Texas has some of the most restrictive abortion laws in the U.S. Could they get stricter?

Lauren Miller and her husband were thrilled when they found out she was pregnant in July 2022.

She was having twins, but at her 12 week ultrasound Miller received heartbreaking news. One of the twins would not survive. Doctor after doctor told her the same thing, she said: Their son would die.

“It was just a matter of how soon, and every day that he continued to develop, he put his twin and myself at greater risk,” Miller, who is from Dallas, told reporters during a June 3 news conference.

She needed a single fetal abortion, but doctors were hesitant to even say the word “abortion,” Miller recalls. One specialist tore up his gloves in frustration, throwing them in the trash: “I can’t help you anymore,” he said. “You need to leave the state.”

That was Miller’s experience under Texas’ current abortion law that bars almost all abortions. Now, she fears what will happen to other pregnant patients in similar situations if the state’s abortion laws are restricted even further.

Texas has some of the strictest abortion laws in the country, but some advocates want the state to go further and “abolish abortion” by extending criminal penalties to abortion patients.

It’s a position that’s dividing Republicans and anti-abortion advocates and concerning Democrats, who have made abortion access a top issue for the November election.

The idea goes too far, some advocates say, as they push for other changes to state law, such as restricting access to abortion medications and bolstering resources for pregnancy centers.

Meanwhile, Democrats and advocates for abortion are looking to the federal government to step in and restore abortion access in Texas.

The debates are playing out against the backdrop of a post-Roe country, as patients seeking an abortion in states like Texas with virtual abortion bans struggle to access care, even in emergencies where their lives could be in jeopardy.

The state of Texas abortion access

When Roe v. Wade was overturned in 2022, Texas had a law ready to restrict abortion access.

The law, authored by state Rep. Giovanni Capriglione, a Southlake Republican, makes it a crime to perform or attempt an abortion. A person who performs, induces or attempts an abortion could face up to life in prison, if the abortion is successful. They could also be fined at least $100,000 for each violation.

A separate Texas law bans abortions once cardiac activity is detected in a fetus. It’s enforced through a civil mechanism that allows a person to sue someone who performs an abortion or aids in the performance of an abortion.

There are exceptions to the laws for medical emergencies, but doctors have expressed confusion over what necessitates an emergency. The Texas Medical Board clarified the law in June, but some say it still doesn’t provide enough guidance.

Since Roe was overturned, an average of five abortions per month are performed in Texas, according to The Texas Tribune. Before that, Texas used to see about 4,400 each month, The Texas Tribune reported.

More than 35,000 people traveled out of Texas for abortions in 2023, according to the Guttmacher Institute, a research group that works to advance sexual and reproductive health rights.

“I think if a woman comes in and is, at the moment, healthy with a pregnancy that is not determined to be viable, unfortunately our only thing that we can offer her are recommendations of where else to go besides Texas,” said Dr. Andrea Palmer, a Fort Worth OB-GYN.

An April poll found that 45% of Texans think the state’s abortion laws should be less strict, 23% think they should be kept as they are and 20% think they should be more strict, according to a poll from the Texas Politics Project at The University of Texas at Austin.

Protesters outside Planned Parenthood in Fort Worth in 2015 called for the defunding of the organization. Some anti-abortion advocates in Texas favor bringing criminal charges against abortion patients.
Protesters outside Planned Parenthood in Fort Worth in 2015 called for the defunding of the organization. Some anti-abortion advocates in Texas favor bringing criminal charges against abortion patients.

When separating those results by political party, 35% of Republicans said the laws should not be altered, 26% said they should be more strict, and 26% say they should be less strict. Among Democrats, 68% say state abortion laws should be loosened, while 15% want stricter laws and 11% want the laws left alone.

The push to “abolish abortion”

So far in Texas, the idea of extending criminal penalties to abortion patients hasn’t become mainstream among Texas Republicans. Bills have been filed in past legislative sessions, but have never had a committee hearing. The idea is also unpopular with voters: 66% somewhat or strongly disagree with it, including 55% of Republicans, according to the April poll.

Still, advocates have seen some success widening support for the idea.

