Amanda Zurawski—one of 13 plaintiffs in a suit against the State of Texas—testifies during the April 26 Senate Judiciary Committee hearing titled “The Assault on Reproductive Rights in a Post-Dobbs America” about her experience of being denied an abortion for a pre-labor rupture, which resulted in her contracting life-threatening sepsis. Photo by Tom Williams / CQ-Roll Call, Inc. via Getty Images.

Women, physicians, and abortion providers in multiple states have filed lawsuits to modify state abortion laws that interfere with appropriate medical care for women with dangerous pregnancy complications, including fetal anomalies incompatible with life.

In Texas, the Center for Reproductive Rights filed suit last spring on behalf of 13 women and two obstetrician-gynecologists, claiming that the state's abortion law put women's health and lives at risk and threatened their reproductive futures. They also contend that the language about what constitutes a lifesaving abortion (which the law permits) is so murky that its effect is to sow confusion and fear among physicians, who face fines and jail terms of up to 99 years for violating the law.

The first round in the case, Zurawski v. State of Texas, went to the plaintiffs when the trial judge blocked all abortion restrictions that undermine physicians' “good faith judgment” in consultation with their patients about the need to terminate a pregnancy. But state officials immediately appealed the August 4 ruling, which had the effect of reinstating the original law's restrictions until the Texas Supreme Court decides the appeal.

Additional legal actions are pending on behalf of women in Idaho, Oklahoma, and Tennessee. As in Texas, the plaintiffs do not seek to overturn the abortion laws but rather to clarify the conditions under which women can legally receive abortions. With criminal penalties for noncompliance embedded in these laws, clinicians say they practice in fear of reprisal, including fines, loss of license, and imprisonment. Compounding these fears are additional laws, such as one in Texas, that puts bounties on the heads of abortion providers and gives ordinary citizens vigilante authority to report and sue them for “statutory damages in an amount of not less than $10,000 for each abortion that the defendant performed.”

The nonclinician plaintiffs in these cases tell harrowing stories. Jaci Statton, 26, a complainant in the Oklahoma case, went to the ED with severe pain and bleeding after being diagnosed with a partial molar pregnancy, in which there is no viable fetus but only tissue that can turn cancerous if left intact. She testified in a hearing that hospital medical staff told her she would die without an abortion, but under Oklahoma's abortion law, “we cannot touch you unless you are crashing in front of us or your blood pressure goes so high that you are fixing to have a heart attack.” Statton and her husband were advised to leave the ED and wait in their car for symptoms to become overtly life-threatening. As symptoms worsened, the couple decided instead to drive three hours to a neighboring state to get the care Statton needed.

Experiences like Statton's are what the lawsuits aim to prevent. In addition to clarifying the parameters of a life-threatening pregnancy and the authority of physicians to determine that, plaintiffs are also seeking amendments to allow termination of pregnancies when fatal fetal abnormalities are present.—Karen Roush, PhD, RN, FNP-BC, news director