A Texas judge grants a woman’s request for an abortion, in a rare case after a doe

A Texas judge on Thursday granted a request to allow abortion despite the state’s strict bans, ruling in the case of a pregnant woman whose fetus was diagnosed with a deadly disease.

The case is believed to be among the first attempts in the country to seek court-sanctioned abortion since the US Supreme Court overturned Roe v. Wade last year and allowed states to impose their own abortion restrictions.

The judge, Maya Guerra Gamble of Travis County District Court, sided with the woman, Kate Cox, who is 20 weeks pregnant, and issued a temporary restraining order to allow her doctor to perform the abortion without facing civil or criminal penalties.

The judge, a Democrat, agreed with Ms. Cox’s lawyers that the procedure was necessary to protect Ms. Cox from a potentially dangerous birth and to preserve her future fertility.

“The idea that Ms. Cox is desperate to be pregnant, and this law could actually cause her to lose that ability, is shocking and would represent a true miscarriage of justice,” the judge said at the end of the roughly 30-minute video hearing. “So I’ll sign the order and it will be processed and shipped today.”

The ruling affects only Ms. Cox, although it represents another front in the effort to force Texas, which bans most abortions from conception, to allow abortions under medical exceptions to its bans. A separate lawsuit filed by a group of Texas women who say they were denied abortions state law, requires the state to clarify the conditions under which medical exemptions would apply.

Since the Supreme Court struck down federal abortion rights in 2022, more than a dozen conservative states have enacted abortion bans or severely restricted the procedure. The bans generally allow for limited medical exceptions. In some of those states, women representing abortion rights groups sued to clarify when the procedure could be performed or to overturn the bans.

Those lawsuits were filed after women were denied abortions. In some cases, women have alleged that they suffered harm to their health or were forced to leave the country, at significant expense, disruption or risk, to seek abortion elsewhere.

What made Ms Cox’s case different was that she sought the court order while she was still pregnant.

Mrs Cox’s fetus was found to have trisomy 18, a genetic condition which in all but very rare cases leads to miscarriage or stillbirth, or the death of the baby in the first year. Her attorneys said she visited the emergency room four times because of pain and discharge — including once after the lawsuit was filed Tuesday — but that doctors told her she must continue the pregnancy under Texas law.

Mrs Cox, 31, could be seen wiping tears from her eyes as she watched the judge make his decision in a video taken with her husband Justin. She said in an interview Tuesday that she and her husband, who live in the Dallas area and have two young children, had hoped for a large family and had never planned an abortion.

The Texas attorney general’s office, which opposed the warrant on Thursday, may seek a higher court’s intervention.

After the verdict, Attorney General Ken Paxton sent a letter to top officials at the Houston hospital where Ms. Cox is receiving her doctorate, saying she and hospital staff could still face criminal and civil penalties, despite the judge’s order.

“The TRO will not insulate you, or anyone else,” Mr. Paxton wrote, adding that it would expire “well before the statute of limitations for violations of Texas’ abortion law expires.”

Mr. Paxton’s letter contradicted an order issued by a judge, which barred the state from enforcing its laws against Ms. Cox’s doctor, Damla Karsan, and anyone else involved in the case.

Marc Hearron of the Center for Reproductive Rights and one of Ms. Cox’s lawyers said that Mr. Paxton misrepresented the judge’s order. “He is trying to destroy the legal system to ensure that Kate and pregnant women like her continue to suffer,” he said in a statement.

Since the overturning of Roe v. Wade, the issue of abortion has become a national political commitment for Republicans. But Mr. Paxton was recently re-elected to a third term with the support of hard-right Republicans in Texas, where the Republican primary remains a critical contest for statewide office.

Texas is at the forefront of states restricting abortion and has three overlapping bans that prohibit abortion from the moment of conception and allow private citizens to sue others who help a woman have an abortion.

The laws provide for some limited exceptions to save the health and life of the pregnant woman. Abortion rights advocates argue that the provisions are vague and put women with pregnancy complications at risk.

The Texas Supreme Court, the state’s highest civil court, is currently considering a broader effort by doctors, women and abortion advocates to clarify the law’s medical exemptions in a separate case, Zurawski v. State of Texas, brought by the Center for Reproductive Rights.

One of the attorneys in the case, Molly Duane, is also representing Ms. Cox. At a court hearing Thursday, Ms. Duane argued that her client qualified for an abortion under medical exemptions barred by the state and asked the court to bar the state from enforcing injunctions against Dr. Karsana, so that the doctor could proceed with the abortion without fear of punishment.

A doctor convicted of performing an illegal abortion in Texas could face up to 99 years in prison and a fine of at least $100,000.

Johnathan Stone, a lawyer with the Texas attorney general’s office, argued that Ms. Cox’s pregnancy did not meet “the elements of the medical exception to Texas’ abortion laws,” citing a different doctor’s assessment of her condition.

Ms. Duane said the state’s argument underscored the confusion over what standard to use to evaluate a doctor’s decision that a patient meets the medical exception, which has led many doctors to avoid performing abortions altogether.

The problem, Ms. Duane said, is that while the law allows for narrow medical exceptions, “nobody knows what that means and the state won’t tell us.”

In her order, the judge found that Ms. Cox’s doctor “believes in good faith, in the exercise of her medical judgment,” that the abortion was medically recommended and that the medical exception “permits an abortion in Ms. Cox’s circumstances.”

The judge said her order would protect Ms. Cox’s doctor and other hospital workers involved in the abortion procedure, as well as Mr. Cox, who could otherwise face legal liability under the Texas bans.

Before passing judgment, anti-abortionists said they opposed efforts to interpret the law to allow an abortion in Ms. Cox’s case.

Amy O’Donnell, director of communications for the Texas Alliance for Life, said that while it is “heartbreaking to hear of any family facing a tragic diagnosis for their unborn child,” the group “does not support taking the life of an unborn child because of a life-limiting diagnosis or is fatal.”

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