The Texas GOP platform has previously called to “abolish abortion,” but has gone further in 2022 and 2024, supporting “equal protection of the laws to all preborn children from the moment of fertilization.” This year’s platform also states “abortion is not healthcare, it is homicide.”

While it doesn’t explicitly state it, some interpret the platform items as meaning abortion patients could be subject to criminal penalties, even the death penalty for murder.

The platform also states that, “criminal penalties be attached to any entity convicted of selling body parts of aborted children or, excluding the mother, of conducting an illegal abortion.”

The idea of criminal penalties for an abortion patient is embraced by Abolish Abortion Texas, which describes itself as “mobilizing Christians to advocate in the political halls of power for the end of elective abortion in Texas.”

“We believe that the same laws that protect you and me, born people, should also protect preborn people,” said Paul Brown, the group’s director of policy and operations. In other words, “we believe it should be illegal for everyone to murder anyone,” Brown said.

Asked if mothers who have abortions should face the death penalty, Brown said the group isn’t prescribing specific penalties. That should be left up to the courts, he said.

“We would not say that the death penalty is wrong or evil or something that we oppose, but we’re not asking for special provisions to ensure that the mother gets the death penalty under these laws,” Brown said.

Betsy Riot, center, takes part in the International Women’s Day Sit-In for Abortion Rights in the Texas State Capitol Rotunda in March 2023. Both abortion rights and anti-abortion protesters were present on the rotunda.
Betsy Riot, center, takes part in the International Women’s Day Sit-In for Abortion Rights in the Texas State Capitol Rotunda in March 2023. Both abortion rights and anti-abortion protesters were present on the rotunda.

Sixteen Republican Texas House candidates who are on the November ballot, including several who ousted incumbents in the primary, have signed a pledge from the group to “abolish abortion” in the state. Among them is David Lowe, who beat Rep. Stephanie Klick for a Fort Worth-area seat.

The Star-Telegram reached out to Lowe and 10 Republicans in the House and Senate for comment on what could be next for abortion laws in the state. All but two did not respond or were not available for an interview.

Other anti-abortion groups in Texas say enacting criminal penalties for abortion patients goes too far.

“Whenever I talk to committee chairs, whenever I talk to leading legislators who have passed pro-life legislation, this is not a priority,” said John Seago, president of Texas Right to Life, an anti-abortion group.

It’s also not a priority for Texas Right to Life. Bills the group will push for the legislative session next year will continue to preclude abortion patients from prosecution, he said.

Brandon Rottinghaus, a University of Houston political science professor, doesn’t see the issue gaining traction in the Texas Legislature. Instead, he expects policies related to abortion to focus on limiting out of state travel for abortions or clarifying exceptions to existing laws. He could also see the Legislature debating policies related to in vitro fertilization.

Ultimately, the direction of abortion policy in Texas will depend on how far Texas Republicans want to push these issues and who the leaders in the Legislature are, he said. The issue could also be eclipsed by other social issues.

“These issues ebb and flow,” Rottinghaus said. “The base cares about various types of social issues, more or less, depending on what else is on the agenda.”

Hundreds of abortion-rights advocates march toward the Tarrant County Courthouse at the end of a protest in downtown Fort Worth in June 2022. In a sea of hand-drawn signs, chanting people alternated between “My body, my choice” and “Reproductive rights are human rights.”
Hundreds of abortion-rights advocates march toward the Tarrant County Courthouse at the end of a protest in downtown Fort Worth in June 2022. In a sea of hand-drawn signs, chanting people alternated between “My body, my choice” and “Reproductive rights are human rights.”

Republican state Sen. Kelly Hancock of North Richland Hills said in a written statement that he’s focused on reforms to foster care and adoption laws.

“For too long the far left has made the untrue, straw man argument that pro-life Texans only care about the lives of the unborn, so I see right now as the perfect opportunity to prove them wrong,” he said. “I’m committed to working just as hard at supporting mothers and young families as we have worked to limit the horrors of abortion, and I believe we can do that effectively without having to grow government.”

Rep. Brian Harrison, a Midlothian Republican who served in the U.S. Department of Health and Human Services under President Donald Trump, said he looks forward to defending “Texas’ laws to protect the unborn,” criticizing the Biden administration’s “extreme abortion agenda.”

