Texans' Abortion Law: A Complex Emotional Divide

The abortion debate in Texas has been a highly contested issue, with the state implementing some of the most restrictive abortion laws in the nation. Texas law prohibits abortions once a fetal heartbeat is detected, which is usually around six weeks into a pregnancy, and criminalizes anyone who performs or aids in the procedure. This has sparked heated debates and legal challenges, with the Supreme Court being asked to intervene in cases where emergency abortions are necessary to save the life of the mother. While the Supreme Court has declined to hear some of these cases, the impact of the abortion ban in Texas has been significant, with a spike in births and a maternal mortality rate that has increased by 56% since the ban took effect.

The impact of Texas abortion restrictions on birth rates

Texas's abortion restrictions have had a significant impact on birth rates in the state. The state's abortion law, which prohibits physicians from performing abortions once a fetal heartbeat is detected, effectively banning most abortions after six weeks of pregnancy, has led to an increase in births and infant deaths in Texas.

The law, which went into effect on September 1, 2021, has faced legal challenges and sparked heated debates across the nation. One of the main concerns with the law is the lack of clear exceptions for medical emergencies, which has left doctors unsure of when they can legally perform an abortion. This has had life-threatening consequences for pregnant women, as highlighted in the case of Kelsie Norris-De La Cruz, who was denied care for an ectopic pregnancy, a life-threatening condition, and had to wait for her situation to worsen before receiving treatment.

The impact of the abortion restrictions on birth rates is evident in a study by researchers from the Johns Hopkins Bloomberg School of Public Health, which estimated that the abortion ban was associated with 9,799 additional live births in Texas between April and December 2022. The study also found that the number of abortion procedures decreased by 38% in the month after the ban went into effect. This suggests that many pregnant individuals in Texas were unable to overcome the barriers to abortion access, resulting in an increase in births.

The Texas abortion restrictions have also had a significant impact on infant mortality rates. A study by researchers from the same institution found that infant deaths in Texas increased by 12.9% in the year following the abortion ban, compared to a 1.8% increase in the rest of the United States during the same period. Congenital anomalies, or birth defects, were the leading cause of infant death, with a 22.9% increase in Texas compared to a 3.1% decrease in other states. These findings suggest that the abortion ban has had devastating consequences for pregnant people and their families, as they are forced to continue with unwanted or unsafe pregnancies.

The impact of the Texas abortion restrictions on birth rates highlights the unintended consequences of restrictive abortion policies and the importance of access to safe and legal abortion services. While supporters of the abortion ban in Texas may view it as a pro-life measure, the increase in infant deaths and the trauma inflicted on families underscore the need for clear and compassionate abortion laws that prioritize the health and well-being of pregnant individuals.

The Texas Heartbeat Bill

The bill was signed into law by Texas Governor Greg Abbott, who stated:

> "Our creator endowed us with the right to life and yet millions of children lose their right to life every year because of abortion. In Texas, we work to save those lives."

The bill sets out a civil penalty of $10,000 for anyone performing an abortion after a fetal heartbeat is detected, as well as court costs and attorney fees. It is important to note that there is no criminal penalty for this offense. The bill also includes provisions that prevent the government from enforcing or attempting to enforce the law, which is intended to help the law withstand constitutionality challenges.

The Biden administration's stance on abortion

The Biden administration has taken a strong stance against the restrictions on abortion rights in Texas and other states. After the Supreme Court overturned Roe v. Wade in June 2022, President Biden and his administration issued guidance to protect access to abortion, particularly in emergency medical situations. They asserted that the Emergency Medical Treatment and Labor Act (EMTALA) mandates emergency abortion care to save a pregnant woman's life or prevent serious harm to her health.

The Biden administration's guidance reminded healthcare providers of their obligations under EMTALA to ensure hospitals offer emergency care to stabilise patients, regardless of their ability to pay. This includes providing abortions if necessary to resolve a medical emergency, even in states like Texas, with strict abortion bans. The administration argued that EMTALA takes precedence over state abortion bans and penalised hospitals that did not comply with up to $120,000 per violation.

However, Texas and two anti-abortion medical associations sued the administration, arguing that the guidance unlawfully compelled healthcare providers to perform abortions. A US district judge blocked the enforcement of this guidance in Texas, and the Supreme Court declined to intervene, leaving the lower court's ruling in place. Despite this setback, the Biden administration has continued to defend abortion rights and protect access to reproductive healthcare. They have issued multiple executive orders and taken other actions, such as defending FDA approval of medication abortion and supporting access to reproductive healthcare for veterans and service members.

The Biden-Harris administration remains committed to defending reproductive rights and ensuring that women in every state have access to abortion and reproductive healthcare services. They have called on Congress to restore the protections of Roe v. Wade and taken executive action to protect access to abortion and contraception.

