to the ambiguous nature of the abortion laws.

The criticism of Texas abortion laws extends beyond the medical and legal communities. In August 2024, two Texas women filed federal complaints against hospitals that denied them treatment for ectopic pregnancies, despite the fact that Texas law allows for the termination of such pregnancies. The severe penalties for violating the state's abortion ban, including fines of up to $100,000 and life imprisonment, have instilled fear in doctors and hindered their willingness to provide care.

The cities of Austin, Dallas, Denton, El Paso, and Houston have enacted resolutions instructing city officials to deprioritize the enforcement of the state's abortion laws. However, anyone violating the abortion laws in these cities remains subject to criminal prosecution and civil penalties. The ambiguous nature of the laws and the severe penalties for violations have created a challenging environment for medical professionals, patients, and city officials, leading to criticism and calls for reform.

Texas abortion laws have resulted in women seeking abortions elsewhere

Texas has one of the strictest abortion bans in the US. The state's abortion laws ban the procedure in most cases, with nominal exceptions to save the mother's life or prevent "substantial impairment of [a] major bodily function". However, the law is written ambiguously, and life-threatening or harmful pregnancies do not explicitly constitute an exception. As a result, some pregnant women are forced to leave the state to seek an abortion elsewhere, with an estimated 35,000 crossing Texas state lines for legal abortions in 2023.

The Texas abortion ban, like those in other states, exempts women who seek abortions from criminal charges. However, the law provides for enforcement through private civil action or under the state's criminal statutes, punishable by up to life in prison, for anyone found to have helped a woman obtain an abortion. The severe penalties for violating the state's abortion ban, which include $100,000 in fines and up to life in prison, have instilled fear in doctors, jeopardising their willingness to provide care.

The threat of jail time and six-figure fines for medical professionals has led some hospitals and doctors in the state to deny or delay care for pregnancy complications. This has resulted in dangerous delays in treatment for conditions such as bleeding, hemorrhaging, septic miscarriages, and ectopic pregnancies, which can become lethal if left untreated.

In August 2024, two Texas women filed federal complaints against hospitals that refused to treat their ectopic pregnancies, despite Texas law allowing doctors to terminate such pregnancies. The complaints allege that the hospitals violated the longstanding Emergency Medical Treatment and Labor Act (Emtala), which requires hospitals to provide stabilising care, including abortions, to patients with emergency medical conditions.

The Texas abortion ban has had a significant impact on women's access to reproductive healthcare and has resulted in women seeking abortions elsewhere, either in other states or through other means.

Frequently asked questions