The Texas Right to Life’s biggest focus for lawmakers is curbing the use of websites to buy abortion medications. Access to the pills is already restricted in Texas.

This could be achieved by extending civil penalties to internet providers that don’t shut off access to the sites or by requiring credit card providers to block people with billing addresses in Texas from buying abortion medicine.

The group would also like to extend the mechanism in Texas’ so-called “heartbeat” law that allows virtually anyone to sue a person who performs or aids in accessing an abortion to other abortion laws.

Seago, in an interview before the Texas Medical Board offered some clarity on Texas’ abortion law, said the state’s definition of medical emergencies is clear. Doctors and hospital administrators need to be educated on what is and is not permitted, but the law itself doesn’t need to be changed, he said.

Texas Alliance for Life, another anti-abortion group, wants to bolster the state’s Healthy Texas Families Program to help connect women with an unplanned pregnancy with resources, said Jo Pojman, the group’s executive director.

He doesn’t expect major changes to Texas’ current laws restricting abortion access. As for extending criminal penalties to abortion patients: “We think that’s a terrible idea,” he said.

“Virtually the entire pro-life movement thinks that’s a very bad idea,” Pojman said.

The best hope for abortion access

Tightened abortion laws could have unintended consequences for access to women’s healthcare in general, said Palmer, the Fort Worth OB-GYN. The “best and brightest” used to consider Texas a place to get a wonderful education, but that’s no longer the case, she said.

“Outside the need of abortion care, I think we’re going to end up with fewer OB-GYNs in the state over time,” Palmer said.

Abortion-rights advocates line the steps of the Tarrant County Courthouse after a march downtown in June 2022. Hundreds gathered with a rallying cry of “My body, my choice” after Roe v. Wade was overturned the day before.
Abortion-rights advocates line the steps of the Tarrant County Courthouse after a march downtown in June 2022. Hundreds gathered with a rallying cry of “My body, my choice” after Roe v. Wade was overturned the day before.

As abortion advocates look to the Texas Legislature for signs of hope, Democrats in the legislature have been frustrated in their efforts to deliver. They say they’re simply outnumbered, and their Republican colleagues aren’t willing to bend on the topic.

“The reality is that the Republican Party, on the issue of abortion, has been so hijacked by the extremists in their party that they wouldn’t even accept an amendment to create an exception in cases of rape or incest,” said State Rep. Chris Turner, an Arlington Democrat.

State Sen. Nathan Johnson, a Dallas Democrat, introduced three bills in the last legislative session aimed at protecting abortion access. The proposals would have protected and assisted with travel for abortions and prohibited penalties for getting an abortion.

The bills didn’t gain traction in the Texas Legislature when lawmakers met in 2023. Lawmakers return to Austin on Jan. 14.

“We can’t outnumber people who will vote to take away abortion rights, and until we actually outnumber people who take away abortion rights, what am I doing?” Johnson said.

On the whole, Texas Democrats believe there are two paths forward for abortion access in the state: Either the federal government steps in, or Texas voters step up.

In the short term, action from the federal government is the only hope, Turner said.

“As long as Greg Abbott is governor and as long as Republicans are in the majority in the legislature, I don’t see [abortion laws] changing,” he said.

National and Texas Democrats are making abortion a top issue in the presidential race and down the ballot, including in the contest between U.S. Sen. Ted Cruz, a Republican, and U.S. Rep. Colin Allred, a Democrat hoping to unseat the longtime senator.

Miller, the Dallas woman who was unable to obtain an abortion in her home state, was speaking on a video news conference hosted by the Democratic National Committee when she shared her story in June. She, more than a dozen other Texas women and two doctors sued Texas over the law, arguing more defined exceptions are needed in medical emergencies. The state Supreme Court in late May upheld the law.

Miller raised concerns about the platform item and the prospect of Trump as president, whom she blames for “the devastating choices families like mine had to make” and the hurdles to access an abortion.

Miller said she was extremely sick throughout her pregnancy and ultimately made plans to get an abortion out of state.

“I was always going to lose one of my sons, and if the Texas Republicans get their way, I could be sentenced to death for trying to save my life and that of our viable twin,” Miller said.