Texas Approves Abortion Only After Woman Sues to Prove Medical Emergency

Reproductive rights groups expressed relief Thursday that one woman in Texas was permitted to get abortion care after a Travis County judge granted a temporary restraining order to circumvent the state's pro-forced pregnancy laws, but said it was "unforgivable that she was forced to go to court" to request urgent medical care.

The Center for Reproductive Rights (CRR) filed a lawsuit against the state last week on behalf of Kate Cox, a Dallas resident, who had just learned at 20 weeks pregnant that her fetus had the fatal diagnosis of trisomy 18, as well as a spinal abnormality and other health issues.

Cox's case is the first in which a pregnant plaintiff has asked a court for an emergency abortion since Roe v. Wade was overturned in 2022.

In court this week, Cox's lawyer, CRR senior staff attorney Molly Duane, told Judge Maya Guerra Gamble that Cox had had to go to the emergency room with cramping and fluid loss in the two days since she filed the lawsuit.

Since learning of the fetal diagnosis last week, Cox has sought emergency medical care four times due to her symptoms but doctors have been unable to provide her with legal abortion care due to the ban that took effect two months after the U.S. Supreme Court overturned Roe v. Wade in 2022.

Before Thursday, Cox's only options under Texas law were to have a Caesarean section after carrying the pregnancy to term—even as her health grew worse—or to have labor induced in the case of the fetal heartbeat stopping.

"Due to Kate's medical history," said CRR, "her OB-GYNs warned her that continuing to carry the pregnancy could jeopardize her health and future fertility."

Advocates including Duane and author Jessica Valenti expressed outrage at the arguments presented by the state—which, noted Slate journalist Mark Joseph Stern, "will likely appeal to try to block Cox's abortion."

Jonathan Stone, the lawyer representing Texas, told Gamble that "the only party that's going to suffer an immediate and irreparable harm in this case if the court enters a TRO [temporary restraining order] is the state," because the government would not be able to make its case in a regular hearing.

"The abortion once performed is permanent and cannot be undone," Stone said. "The plaintiffs are going to obtain permanent relief in this case through this TRO application without any evidence being considered by this court and in full-blown evidentiary hearing."

The state also claimed that Cox was not at a particular risk for life-threatening complications, despite her doctors' advice.

"These arguments are frankly stunning," said Duane. "The state goes as far to characterize her claims as 'a frivolous assertion of harm.'"

Cox's lawyers added that "the harm to Ms. Cox's life, health, and fertility are very much also permanent and cannot be undone."

Cox "should never have had to fight in court for her life, her health, and her future," said U.S. Rep. Katherine Clark (D-Mass.). "This is the result of the GOP war on reproductive freedom. And it must be stopped."

Texas Attorney General Ken Paxton said after Gamble's ruling was announced that while the TRO "purports" to allow an abortion to proceed, it "will not insulate hospitals, doctors, or anyone else from civil and criminal liability for violating Texas' abortion laws."

"Most women are not able to do what Kate has done—many Texans have been forced to continue pregnancies that put their lives at risk," said Duane. "That is happening every day across Texas. As long as abortion is banned, pregnant people will suffer."