The Texas Supreme Court's ruling on abortion

The Texas abortion law prohibits physicians from performing abortions once a fetal heartbeat is detected. The Texas Heartbeat Bill became state law with a trigger in place that subjected it to a Supreme Court ruling which has now effectively enabled it. This legislation went into effect on September 1, 2021, sparking heated debates and legal challenges.

On May 31, 2024, the Texas Supreme Court issued its ruling in Zurawski v. State. In Zurawski, twenty women and two doctors claimed that the Texas abortion law's restrictions caused significant harm by stopping doctors from performing medically necessary abortions. In August, a judge in Travis County issued a temporary injunction. This injunction allowed Texans with complicated pregnancies to get abortions if their doctor believed it was necessary. However, the Texas Attorney General's Office appealed this decision, leading to the Texas Supreme Court's review. The Attorney General argued that the high bar set by Texas for qualifying for an abortion is constitutional. The plaintiffs' lawyers countered that the law's vague language leaves doctors unsure of when they can act, endangering women's lives.

In its opinion, the Texas Supreme Court wrote:

> Texas law permits a physician to address the risk that a life-threatening condition poses before a woman suffers the consequences of that risk. A physician who tells a patient, "Your life is threatened by a complication that has arisen during your pregnancy, and you may die, or there is a serious risk you will suffer substantial physical impairment unless an abortion is performed" and in the same breath states "but the law won't allow me to provide an abortion in these circumstances" is simply wrong in that legal assessment.

As a result, the Texas Supreme Court concluded that the plaintiffs had not shown that the Texas abortion law was unconstitutional.

The Texas abortion law continues to be challenged and subject to various court rulings. For example, on August 4, 2023, a Texas judge granted a temporary injunction clarifying what abortions due to medical emergencies are, including pregnancies that are unsafe for the mother, among other things. Existing laws prohibit all abortions after six weeks of pregnancy except for medical emergencies, and the passed heartbeat bill legislation prohibits providers from performing an abortion after a fetal heartbeat is detected.

The Texas Supreme Court has also ruled on specific cases, such as that of Kate Cox, who petitioned state courts to allow her to terminate her pregnancy due to a condition that gave her fetus very low chances for survival. The court recognized that only a doctor, not a judge or trial court, could decide whether a pregnant woman had a life-threatening physical condition that made an abortion necessary to save her life or protect her from "a serious risk of substantial impairment of a major bodily function."

The criminal prosecution of abortion in Texas

Laws and Penalties

The Texas abortion law imposes criminal penalties on individuals who perform or aid in abortions. Here are some of the key laws and their associated penalties:

• Texas Government Code Sec. 171.203, commonly known as the "heartbeat law,"" prohibits physicians from performing abortions after detecting a fetal heartbeat. It imposes a civil penalty of $10,000, but there is no criminal penalty.
• Health and Safety Code Section 171.018 penalizes doctors who perform an abortion without providing a sonogram, having the mother listen to the heartbeat, and offering certain explanations. This is classified as a misdemeanor punishable by a fine of up to $10,000.
• Section 171.065 of the Texas Health and Safety Code makes it a state jail felony for anyone to intentionally, knowingly, or recklessly cause a drug-induced abortion.
• Section 171.102 of the Texas Health and Safety Code classifies performing a partial-birth abortion as a state jail felony.
• Section 171.153 of the Texas Health and Safety Code considers performing a dismemberment abortion as a state jail felony.
• Texas abortion law makes it a second-degree felony to knowingly perform, induce, or attempt an abortion. If the unborn child dies due to the abortion, it becomes a first-degree felony punishable by five to 99 years in prison.

Exceptions and Defenses

While Texas abortion laws are strict, there are some exceptions and defenses in place:

• The law allows for abortions when a pregnant patient faces "a life-threatening physical condition aggravated by, caused by, or arising from a pregnancy."
• House Bill 3058 (HB 3058) provides an affirmative defense for doctors who perform abortions in cases of ectopic pregnancies or premature rupture of the amniotic membrane in a pre-viable embryo.
• Doctors can also legally perform abortions to save the life of the mother or prevent severe injury.

Enforcement and Prosecution

The Texas abortion law enables district attorneys to criminally prosecute individuals who perform or aid in abortions. However, the law does not allow for the prosecution of the pregnant patient who undergoes an abortion. Additionally, the government is prevented from enforcing or attempting to enforce the law, leaving enforcement primarily to district attorneys.

Public Opinion and Legal Challenges

The abortion laws in Texas have sparked heated debates and legal challenges. The Supreme Court's decision to overturn Roe v. Wade in 2022 allowed states to set their own abortion laws, and Texas has implemented restrictive abortion laws. Public opinion on these laws is divided, with some Texans supporting the laws as upholding the right to life, while others view them as infringing on reproductive rights. Legal challenges have been mounted, with abortion rights advocates arguing for clearer exceptions and protections for pregnant mothers facing medical emergencies. The Supreme Court's refusal to intervene in certain emergency abortion cases has added to the complexity and uncertainty surrounding abortion laws in Texas.

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