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kate cox
After Texas Abortion Ruling, 'Make No Mistake—This Is the America the GOP Wants'
The case of a woman who had to flee Texas to get abortion care "has shown the world that abortion bans are dangerous for pregnant people," said one advocate.
Dec 12, 2023
The Texas Supreme Court's ruling late Monday, in which the all-Republican panel said Dallas resident Kate Cox could not obtain an abortion despite a lethal fetal diagnosis, did not stop the 31-year-old woman from getting care outside the state. But the ruling, said rights advocates on Tuesday, carries major implications for other Texans and people across the United States.
The state Supreme Court handed down a seven-page ruling saying that Travis County District Judge Maya Guerra Gamble was wrong to issue a temporary restraining order last week, which had barred the state from prosecuting Cox's physician for providing abortion care.
Cox learned earlier this month at about 20 weeks pregnant that her fetus had trisomy 18, a condition that results in miscarriage, stillbirth, or the death of a newborn in the days or weeks after birth.
Under Texas' near-total abortion ban, which ostensibly allows exceptions in cases in which an abortion is medically necessary to protect the pregnant person's life or to prevent unspecified "substantial impairment," Cox's physician said she would have to carry the pregnancy and have a Caesarean section, which could have resulted in uterine rupture and threatened her future fertility.
Republican Attorney General Ken Paxton appealed Gamble's ruling to the state Supreme Court, which said in its decision Monday: "A woman who meets the medical-necessity exception need not seek a court order to obtain an abortion. Under the law, it is a doctor who must decide that a woman is suffering from a life-threatening condition during a pregnancy, raising the necessity for an abortion to save her life or to prevent impairment of a major bodily function."
In other words, said Politico healthcare reporter Alice Miranda Ollstein, "the court views the lawsuit itself as evidence Cox does not qualify for relief from the state's ban."
The Republican justices, like the state abortion ban, did not provide guidance to help physicians determine situations in which they could provide abortion care without fearing prosecution and a potential life prison sentence.
Molly Duane, a senior staff attorney at the Center for Reproductive Rights (CRR) who has represented Cox in the case, said on Tuesday that Cox's ordeal offers the latest proof that so-called "exceptions" don't work, and it's dangerous to be pregnant in any state with an abortion ban."
"This ruling should enrage every Texan to their core. If Kate can't get an abortion in Texas, who can?" said Duane. "Doctors still don't know what the exception means, and the Texas Medical Board remains silent. If the highest court in Texas can't figure out what this law means, I'm not sure how a doctor could. Meanwhile, the lives of Texans hang in the balance.”
The court's ruling and its vague reasoning about co-called "exceptions" to abortion bans, said Mini Timmaraju, president and CEO of Reproductive Freedom for All, represents "the America the GOP wants."
For many Texans, said Nancy Northrup, president and CEO of CRR, a pregnancy complication like Cox's "could be a death sentence" under the state's laws.
"Kate's case has shown the world that abortion bans are dangerous for pregnant people," Northup said. "She desperately wanted to be able to get care where she lives and recover at home surrounded by family. While Kate had the ability to leave the state, most people do not."
Meanwhile, said author and advocate Jessica Valenti, Republicans are still pushing for a nationwide 15-week abortion ban. Susan B. Anthony Pro-Life America, a major group that supports forced pregnancy, has said it will not endorse a 2024 GOP candidate who doesn't back the proposal.
"What if there was no other state to go to? What if instead of being forced to travel to a neighboring state—an already-impossible hurdle for many Americans—Cox had to travel to a nearby country?" wrote Valenti on Monday. "That is not some hyperbolic hypothetical: It's exactly what life would look like under Republicans' 15-week national ban. And we can't let voters forget it."
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After Court Fight, Kate Cox Flees Texas for Abortion
"Her health is on the line. She's been in and out of the emergency room and she couldn't wait any longer," said Nancy Northup at the Center for Reproductive Rights.
Dec 11, 2023
After the Texas Supreme Court blocked a judge's order enabling Kate Cox to terminate a pregnancy due to the fetus having a fatal condition, the 31-year-old Dallas resident has fled the state for abortion care, her lawyers announced Monday.
