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Rolling Stone

Supreme Court Lets Texas Ban Emergency Room Abortions

Nikki McCann Ramirez
3 min read
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The Supreme Court will allow Texas to continue enforcing its ban on abortions — including emergency abortions in hospitals.

On Monday, the nation’s highest court declined an appeal from the Biden administration, keeping in place a lower court order that says hospitals cannot be compelled to provide care that would violate Texas’ strict ban on abortions. Biden’s Department of Health and Human Services previously issued guidance alerting hospitals that they were required to “provide stabilizing medical treatment to your pregnant patients,” including abortion care, “regardless of the restrictions in the state.”

The policy is based on the enforcement of the Emergency Medical Treatment and Active Labor Act (EMTALA), a 1986 law requiring hospital emergency departments to treat individuals who seek care regardless of ability to pay, citizenship, or demographics.

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In the aftermath of Dobbs v. Jackson, the 2022 Supreme Court ruling that overturned the right to abortion established by Roe v. Wade, Texas implemented one of the strictest bans on pregnancy terminations in the country. Abortion is illegal in the state in virtually all cases. In order to obtain one, a patient must have a life-threatening condition and be at risk of death or “substantial impairment of a major bodily function.” Texas’ statutes, however, do not define the threshold to meet those requirements — but they do threaten criminal penalties against physicians found to violate them, leaving doctors struggling to balance care for their patients with the risk of criminal liability.

In 2022, Texas sued the Biden administration in a challenge to their invocation of EMTALA guidelines. Earlier this year, the Fifth Circuit Court of Appeals sided with the state, and the administration appealed the ruling to the Supreme Court. Monday’s rejection will allow the state to continue denying life-saving care to pregnant patients, a practice that has skyrocketed maternal and infant mortality rates in the state.

According to a September analysis by the Gender Equity Policy Institute, between 2019 and 2022 — the years before and after passage of the 2021 Texas Heartbeat Act — maternal mortality rose by 56 percent. A separate analysis by JAMA Pediatrics published in June found a 12.9 percent increase in infant deaths between 2021 and 2022.

“Congenital anomalies, which are the leading cause of infant death, also increased in Texas but not the rest of the U.S.,” researchers wrote. “The results suggest that restrictive abortion policies may have important unintended consequences in terms of trauma to families and medical cost as a result of increases in infant mortality.”

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With their lives increasingly at risk, women in Texas are fighting back. In 2023,  Amanda Zurawski sued the state after being denied emergency care when she went into premature labor. Her daughter, Willow, was not expected to survive birth, but because her heart was still beating, Zurawski was denied an abortion. Three days after receiving the heartbreaking diagnosis, Zurawski was septic and near death before doctors finally terminated her pregnancy. She would go on to speak about her experience at the Democratic National Convention this summer.

“I was lucky. I lived,” Zurawski said. “Today because of Donald Trump, more than one in three women of reproductive age in America lives under an abortion ban. A second Trump term would rip away even more of our rights.”

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