"This past week of legal limbo has been hellish for Kate," said Nancy Northup, president and CEO at the Center for Reproductive Rights (CRR), which filed the case for Cox last week. "Her health is on the line. She's been in and out of the emergency room and she couldn't wait any longer. This is why judges and politicians should not be making healthcare decisions for pregnant people—they are not doctors."
"This is the result of the Supreme Court's reversal of Roe v. Wade: Women are forced to beg for urgent healthcare in court," Northup added. "Kate's case has shown the world that abortion bans are dangerous for pregnant people, and exceptions don't work. She desperately wanted to be able to get care where she lives and recover at home surrounded by family. While Kate had the ability to leave the state, most people do not, and a situation like this could be a death sentence."
CRR is not disclosing where Cox is going for care. The mother of two is about 20 weeks pregnant with a fetus that has trisomy 18, a chromosomal abnormality that could result in a miscarriage, stillbirth, or the death of her child in the hours or days after birth. Her doctors warned that continuing the pregnancy would threaten her future fertility.
The Texas Supreme Court's Friday decision blocking the judge's order was only temporary. The Monday announcement from CRR came as Cox was still awaiting a permanent decision, which could have been appealed to the U.S. Supreme Court.
Cox's case has garnered attention across Texas and the United States. Former Democratic Texas Sen. Wendy Davis took aim at the state's Republican attorney general, governor, and lieutenant governor, saying Monday that "my heart breaks for Kate Cox and her family as they endure the emotional and physical stress of this journey—one created by the cruel and inhumane policies of politicians like Ken Paxton, Greg Abbott, and Dan Patrick."
Along with thanking CRR for its "incredible work on the judicial front" fighting "for people like Kate Cox," Davis—who made national headlines a decade ago for her hourslong filibuster of anti-choice legislation—declared that "to turn things around, we must confront these injustices at both the ballot box and in the courtroom."
Congresswoman Katherine Clark (D-Mass.), the House minority whip, said on social media that "Kate Cox is bravely sharing her pain with the world while Republican extremist Ken Paxton threatens to throw her doctors in jail if they provide her abortion care. This is the GOP's post-Roe America. It's cruel. It's inhumane. And we have to stop them."
As the Houston Chroniclereported on Cox's decision to leave the state:
The development likely marks the end of the litigation, as the abortion in question is now a moot issue, said Joanna Grossman, a law professor at Southern Methodist University. Yet, the case could inspire other women with dangerous pregnancies to file similar suits, she said.
Cox is believed to be the first in the country to sue for permission to get an abortion since the fall of Roe v. Wade and Texas' implementation of a near-total abortion ban.
"It kind of gives a blueprint for other plaintiffs who are in similar situations," Grossman said. "I expect we'll see more of these cases, both in Texas and in other banned states.
The newspaper noted that "the Texas Supreme Court is still weighing a larger case brought by 22 women who, like Cox, faced dangerous pregnancy complications and were denied abortions because the emergency exception to the state's ban was so vague their doctors feared legal consequences."
Since the Supreme Court overturned Roe in Dobbs v. Jackson Women's Health Organization last year, over a dozen states have banned abortion with very limited exceptions—forcing nearly 1 in 5 patients to travel out of state to obtain abortion care in the first half of this year, according to research released Friday by the Guttmacher Institute.
"We knew that more people have been traveling across state lines for abortion since the end of Roe, but these findings are stunning nonetheless, and powerfully illustrate just how disruptive the overturning of Roe has been for tens of thousands of abortion patients," said institute data scientist and project lead Isaac Maddow-Zimet.
Kelly Baden, Guttmacher's vice president for public policy, stressed that "policies that protect and expand access, such as those that permit any qualified healthcare provider—not just physicians—to offer abortion care or shield laws that protect providers from criminal investigation from hostile states, have been critical in helping states meet patients' needs."
"We must also acknowledge the role that abortion funds and other support networks have played in helping people overcome the numerous financial and logistical barriers that traveling for abortion care entails," Baden added. "However, nothing can substitute for sound public policy that recognizes abortion as a critical, necessary component of basic healthcare that everyone deserves, regardless of where they live."
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Texas Supreme Court Blocks Ruling Allowing Woman to Get Abortion
"Courts are arguing with each other about whether a woman can have a medically necessary abortion," said one advocate. "This is not a hypothetical nightmare—it is a living one."
Dec 09, 2023
Reproductive justice groups on Friday night said the Texas Supreme Court and Republican Attorney General Ken Paxton were "directly endangering" a pregnant women who recently received news that her fetus has a life-threatening condition, after the high court halted a judge's order permitting the woman to obtain abortion care.
The state Supreme Court issued a stay temporarily blocking Travis County Judge Maya Guerra Gamble's Thursday ruling. Gamble had issued a temporary restraining order, allowing Dallas resident Kate Cox to obtain an abortion and protecting her physician, Dr. Damla Karsan, from civil or criminal liability under Texas' near-total ban on abortions.
Paxton quickly appealed Gamble's ruling, telling the court, "Nothing can restore the unborn child's life that will be lost as a result."
Molly Duane, senior staff attorney for the Center for Reproductive Rights (CRR), which is representing Cox, said Friday night that the group is holding out hope that "the [state Supreme Court] ultimately rejects the state's request and does so quickly."
"In this case we fear that justice delayed will be justice denied," said Duane. "We are talking about urgent medical care... This is why people should not need to beg for healthcare in a court of law."
Cox, who is about 20 weeks pregnant, discovered last week that her fetus has abnormalities including trisomy 18, a condition that would result in a miscarriage, stillbirth, or the death of her baby in the hours or days after birth.
Cox has sought emergency medical care several times since finding out the diagnosis, reporting symptoms such as cramping and fluid loss to emergency room doctors—but while Texas' abortion bans claim to allow exceptions in cases where a pregnant person's life or health are at risk, many health professionals are unwilling to risk potential life imprisonment by providing care.
Karsan has advised Cox that continuing the pregnancy could put her health and fertility at risk. Under Texas' abortion bans, Cox's only options are to have a Caesarean section after carrying the pregnancy to term—even as her health grows worse—or to have labor induced in the case of the fetal heartbeat stopping. Due to previous C-sections, doctors have told Cox that she could experience a uterine rupture if she is forced to give birth to the baby.
On PBS Newshour on Friday, Cox described how her baby "would need to be placed directly onto hospice" care if she is forced to go through childbirth.
Paxton and the state Supreme Court, which consists entirely of Republican judges, are "100% committed to torturing" Cox, said Slate journalist Mark Joseph Stern.
By challenging Gamble's ruling, CRR said in court filings that the state demonstrated "stunning... disregard for Ms. Cox's life, fertility, and the rule of law."
Before appealing Gamble's decision, Paxton wrote a letter to three hospitals where Karsan has admitting privileges, warning that if she provides abortion care to Cox there they could face civil or criminal penalties regardless of the lower court ruling. The attorney general said Gamble was "not medically qualified to make this determination."
The letter was the state's attempt to "intimidate [Karsan] to not act," Dr. Judy Levison, another obstetrician-gynecologist in Houston, toldThe New York Times.
"They named her and so, it's intimidating," Levison said.
On Thursday, Duane refused to comment in a news briefing about whether Cox and her doctors were planning to move forward with the abortion and when or where she might obtain care.
Cox is reportedly the first pregnant patient to request an emergency abortion from a court since the U.S. Supreme Court overturned Roe v. Wade last year.
On Friday, the day after Gamble ruled, a pregnant woman in Kentucky sued the state, saying its abortion ban violates residents' constitutional right to privacy and self-determination.
Mary Ziegler, a law professor at the University of California at Davis who specializes in abortion, told The Washington Post that Paxton likely "wants to stop Cox from being an example" for other pregnant people who need or want to terminate their pregnancies.
"Courts are arguing with each other about whether a woman can have a medically necessary abortion while she continues to remain pregnant with an unviable pregnancy," said activist Olivia Julianna. "This is not a hypothetical nightmare—it is a living one."
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